Title XVII, Economic Security and Public Welfare

levy or execution. (1) Payments of public assistance grants for eligible individuals shall be made at the time and in the manner prescribed by regulation to: (a) The needy aged or needy blind or needy permanently and totally disabled person or recipient; or (b) The parent or rela…

(1) The secretary or his authorized representative may initiate any action under the laws of this state against a parent or other person legally liable for support who has failed to provide support for the person to whom an obligation of support is owed and who is receiving publi…

(1) The Office of Administrative Hearings within the Department of Law shall appoint one (1) or more impartial hearing officers to hear and decide upon appealed decisions. (2) Any applicant or recipient who is dissatisfied with the decision or delay in action on his or her applic…

Administrative regulations. (1) If a custodial parent of a dependent child is disqualified from receiving cash assistance benefits pursuant to KRS 205.193 or 205.200, the dependent child's eligibility and any other adult family member's eligibility for cash assistance benefits sh…

Any individual claiming public assistance in any proceeding before the appeal board or a court may be represented by counsel; but no counsel shall either charge or receive for such service more than an amount established by the secretary by administrative regulation.

All money appropriated by this state, all money received from the United States or any agency thereof, and all money received from any other source for the public assistance functions administered by the cabinet are hereby appropriated and shall be available to the secretary for …

Money payments made by the Cabinet for Health and Family Services to the needy aged, needy blind, and the needy permanently and totally disabled shall be: (1) Mandatory state supplementation of the supplemental security income program as established by federal law and regulations…

The amounts recovered for any reason from a recipient or the estate of a recipient of public assistance shall be deposited to a special account in the revolving, trust and agency fund account of the cabinet. This fund shall be administered and disbursed in the same manner and und…

In addition to any other liability imposed by law, the stepparent of any child who is an applicant or recipient of public assistance shall be legally chargeable with the support of such child in the same manner as a biological parent.

Allocation of funds -- Payments. (1) There is established within the Cabinet for Health and Family Services an Energy Cost Assistance Program for making money payments to or on behalf of citizens of the Commonwealth for the purpose of purchasing or supplementing the cost of energ…

As used in KRS 205.460: (1) "Chore services" means the performance of heavy housecleaning, minor household repairs, yard tasks, and other activities needed to assist in the maintenance of a functionally impaired elderly person in his own home. (2) "Core services" means those serv…

(1) The cabinet shall fund, directly or through a contracting entity or entities, in each district, a program of essential services which shall have as its primary purpose the prevention of unnecessary institutionalization of functionally impaired elderly persons. The cabinet may…

individuals with an intellectual disability or other developmental disability. (1) As used in this section, "aging caregiver" means an individual age sixty (60) or older who provides care for an individual with an intellectual disability or other developmental disability. (2) If …

As used in this chapter as it pertains to medical assistance unless the context clearly requires a different meaning: (1) "Behavioral health professional" means a person authorized to provide mental health or substance use disorder services under the laws of the Commonwealth; (2)…

(1) Beginning January 1, 2027, the cabinet shall, in accordance with 42 U.S.C. sec. 1396a(e)(14)(L), conduct Medicaid eligibility redeterminations once every six (6) months for individuals who are: (a) Described in 42 U.S.C. sec. 1396a(e)(14)(L)(i)(I) and (II); and (b) Not exempt…

Notwithstanding 42 C.F.R. sec. 431.17(c), all records required to be retained by 42 C.F.R. sec. 431.17(b) shall be retained by the Department for Medicaid Services for a period of not less than seven (7) years following the beneficiary's most recent disenrollment from the Medicai…

parties for services rendered. (1) KRS 205.510 to 205.630 shall be known as the "Medical Assistance Act." (2) The General Assembly of the Commonwealth of Kentucky recognizes and declares that it is an essential function, duty, and responsibility of the state government to provide…

organizations to comply with specified sections of KRS Chapter 304. (Effective until January 1, 2027) (1) With respect to the administration and provision of Medicaid benefits pursuant to this chapter, the Department for Medicaid Services, any managed care organization contracted…

Requirements and procedures for compliance. (1) As used in this section: (a) "CMS" means the federal Centers for Medicare and Medicaid Services; (b) "Department" means the Department for Medicaid Services; (c) "KCHIP state plan" means the federally approved, legally binding contr…

request for state plan amendment -- Cabinet to provide updates upon request. (1) Concurrent with submitting an application for a waiver, waiver amendment, waiver renewal, or a request for a state plan amendment to any federal agency that approves waivers, waiver amendments, waive…

In the event that the cabinet seeks and receives approval of a Medicaid Section 1115 waiver under 42 U.S.C. sec. 1315 for the purpose of providing Medicaid coverage to prisoners thirty (30) days prior to their release, the cabinet shall prioritize provision of such coverage.

organization -- Continuation of services for eligible children -- Billing -- Gaps in service and lack of access. (1) As used in this section, "IMPACT Plus" program means the program of community-based behavioral health services provided to an eligible IMPACT Plus recipient throug…

