902 KAR 30:200 - Coverage and payment for services
RELATES TO: KRS 200.654, 200.672, 34 C.F.R. 303.520, 303.521, 20 U.S.C. 1438, 1440
NECESSITY, FUNCTION, AND CONFORMITY: KRS 200.660 requires the Cabinet for Health and Family Services to administer funds appropriated to implement the provisions of KRS 200.650 to 200.676, to enter into contracts with service providers, and to promulgate administrative regulations necessary to implement KRS 200.650 to 200.676. This administrative regulation establishes the provisions relating to early intervention services for which payment shall be made on behalf of eligible recipients.
Section 1. Participation
Requirements. An early intervention provider that requests to participate as an
approved First Steps provider shall comply with the following:
(1) Submit to an ongoing review by the
Department for Public Health, or its agent, for compliance with 902 KAR Chapter
30;
(2)
(a) Meet the qualifications for a
professional or paraprofessional established in
902 KAR
30:150; or
(b) Employ or contract with a professional or
paraprofessional who meets the qualifications established in
902 KAR
30:150;
(3) Ensure that a professional or
paraprofessional employed by the provider who provides a service in the First
Steps Program shall complete training on First Steps' philosophy, practices,
and procedures provided by First Steps representatives prior to providing First
Steps services;
(4) Agree to
provide First Steps services as authorized by an individualized family service
plan as required by
902
KAR 30:130;
(5) Agree to maintain and to submit as
requested by the Department for Public Health required information, records,
and reports to ensure compliance with 902 KAR Chapter 30;
(6) Establish a contractual arrangement with
the Cabinet for Health and Family Services for the provision of First Steps
services; and
(7) Agree to provide
upon request information necessary for reimbursement for services by the
Cabinet for Health and Family Services in accordance with this administrative
regulation, which shall include the tax identification number and usual and
customary charges.
Section
2. Reimbursement. The Department for Public Health shall reimburse
a participating First Steps provider the lower of the actual billed charge for
the service or the fixed upper limit established in this section for the
service being provided.
(1) A charge
submitted to the Department for Public Health shall be the provider's usual and
customary charge for the same service.
(2) The fixed upper limit for services shall
be as established in this subsection.
(a)
Initial evaluation. The developmental component of the initial evaluation for a
child without an established risk condition shall be provided by face-to-face
contact with the child and parent.
1. In the
office or center-based site, the fee shall be $270 per service event.
2. In the home or community site, the fee
shall be $270 per service event.
(b) Five (5) Area Assessment. The
developmental component of the initial evaluation for the child with an
established risk condition shall be provided by face-to-face contact with the
child and parent.
1. In the office or
center-based site, the fee shall be $175 per service event.
2. In the home or community-based site, the
fee shall be $175 per service event.
(c) Annual or exit assessment. The annual or
exit assessment shall be provided by face-toface contact with the child and
parent.
1. In the office or center-based site,
the fee shall be $175 per service event.
2. In the home or community-based site, the
fee shall be $175 per service event.
(d) Discipline specific assessment. The
discipline specific assessment conducted by a direct service provider shall be
provided by face-to-face contact with the child and parent.
1. In the office or center-based site, the
fee shall be $175 per service event.
2. In the home or community-based site, the
fee shall be $175 per service event.
(e) Record review. A record review shall be
provided by a Department for Public Health approved team and paid at the
contracted amount.
(f) Intensive
clinic evaluation. The intensive level evaluation shall be provided by a
Department for Public Health approved team and shall include face-to-face
contact with the child and parent.
1. In the
office or center-based site, which involves a board certified physician, the
fee shall be $1,100 per service event.
2. In the community site, which involves a
board certified physician, the fee shall be $1,100 per service event.
(g) Early intervention or
collateral services in accordance with Section 3(1), (2), (4) and (5) of this
administrative regulation shall have the fixed upper limits established in this
paragraph.
1. For an audiologist:
a. In the office or center based site, the
fee for a collateral service or an early intervention service including
cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
2. For a marriage and family
therapist:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be sixty-three (63) per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) per hour of service.
