Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
205.520,
214.540,
214.542,
214.543,
304.17A-257,
42
U.S.C. 9902(2)
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050(1) requires the
secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to operate the programs and fulfill the
responsibilities vested in the cabinet.
KRS
214.542(6) requires the
Department for Public Health to promulgate administrative regulations to
implement the Kentucky Colon Cancer Screening Program. This administrative
regulation establishes the eligibility criteria, services, and requirements for
participation in the colon cancer screening program.
Section 1. Definitions.
(1) "Applicant" means an individual desiring
services paid in part by the screening program.
(2) "Contractor" means a person or facility
that agrees to the terms of participation of the screening program in contract
and ensures services are delivered pursuant to the screening program
terms.
(3) "Department" is defined
by
KRS
214.540(1)(a).
(4) "Program" is defined by
KRS
214.540(1)(b).
Section 2. Eligibility Criteria.
(1) In order to receive a service established
in Section 3 of this administrative regulation, an applicant shall:
(a) Meet the eligibility for screening
pursuant to American Cancer Society Colorectal Cancer Screening
Guidelines;
(b) Be a legal resident
of Kentucky;
(c) Have an individual
income at or below 300 percent of the federal poverty level, established
annually by the United States Department of Health and Human Services pursuant
to 42 U.S.C.
9902(2); and
(d) If covered by health insurance, have an
out-of-pocket maximum that is five (5) percent or more of the individual's
annual income.
(2) A
service received without prior authorization from the screening program shall
be covered.
Section 3.
Services. If funding is available, the services to be paid in part by the
program shall include colon cancer screening tests and may include:
(1) Referral, examination, and rescreening
for individuals for whom further examination or treatment is indicated by the
colon cancer screening;
(2)
Surveillance; and
(3)
Treatment.
Section 4.
Contractor Responsibility. A contractor shall:
(1) Complete a KCCSP 101, Kentucky Colon
Cancer Screening Program Eligibility and Enrollment, with the
applicant;
(2) Review the completed
KCCSP 102, Kentucky Colon Cancer Screening Program Affidavit;
(3) Determine applicant eligibility pursuant
to Section 2 of this administrative regulation;
(4) If the applicant is eligible, provide
service or referral for service; and
(5) Report program data into the data
collection system pursuant to Section 5 of this administrative
regulation.
Section 5.
Fees.
(1) A nominal fee up to five (5) dollars
may be charged for colon cancer screening services as specified by the
Department for Public Health.
(2) A
contractor shall have approval of the department before charging an applicant
fee.
Section 6. Data
Collection System. The contractor shall submit to the department:
(1) The total number of colon cancer
screening services specified in Section 3 conducted; and
(2) The applicant demographic information as
documented on the KCCSP 101 form.
Section 7. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) Form KCCSP 101, "Kentucky Colon
Cancer Screening Program Eligibility and Enrollment", 11/2018; and
(b) Form KCCSP 102, "Kentucky Colon Cancer
Screening Program Affidavit", 11/2018.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Department for Public
Health, First Floor, Health Services Building, 275 East Main Street, Frankfort,
Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.
STATUTORY AUTHORITY:
KRS
194A.050(1),
214.542(6)
