Kentucky Administrative Regulations
Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES
Chapter 13 - Private Duty Nursing
Section 907 KAR 13:015 - Private duty nursing service or supply reimbursement provisions and requirements
Current through Register Vol. 50, No. 6, December 1, 2023
RELATES TO: KRS 205.520
NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Health and Family Services, Department for Medicaid Services, has a responsibility to administer the Medicaid Program. KRS 205.520(3) authorizes the cabinet, by administrative regulation, to comply with any requirement that may be imposed or opportunity presented by federal law to qualify for federal Medicaid funds. This administrative regulation establishes the Department for Medicaid Services' reimbursement provisions and requirements regarding private duty nursing services and supplies.
Section 1. General Requirements. For the department to reimburse for a private duty nursing service or supply under this administrative regulation, the:
Section 2. Reimbursement. The department shall:
Section 3. Not Applicable to Managed Care Organizations. A managed care organization shall not be required to reimburse the same amount as established in this administrative regulation for a service or supply covered pursuant to 907 KAR 13:010 and this administrative regulation.
Section 4. Federal Approval and Federal Financial Participation. The department's reimbursement for services or supplies pursuant to this administrative regulation shall be contingent upon:
Section 5. Appeal Rights. A provider may appeal an action by the department as established in 907 KAR 1:671.
Section 6. Incorporation by Reference.
40 Ky.R. 2062; 2777; eff. 7-7-2014; Crt eff. 12-6-2019.
STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 205.520(3)