3. For a licensed psychologist, a licensed
psychological practitioner, a licensed professional clinical counselor, or
certified psychologist with autonomous functioning:
a. In the office or center based site, the
fee for a collateral service or an early intervention service including
cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
4. For a licensed psychological
associate or a certified psychologist:
a. In
the office or center-based site, the fee for a collateral service or an early
intervention service including cotreatment shall be sixty-one (61) dollars per
hour of service; or
b. In the home
or community site, the fee for a collateral service or an early intervention
service including cotreatment shall be eighty-one (81) dollars per hour of
service.
5. For a
developmental interventionist:
a. In the
office or center based site, the fee for a collateral service or an early
intervention service including cotreatment shall be sixty-three (63) dollars
per hour of service; or
b. In the
home or community site, the fee for a collateral service or an early
intervention service including cotreatment shall be eighty-nine (89) dollars
per hour of service.
6.
For a registered nurse:
a. In the office or
center based site, the fee for a collateral service or an early intervention
service including cotreatment shall be sixty-three (63) dollars per hour of
service; or
b. In the home or
community site, the fee for a collateral service or an early intervention
service including cotreatment shall be eighty-nine (89) dollars per hour of
service.
7. For a
dietitian:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
8. For an occupational therapist:
a. In the office or center based site, the
fee for a collateral service or an early intervention service including
cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
9. For an occupational therapy
assistant:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be forty-six (46) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be seventy (70) dollars per hour of service.
10. For an orientation and
mobility specialist:
a. In the office or
center-based site, the fee for a collateral service or an early intervention
service including cotreatment shall be sixty-three (63) dollars per hour of
service; or
b. In the home or
community site, the fee for a collateral service or an early intervention
service including cotreatment shall be eighty-nine (89) dollars per hour of
service.
11. For a
physical therapist:
a. In the office or center
based site, the fee for a collateral service or an early intervention service
including cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
12. For a physical therapist
assistant:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be forty-six (46) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be seventy (70) dollars per hour of service.
13. For a speech therapist:
a. In the office or center based site, the
fee for a collateral service or an early intervention service including
cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
14. For a social worker:
a. In the office or center based site, the
fee for a collateral service or an early intervention service including
cotreatment shall be sixty-one (61) dollars per hour of service; or
b. In the home or community site, the fee for
a collateral service or an early intervention service including cotreatment
shall be eighty-one (81) dollars per hour of service.
15. For a teacher of the deaf and hard of
hearing:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
16. For a teacher of the visually
impaired:
a. In the office or center based
site, the fee for a collateral service or an early intervention service
including cotreatment shall be sixty-three (63) dollars per hour of service; or
b. In the home or community site,
the fee for a collateral service or an early intervention service including
cotreatment shall be eighty-nine (89) dollars per hour of service.
17. For a physician or a nurse
practitioner providing a collateral service in the office or center based site,
the fee shall be seventy-six (76) dollars per hour of service. A physician or a
nurse practitioner shall not receive reimbursement for early
intervention.
18. For an assistive
technology specialist:
a. In the office or
center based site, the fee for a collateral service or an early intervention
service including cotreatment shall be sixty-one (61) dollars per hour of
service; or
b. In the home or
community site, the fee for a collateral service or an early intervention
service including cotreatment shall be eighty-one (81) dollars per hour of
service.
19. For a sign
language and cued language specialist:
a. In
the office or center based site, the fee for a collateral service or an early
intervention service including cotreatment shall be sixty-three (63) dollars
per hour of service; or
b. In the
home or community site, the fee for a collateral service or an early
intervention service including cotreatment shall be eighty-nine (89) dollars
per hour of service.
20.
For an optometrist or ophthalmologist providing collateral service in an office
or center based site, the fee shall be sixty-three (63) dollars per hour of
service. An optometrist or ophthalmologist shall not receive reimbursement for
early intervention.
(h)
Respite shall be seven (7) dollars and sixty (60) cents per hour.
(3)
(a) For early intervention or collateral
services, hours shall be determined using the beginning and ending time for a
service.
1. The hours shall be computed as
follows:
a. Fifteen (15) to twenty-nine (29)
minutes shall equal 0.25 hours;
b.
Thirty (30) to forty-four (44) minutes shall equal 0.50 hours;
c. Forty-five (45) to fifty-nine (59) minutes
shall equal 0.75 hours; and
d. Sixty
(60) to seventy-four (74) minutes shall equal one (1) hour.
