RELATES TO:
KRS
200.654,
200.656,
200.664,
200.668,
200.676,
205.520,
42
C.F.R. 431.615,
42 U.S.C.
1471-1485
NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726, effective
July 9, 2004, reorganized the Cabinet for Health Services and placed the
Department for Medicaid Services and the Medicaid Program under the Cabinet for
Health and Family Services. The Cabinet for Health and Family Services,
Department for Medicaid Services, has 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 for the provision of
medical assistance to Kentucky's indigent citizenry.
KRS
200.660(7) requires the
cabinet to promulgate administrative regulations to implement the Kentucky
Early Intervention Program. This administrative regulation establishes
requirements for coverage and payment for early intervention services provided
through an agreement with the state Title V agency, the Commission for Children
with Special Health Care Needs.
Section
1. Definitions.
(1) "Department"
means the Department for Medicaid Services or its designee.
(2) "Early intervention services" is defined
in
KRS
200.654(7).
(3) "Title V agency" means the Commission for
Children with Special Health Care Needs.
Section 2. Covered Services.
(1) Services shall be provided for a Medicaid
eligible child under the age of three (3) who meets eligibility requirements
for early intervention as established in
902 KAR
30:120, Section 2.
(2) The service to be provided shall be a
service described in
902 KAR 30:160
except for the following services which shall not be covered:
(a) Respite care;
(b) Transportation;
(c) Teacher of the deaf and hard of hearing;
and
(d) Teacher of the visually
impaired.
(3) Services
shall be coordinated and information exchanged with the child's assigned
primary care provider in the:
(a) Health Care
Partnership in accordance with
907
KAR
1:705; or
(b) KenPAC Program in accordance with
907 KAR
1:320.
(4) Services shall be provided pursuant to an
interagency agreement between the department and the Title V
agency.
Section 3.
Provider Qualifications and Conditions for Participation. The following
provider qualifications and conditions for participation shall be applicable
for services provided pursuant to this administrative regulation.
(1) Services shall be provided by the Title V
agency or through a subcontractor of the Title V agency.
(2) If the Title V agency seeks to
subcontract for the provision of services, the Title V agency shall subcontract
for the provision of services in accordance with the provisions of the
interagen-cy agreement between the Title V agency and the department.
(3) A service which is provided by the Title
V agency or its subcontractors shall meet the appropriate requirements for the
service, as established in
902 KAR
30:160.
Section 4. Reimbursement.
(1) Reimbursement for services provided on
and after October 22, 2001 shall be based on cost associated with providing the
service that includes the:
(a) Direct
cost;
(b) Overhead cost;
and
(c) Administrative cost
associated with providing the service.
(2) Payments shall be made on an interim
basis in accordance with the fee schedule established in
902 KAR
30:200 with a settlement to cost at the end of the
fiscal year.
(3) An annual cost
report shall be submitted to the department within 180 days after the close of
the state fiscal year.
(4) Interim
payments shall be adjusted to actual cost based upon review and acceptance of
the cost report by the department.
(5) The Title V agency may submit for
consideration an amended cost report for a state fiscal year up to twenty-four
(24) months after the close of that state fiscal year.
