Title XVII, Economic Security and Public Welfare
31 chapters · 957 sections in this title.
KRS § 205.2005 Opt-out of 21 U.S.C. sec. 862a(a)
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Pursuant to 21 U.S.C. sec. 862a(d)(1), all individuals residing in Kentucky shall be exempt from the application of 21 U.S.C. sec. 862a(a).
KRS § 205.201 Duties of cabinet as to the aging and the minority elderly
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The duties of the Cabinet for Health and Family Services shall be to: (1) Promote and aid in the establishment of local programs and services for the aging; (2) Conduct programs to educate the public as to problems of the aging; (3) Review existing state programs and services for…
KRS § 205.202 Acceptance and disposition of gifts and grants
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The secretary of the Cabinet for Health and Family Services shall be empowered to accept and expend gifts and grants from any source. Such moneys shall go into a trust and agency fund to be administered by the cabinet in furtherance of the purposes of the provisions of KRS 205.20…
KRS § 205.203 Authorization to provide in-home services to the aging -- Collection of fees
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(1) The secretary of the Cabinet for Health and Family Services may provide, within budgetary limitations, for in-home services to the aging to include, but not necessarily limited to: homemaker services; home-help therapy services; day-care services; home-delivered meal services…
KRS § 205.204 Cabinet to administer Older Americans Act -- Regulatory authority
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(1) The Cabinet for Health and Family Services, unless otherwise directed by an executive order of the Governor, is designated the agency of this state for the purpose of administering the Older Americans Act of 1965, Pub. L. 89-73, including all amendments thereto. In administer…
KRS § 205.210 Amount of assistance -- Proration in case of deficiency -- Resources defined
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defined. (1) The amount of public assistance to be granted shall be determined with due regard to the needs and resources of the individual and family as prescribed by regulation, provided, that if available funds during a budgetary period are insufficient to meet the full needs …
KRS § 205.211 Secretary to correct any underpayment or overpayment of public assistance benefits
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assistance benefits. (1) Except as otherwise provided by law, the secretary may, in accordance with the regulations he may prescribe and to the extent permitted by federal law, take all necessary steps to correct any underpayment or overpayment of public assistance benefits under…
KRS § 205.213 Technical amendment to material that has been incorporated by reference in administrative regulation governing Supplemental Nutrition Assistance Program
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in administrative regulation governing Supplemental Nutrition Assistance Program. Notwithstanding the provisions of KRS Chapter 13A, the Cabinet for Health and Family Services may amend material that had been previously incorporated by reference in an administrative regulation go…
KRS § 205.220 Payments, to whom made -- Accounting -- Exemption from assignment, levy or execution
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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…
KRS § 205.227 Action by secretary against persons legally liable for support
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(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…
KRS § 205.231 Appeals -- Hearing officers -- Appeal board -- Procedure
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(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…
KRS § 205.232 Cash assistance benefits disqualification -- Protective payee -- Administrative regulations
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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…
KRS § 205.237 Public assistance claimant may have counsel -- Fees
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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.
KRS § 205.240 Public assistance funds -- Availability to secretary
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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 …
KRS § 205.245 Supplementary payments
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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…
KRS § 205.290 Revolving fund -- Disbursement -- Balance not to lapse
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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…
KRS § 205.310 Liability of stepparent for support furnished child
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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.
KRS § 205.400 Energy Cost Assistance Program established -- Eligibility requirements -- Allocation of funds -- Payments
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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…
KRS § 205.455 Definitions for KRS 205.460
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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…
KRS § 205.460 Essential services -- Funding -- Collection of fees and contributions
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(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…
KRS § 205.470 Centralized resource and referral center for aging caregivers of individuals with an intellectual disability or other developmental disability
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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 …
KRS § 205.510 Definitions for medical assistance law
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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)…
KRS § 205.513 Eligibility determinations and redeterminations
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(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…
KRS § 205.517 Records retention
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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…
KRS § 205.520 Title and purpose of KRS 205.510 to 205.630 -- Recovery from third parties for services rendered
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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…
KRS § 205.522 Duty of Department for Medicaid Services and Medicaid managed care organizations to comply with specified sections of KRS Chapter 304. (Effective until January 1, 2027)
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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…
KRS § 205.524 Annual legislative review of Medicaid state plan and KCHIP state plan -- Requirements and procedures for compliance
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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…
KRS § 205.525 Application by cabinet for waiver, waiver amendment, waiver renewal, or request for state plan amendment -- Cabinet to provide updates upon request
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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…
KRS § 205.526 Application for waiver to provide coverage to prerelease prisoners
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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.
KRS § 205.527 Managing of IMPACT Plus program by Medicaid managed care organization -- Continuation of services for eligible children -- Billing -- Gaps in service and lack of access
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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…
KRS § 205.528 Hospital-to-Home Transition Program
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(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…
KRS § 205.529 Synchronization of multiple prescriptions for treatment of a chronic illness
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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…
KRS § 205.531 Administrative hearings
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All administrative hearings conducted under KRS 205.510 to 205.645 shall be conducted in accordance with KRS Chapter 13B.
KRS § 205.532 Definitions for KRS 205.532 to 205.536 -- Contracts for Medicaid services 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 information
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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…
KRS § 205.5321 Contracts for Medicaid services by managed care organizations -- Extension and procurement requirements -- Sunset
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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…
KRS § 205.533 Website of managed care organization -- Requirements
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(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…
KRS § 205.534 Toll-free telephone line -- Duties relating to adverse determinations -- In-person meeting -- Reprocessing claims -- Internal appeals -- Provider audits -- Timely decisions on authorization and preauthorization requests -- Monthly and annual reports -- Penalties -- Administrative regulations
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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…
KRS § 205.535 Medicaid enrollee not automatically assigned to managed care organization
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organization. The department shall not automatically assign a Medicaid enrollee to a managed care organization.
KRS § 205.5353 Dental services -- Administrative service organization delivery model -- Legislative findings -- Medicaid dental director -- Procurement -- Administrative regulations -- Dental Services Advisory Panel -- Annual report
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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…
KRS § 205.5355 Identification and disenrollment of nonresidents and individuals concurrently enrolled in multiple states -- Procedures -- Notice -- Penalties
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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) …
KRS § 205.5356 Contracts for Medicaid services by managed care organizations -- Required terms and provisions -- Prohibited actions -- Requirements -- Disenrollment of beneficiary with unknown address -- Penalties
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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…
KRS § 205.5357 Medicaid managed care organization compliance fund
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(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.…
KRS § 205.536 Utilization review -- Prohibition against prospective or concurrent review of prescription drug for alcohol or opioid use disorder. (Effective until January 1, 2028)
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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…
KRS § 205.5361 Utilization rates and expenditures for all Medicaid-covered behavioral health and substance use disorder services -- Annual report
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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…
KRS § 205.5363 Nonemergency medical transportation services -- Annual report
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(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…
KRS § 205.5365 Prohibition on expenditure of Medicaid funds for cross-sex hormones for treatment of gender dysphoria or gender reassignment surgery
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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 …
KRS § 205.5366 Coverage for prescription drugs prescribed primarily for weight loss prohibited
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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 …
KRS § 205.5367 Prohibition of coverage for psychoeducational services
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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…
KRS § 205.5369 Report to the Legislative Research Commission on prior authorization. (Effective January 1, 2027)
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(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…
KRS § 205.5370 Waiver programs -- Definitions for section -- Application -- Waitlists -- Assessments and reevaluations -- Eligibility -- Report of possible violations -- Quarterly report
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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…