2. Services shall be documented in
the First Steps data management system and shall include:
a. A service note describing the intervention
provided during the session;
b. A
list of participants present during the early intervention session;
c. The caregiver's report of the child's
progress since the last session, including any modifications to the suggested
intervention or barriers to implementing the intervention;
d. The child's response to intervention that
describes the skill level of the child and if the skill has increased,
decreased, or stayed the same and the method used to measure progress;
and
e. The plan for the next visit,
based on the child's response to intervention and the IFSP outcome.
(b) Service
documentation shall be entered within ten (10) calendar days of the service
delivery date. Documentation entered after ten (10) days from the date of
service shall be immediately disapproved for payment.
(c) Once the provider has entered a corrected
service log, a payment adjustment shall be made. Payment shall be prorated on
the following scale:
1. Correction entered
within one (1) to five (5) days, claim paid at a three (3) dollar
reduction;
2. Correction entered
within six (6) to ten (10) days, claim paid at an eight (8) dollar
reduction;
3. Correction entered
within eleven (11) to fifteen (15) days, claim paid at a twenty-five (25)
dollar reduction;
4. Correction
entered within sixteen (16) to thirty (30) days, claim paid at one half the
maximum KEIS payment; and
5.
Correction entered after thirty (30) days or beyond shall be disapproved and
not adjusted for payment.
(d) For service coordination services, hours
shall be determined using the beginning and ending time for a service
documented in staff notes in accordance with
902 KAR
30:110, Section 2(10).
1. The hours shall be computed as follows:
a. One (1) to twenty-two (22) minutes shall
equal 0.25 hours;
b. Twenty-three
(23) to thirty-seven (37) minutes shall equal 0.50 hours;
c. Thirty-eight (38) to fifty-two (52)
minutes shall equal 0.75 hours; and
d. Fifty-three (53) to sixty-seven (67)
minutes shall equal one (1) hour.
2. Service coordination minutes spent over
the course of a day on a child or family shall be accumulated at the end of the
day in order to determine the total number of hours spent.
(4) A payment for a discipline
specific assessment, five (5) area assessment, annual or exit assessment,
initial or intensive evaluation listed in subsection (2) of this section shall
be based on a complete evaluation as a single unit of service. An individual
provider shall not be reimbursed for participation on the intensive evaluation
team.
(5) Payment for assistive
technology devices shall be made in accordance with
902
KAR 30:130, Section 3.
(a) The total rental cost of an assistive
technology device shall not exceed the purchase price of that device. The
length of rental shall be based on the purchase price of the device and shall
not exceed ten (10) months in length.
(b) The total purchase cost of an assistive
technology device shall include the actual cost of the item being purchased,
all related shipping charges, and an administrative fee not to exceed ten (10)
percent.
(6) Payment for
transportation shall be the lesser of the billed charge or:
(a) For a commercial transportation carrier,
an amount derived by multiplying one (1) dollar by the actual number of loaded
miles using the most direct route;
(b) For a private automobile carrier, an
amount equal to twenty-five (25) cents per loaded mile transported;
or
(c) For a noncommercial group
carrier, an amount equal to fifty (50) cents per eligible child per mile
transported.
(7) A
payment for a group intervention service shall be thirty-two (32) dollars per
child per hour of direct contact service for each child in the group with a
limit of three (3) eligible children per professional or paraprofessional who
can practice without direct supervision.
Section 3. Limitations.
(1) Service Assessments.
(a) Payment for a discipline specific
assessment shall be limited to three (3) assessments per discipline per child,
unless additional hours are necessary based on the reasons listed in paragraph
(b) and documented in accordance with
902
KAR 30:130, Section 1(7) from birth to the age of
three (3) unless preauthorized by the Department for Public Health in
accordance with Section 4 of this administrative regulation.
(b)
1. A
service assessment payment shall not be made for the provision of routine early
intervention services by a discipline in the general practice of that
discipline.
2. Payment for a
service assessment shall be restricted to the need for additional testing due
to new concerns or significant change in the child's status that impacts the
early intervention services authorized on the IFSP.
3. Routine activity of assessing progress and
outcomes shall be billed as early intervention.
