Kentucky Administrative Regulations
Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES
Chapter 15 - Behavioral Health
Section 907 KAR 15:055 - Reimbursement provisions and requirements regarding targeted case management for individuals with a mental health or substance use disorder and chronic or complex physical health issues
Current through Register Vol. 50, No. 6, December 1, 2023
RELATES TO: KRS 205.520, 42 U.S.C. 1396a(a)(10)(B), 42 U.S.C. 1396a(a)(23)
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 reimbursement provisions and requirements regarding Medicaid Program targeted case management services for individuals with a mental health or substance use disorder and chronic or complex physical health issues who are not enrolled with a managed care organization.
Section 1. General Requirements. For the department to reimburse for a service covered under this administrative regulation, the service shall be:
Section 2. Reimbursement.
Section 3. No Duplication of Service.
Section 4. Not Applicable to Managed Care Organizations. A managed care organization shall not be required to reimburse in accordance with this administrative regulation for a service covered pursuant to:
Section 5. Federal Approval and Federal Financial Participation. The department's reimbursement for services pursuant to this administrative regulation shall be contingent upon:
41 Ky.R. 1276; Am. 1827; 1989; eff. 4-3-2015.
STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 205.520(3)