(1) The Department for Medicaid Services shall submit a waiver or waiver amendment for approval to the Centers for Medicare and Medicaid Services in order to establish the Hospital-to-Home Transition Program to provide coverage for services provided by an approved Medicaid waiver…

illness. (1) The Department for Medicaid Services or a managed care organization contracted to provide services pursuant to this chapter shall provide a program for synchronization of medications when it is agreed among the member, a provider, and a pharmacist that synchronizatio…

All administrative hearings conducted under KRS 205.510 to 205.645 shall be conducted in accordance with KRS Chapter 13B.

by managed care organizations -- Credentialing alliance -- Procedures -- Enrollment of and contracts with providers -- Failure to agree on terms and conditions -- Application date -- Credentialing verification by university hospitals -- Electronic verification of licensure inform…

Extension and procurement requirements -- Sunset. (1) Notwithstanding any provision of law to the contrary, the Department for Medicaid Services shall: (a) Extend all contracts with Medicaid managed care organizations in effect on April 14, 2026, through December 31, 2028; and (b…

(1) A managed care organization shall maintain an interactive website, operated by the managed care organization, that allows providers to file grievances, appeals, and supporting documentation electronically in an encrypted format that complies with federal law and that allows a…

person meeting -- Reprocessing claims -- Internal appeals -- Provider audits -- Timely decisions on authorization and preauthorization requests -- Monthly and annual reports -- Penalties -- Administrative regulations. (1) A Medicaid managed care organization with whom the departm…

organization. The department shall not automatically assign a Medicaid enrollee to a managed care organization.

Legislative findings -- Medicaid dental director -- Procurement -- Administrative regulations -- Dental Services Advisory Panel -- Annual report. (1) The General Assembly finds and declares that: (a) Effective management of Medicaid-covered dental services is essential for the ov…

concurrently enrolled in multiple states -- Procedures -- Notice -- Penalties. For the purpose of identifying and, when appropriate, disenrolling individuals from the Kentucky Medicaid program who are concurrently enrolled, or suspected of being concurrently enrolled, in one (1) …

Required terms and provisions -- Prohibited actions -- Requirements -- Disenrollment of beneficiary with unknown address -- Penalties. Any contract entered into, renewed, or extended on or after April 14, 2026, by the cabinet, or any subdivision thereof, and any managed care orga…

(1) (a) There is hereby established in the State Treasury a restricted fund to be known as the Medicaid managed care organization compliance fund. (b) The fund shall consist of all penalties or fines imposed by the cabinet on a managed care organization for violations of KRS 205.…

of prescription drug for alcohol or opioid use disorder. (Effective until January 1, 2028) (1) A Medicaid managed care organization shall have a utilization review plan, as defined in KRS 304.17A-600, that meets the requirements established in 42 C.F.R. pts. 431, 438, and 456. If…

health and substance use disorder services -- Annual report. The Department for Medicaid Services shall monitor utilization rates and expenditures for all Medicaid-covered behavioral health and substance use disorder services and shall submit an annual report to the Legislative R…

(1) The provision of nonemergency medical transportation services to eligible Medicaid enrolled beneficiaries in the Commonwealth shall comply with 42 U.S.C. sec. 1396a(a)(87), 42 C.F.R. sec. 431.53, 42 C.F.R. sec. 440.170, any other relevant federal law or regulation, and this s…

treatment of gender dysphoria or gender reassignment surgery. Notwithstanding any provision of law to the contrary and unless required under federal law, the Department for Medicaid Services and any managed care organization with whom the department contracts for the delivery of …

prohibited. Notwithstanding any provision of law to the contrary, the Kentucky Medicaid program, including the Department for Medicaid Services and any managed care organization with which the department contracts for the delivery of Medicaid services, shall not provide coverage …

Notwithstanding any provision of law to the contrary, the Kentucky Medicaid program, including the Department for Medicaid Services and any managed care organization with which the department contracts for the delivery of Medicaid services, shall not provide coverage for individu…

(Effective January 1, 2027) The commissioner of the Department for Medicaid Services shall: (1) (a) Submit a written report not later than September 30 of each year to the Legislative Research Commission for referral to the Interim Joint Committees on Banking and Insurance and He…

Assessments and reevaluations -- Eligibility -- Report of possible violations -- Quarterly report. (1) As used in this section: (a) "Department": 1. Means the Department for Medicaid Services; and 2. Includes any other agency of state government or nongovernmental entity contract…

(1) (a) The cabinet shall, no later than January 1, 2027, for applicable individuals as defined in 42 U.S.C. sec. 1396a(xx)(9), condition eligibility for enrollment or continued enrollment in the Medicaid program on demonstrated community engagement as defined in and required und…

option to develop basic health program under federal law or make changes related to eligibility, coverage, or benefits -- Fiscal impact assessment required -- Construction. (1) Notwithstanding any provision of law to the contrary, including but not limited to KRS 205.460 and 205.…

state medical assistance program. (1) When the Department for Medicaid Services receives federal funding for the state's medical assistance program which is contingent on temporary maintenance of effort restrictions, such as those restrictions imposed under Pub. L. No. 116-127 se…

Services as qualified health entity. Unless expressly required under federal law, neither the cabinet nor the Department for Medicaid Services shall be designated as a qualified health entity for the purpose of making presumptive eligibility determinations for the state's medical…