(2) For early intervention, unless prior
authorized by the Department for Public Health in accordance with Section 4 of
this administrative regulation, limitations for payment of services shall be as
established in this subsection.
(a) For
office, center, or home and community sites:
1. Payment shall be limited to no more than
one (1) hour per day per child per discipline by a:
a. Professional meeting the qualifications
established in
902 KAR
30:150; or
b. Paraprofessional meeting the
qualifications established in
902 KAR
30:150.
2. Payment shall be limited to no more than
twenty-four (24) hours for a single discipline and thirty-six (36) hours for
more than one (1) discipline during a six (6) month period and for group shall
be limited to an additional forty-eight (48) hours during a six (6) month
period.
(b) For group:
1. Children shall not be eligible for both
group and individual early intervention services by the same discipline
concurrently on the Individualized Family Services Plan.
2. Group service shall be provided by
enrolled First Steps providers in accordance with
902 KAR
30:150, Section 1(11). The ratio of staff to children
in group early intervention shall be limited to a maximum of three (3) children
per professional and paraprofessional per group.
(c) Payment for siblings seen at the same
time shall be calculated by dividing the total time spent by the number of
siblings to get the amount of time to bill per child.
(d) Payment for a service shall be limited to
a service that is authorized by the IFSP team in accordance with
902
KAR 30:130, Section 3(3).
(e)
1.
Except as provided in subparagraph 2. of this paragraph, payment shall be
limited to a service provided as a face-to-face contact with the child and
either the child's parent or care-giver.
2. Early intervention family services
authorized by
KRS
200.654(7) may be provided
without the child present if the reason the child's presence is clinically
contraindicated is documented in the session
note.
(3) For
respite, payment shall:
(a) Be limited to no
more than eight (8) hours of respite per month, per eligible child;
(b) Not be allowed to accumulate beyond each
month; and
(c) Be limited to
families in crisis, or strong potential for crisis without the provision of
respite.
(4) For
collateral services, payment for collateral services shall be a billable
service for First Steps providers, who are providing early intervention
services for the eligible child through an IFSP and paid by the First Steps
system.
(a) The length of an IFSP meeting
shall be limited to no more than one (1) hour.
(b) Payment for attendance at one (1)
Admissions and Release Committee (ARC) meeting held prior to a child's third
birthday shall be limited to the service coordinator and primary service
provider selected by the IFSP team.
(c) Participation at an initial IFSP meeting
by an initial evaluator shall be limited to an evalu-ator who conducted the
initial evaluation in accordance with
902 KAR
30:120, Section 2(5)(a). Payment shall be at the
collateral services rate for the discipline that the evaluator
represents.
(5) For
cotreatment, payment shall be limited to three (3) disciplines providing
services concurrently.
(6) Unless
prior authorized by the Department for Public Health due to a shortage of
direct service providers, an initial evaluator shall not be eligible to provide
early intervention to a child whom the evaluator evaluated and which resulted
in the child becoming eligible.
Section 4. Prior Authorization Process.
(1) Authorization for payment for early
intervention services beyond the limits established in Section 3 of this
administrative regulation shall be submitted to the cabinet or its designee, as
determined by the Department for Public Health, and approved prior to the
service being delivered and shall include the following:
(a) A service exception request completed in
the First Steps data management system; and
(b) The Record Review Supporting
Documentation.
(2) The
record review team shall issue a written recommendation for the IFSP team to
consider within ten (10) calendar days of receipt of the request.
(3) If the IFSP team is not in agreement with
the recommendation of the record review team:
(a) A request for further review shall be
submitted to the Department for Public Health; and
(b) A three (3) person team from the
Department for Public Health, Division of Maternal and Child Health, including
the division director, shall render a recommendation.
(4) If the IFSP team is not in agreement with
the three (3) person team recommendation established in subsection (3)(b) of
this section:
(a) The child's IFSP team shall
be asked to reconvene for an IFSP meeting with a representative from the record
review team and a representative from the three (3) member team; and
(b) If the IFSP team concludes at that IFSP
meeting that the services are still needed, payment for the service shall be
authorized for the duration of the current IFSP.
Section 5. System of Payment and Fees.
