Kentucky Administrative Regulations
Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES
Chapter 1 - Medicaid Services
Section 907 KAR 1:084 - Payment for medical assistance services furnished out of state
Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO: KRS 205.520
NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726, effective July 9, 2004, reorganized the Cabinet for Health Services and placed the Department for Medicaid Services and the Medicaid Program under the Cabinet for Health and Family Services. The Cabinet for Health and Family Services has responsibility to administer the program of Medical Assistance. KRS 205.520(3) empowers the cabinet, by administrative regulation, to comply with any requirement that may be imposed, or opportunity presented, by federal law for the provision of medical assistance to Kentucky's indigent citizenry. This administrative regulation sets forth the conditions under which the Medicaid Program shall pay for covered medical services furnished eligible recipients who are out of state.
Section 1. General. Medicaid services provided to an eligible Medicaid recipient who is a resident of Kentucky while that resident is in another state shall be reimbursed in accordance with Section 2 of this administrative regulation.
Section 2. Criteria for Coverage while Out of State.
Section 3. Exception. For individuals in long-term care out of state prior to the effective date of this administrative regulation, and for whom the cabinet is at that time paying for the cost of care, the cabinet may continue to pay for the cost of care if the cabinet deems the payments to be appropriate. Children in subsidized adoption or foster care status shall be exempt from the restrictions shown in this administrative regulation.
Section 4. Cooperation with other States. The cabinet shall facilitate the furnishing of medical services to individuals who are present in Kentucky and are eligible for Medicaid under another state's Medicaid plan.
STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 42 C.F.R. 447 Subpart B, 42 U.S.C. 1396a, b, d, EO 2004-726