(1) All families enrolling in the First Steps
system shall be assessed for the family's ability to pay a participation fee
for early intervention services in accordance with
KRS
200.654(7)(f) to (m).
Families with private or public insurance shall not be charged
disproportionately more than families without insurance.
(2) A charge to the family shall not be made
for the following functions:
(a) Child find
activities;
(b) Evaluation and
assessment of the child and family;
(c) Service coordination;
(d) Administrative and coordinative
activities including development, review, and evaluation of individualized
family service plans; and
(e) The
implementation of procedural safeguards.
(3) Families shall receive a copy of the
First Steps System of Payment notice during the intake meeting, at the initial
IFSP meeting and each subsequent IFSP meeting.
(4) Payment of fees shall be for the purpose
of:
(a) Maximizing available sources of
funding for early intervention services; and
(b) Giving families an opportunity to assist
with the cost of services if there is a means to do so, in a family share
approach.
(5) The family
share payment shall:
(a) Be based on a sliding
fee scale;
(b) Be explained to the
family by the POE staff; and
(c)
Begin with the provision of an early intervention service, and continue for the
duration of participation in early intervention services.
(6) The ability to pay shall:
(a) Be based on the level of the family gross
income identified on the last Federal Internal Revenue Service statement or
check stubs from the four (4) most recent consecutive pay periods, as reported
by the family; and
(b) The level of
income matched with the level of poverty, utilizing the federal poverty
guidelines as published annually by the Federal Department of Health and Human
Services, based on the following scale:
1.
Below 249 percent of poverty, there shall be no payment;
2. From 250 percent of poverty to 299
percent, the payment shall be five (5) dollars per month of
participation;
3. From 300 percent
of poverty to 349 percent, the payment shall be ten (10) dollars per month of
participation;
4. From 350 percent
of poverty to 399 percent, the payment shall be twenty-five (25) dollars per
month of participation;
5. From 400
percent of poverty to 449 percent, the payment shall be seventy-five (75)
dollars per month of participation;
6. From 450 percent of poverty to 499
percent, the payment shall be $150 per month of participation;
7. From 500 percent of poverty to 549
percent, the payment shall be $200 per month of participation;
8. From 550 percent of poverty to 599
percent, the payment shall be $300 per month of participation; and
9. From 600 percent of poverty and above, the
payment shall be $400 per month of participation.
(7) The family share participation
fee shall not:
(a) Exceed the cost of the
actual monthly Part C service;
(b)
Apply to a family whose child is covered by public insurance benefits
(Medicaid); or
(c) Prevent or delay
a child from receiving services.
(8) The family may request a reduction or
waiver of the family share fee if the family shows to the satisfaction of the
Department for Public Health an inability to pay, in accordance with the
following:
(a) The service coordinator shall
submit to the Department for Public Health First Steps Family Share
Administrator, on behalf of the family, a Family Share Extraordinary Expenses
Worksheet (FS-24) to have the amount of the family share payment reduced or
eliminated for a period not to exceed three (3) calendar months. A request
shall not be submitted for a retroactive period unless extenuating
circumstances, such as an unexpected hospitalization, occurs; and
(b) The family shall undergo a financial
review by the Department for Public Health that may:
1. Adjust the gross household income by
subtracting extraordinary expenses; and
2.
a. Result
in a calculation of a new family share payment amount based on the family's
adjusted income compared to the percentage of the poverty level established in
subsection (6)(b) of this section. If a recalculation is completed, the
Department for Public Health shall conduct a review at least quarterly;
or
b. Suspend or reduce the family
share payment, based on a verified financial crisis that would be exacerbated
by their obligated family share payment. The Department for Public Health shall
conduct a review at least quarterly.
(9) In accordance with
902 KAR
30:180, the family may contest the imposition of a fee
or the determination of their ability to pay by filing:
(a) A request for mediation;
(b) A request for a due process
hearing;
(c) An administrative
complaint; or
(d) An appeal to the
Part C Coordinator for final resolution.
(10) Income shall be verified during the
intake process and at six (6) month intervals, and more often if changes in
household income will result in a change in the amount of the obligated family
share payment.
(11) A family that
refuses to have its income verified shall be assessed a family share payment of
$400 per month of participation.
(12) If multiple children in a family receive
early intervention services, the family share payment shall be the same as if
there were one (1) child receiving services.
(13)
(a) If
a family has the ability to pay the family share but refuses to do so for three
(3) consecutive months, the family shall receive service coordination, IFSP
development, procedural safeguards, and assessment services only until
discharged from the program or the family share balance is paid in full,
whichever occurs first.
(b) The
service coordinator shall provide the family a financial notice of action at
thirty (30) calendar days prior to the suspension of ongoing IFSP
services.
Section
6. Use of Insurance.
(1) Public
Insurance.
(a) The state lead agency shall be
the enrolled Medicaid provider for early intervention services. A contracted
provider or agency shall not bill Medicaid directly for early intervention
services provided in accordance with the IFSP.
(b) Written notification in accordance with
34
C.F.R. 303.520(3)(i)-(iv)
shall be provided to the child's parent or guardian before the use of public
benefits or insurance to pay for early intervention services.
(c) A parent or guardian shall not be
required to sign up for or enroll in public benefits or insurance programs as a
condition of receiving early intervention services.
(2) Private Insurance.
(a) Parent or guardian consent shall be
obtained:
1. For the use of private insurance
to pay for the initial provision of an early intervention service on the IFSP;
and
2. Each time consent for
services is required due to an increase in the frequency, length, duration, or
intensity in the provision of service in the child's IFSP.
(b) A family who chooses to use private
insurance for payment of a First Steps service shall not be responsible for
payment of insurance deductibles or copayments related to this
service.
(c) The fee paid to the
early intervention provider by KEIS shall be the full reimbursement from KEIS
and the provider shall not charge the family any co-pay or deductible
associated with the services.
(d)
Families shall be responsible for payment of their insurance
premiums.
(e) Federal Part C funds
may be used to pay the cost of insurance premiums when obtaining insurance for
the child is the most cost effective method for KEIS to pay for early
intervention services;
(f) A family
who has the ability to pay and gives consent for the use of private insurance
may waive the family share fee. If the consent to bill private insurance is
revoked by the family, the family shall be assessed the corresponding family
share fee;
(g) A family who has the
ability to pay and does not give consent for the use of private insurance shall
be assessed a family share fee as described in Section 5(6)(b) of this
administrative regulation.
(h) If a
family is assessed as having an inability to pay and does not give consent for
the use of private insurance, this lack of consent shall not prevent or delay a
child from receiving services.
(i)
If a family receives payment from insurance, these funds shall be surrendered
to the early intervention provider for services rendered. Failure to surrender
the payment shall result in the amount of the insurance payment being added to
the Family Share balance due.
(j) A
provider shall bill a third-party insurance for an early intervention service
prior to billing First Steps. Documentation regarding the billing, the
third-party insurance representative's re-sponse, and payment, if any, shall be
maintained in the child's record and submitted through the First Steps data
management system.
Section
7. Use of funds. Consistent with
34
C.F.R. 303.120 through
303.122
and
303.220
through
303.226, the state
lead agency may use the federal Part C funds for activities or expenses that
are reasonable and necessary for implementing the Kentucky Early Intervention
System program for infants and toddlers with disabilities including:
(1) For direct early intervention services
for infants and toddlers with disabilities and their families that are not
otherwise funded through other public or private sources;
(2) To expand and improve services for
infants and toddlers with disabilities and their families; and
(3) To strengthen the statewide system by
initiating, expanding, or improving collaborative efforts related to at-risk
infants and toddlers, including establishing linkages with appropriate public
and private community-based organizations, service, and personnel for the
purposes of:
(a) Identifying and evaluating
at-risk infants and toddlers;
(b)
Making referrals for the infants and toddlers identified and evaluated under
paragraph (a) of this subsection; and
(c) Conducting periodic follow-up on each
referral, to determine if the status of the infant or toddler involved has
changed with respect to eligibility of the infant or toddler for
services.
Section
8. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) "Record Review Supporting
Documentation", July 2012;
(b)
"System of Payment Notice", April 2014; and
(c) "Family Share Extraordinary Expenses
Worksheet", December 2013.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Department for Public
Health, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday,
8 a.m. to 4:30 p.m.
Notes
STATUTORY AUTHORITY: KRS 194A.050, 200.654, 200.660(3), (7), (8)
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.