2015 Kentucky Revised Statutes CHAPTER 205 - PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE 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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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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As used in this section, "IMPACT Plus" program means the program of
community-based behavioral health services provided to an eligible IMPACT Plus
recipient through an agreement between the Department for Medicaid Services and
the Department for Public Health as the state agency for the federal Title V
Maternal and Child Health Block Grant, 42 U.S.C. secs. 701 to 710 or as authorized
under subsection (3) of this section.
Any Medicaid managed care organization that contracts with the Department for
Medicaid Services shall, to the extent possible under the Title V agreement, manage
aspects of the IMPACT Plus program for its members, including but not limited to
the determination of a child's eligibility for IMPACT Plus services, processing and
direct payment of claims, and audits. No state agency shall duplicate any function
performed by the Medicaid managed care organizations for the IMPACT Plus
program. Appeals of payments shall be submitted for review to the Department for
Behavioral Health, Developmental and Intellectual Disabilities.
Children eligible for the IMPACT Plus program may continue to receive services, if
the family and provider agree, from:
(a) An individual IMPACT Plus therapist if the child is relocated outside of the
provider's service area; and
(b) The same provider if a child is eligible for those services, but no longer
eligible for IMPACT Plus services, and the provider meets the participation
standards to provide services under the acquired brain injury, the Michelle P.
waiver, the supports for community living, or the home and community based
waiver programs.
IMPACT Plus providers shall bill for all IMPACT Plus services, including case
management, under their IMPACT Plus provider identification. IMPACT Plus
providers shall not be required to obtain a Medical Assistance Identification
Number (MAID). Nothing in this section shall preclude an IMPACT Plus provider
from applying for a MAID number, providing they meet all necessary criteria.
Medicaid managed care organizations may report documented gaps in IMPACT
Plus services or lack of access to IMPACT Plus services to the Department for
Behavioral Health, Developmental and Intellectual Disabilities. The Department for
Behavioral Health, Developmental and Intellectual Disabilities shall verify or not
verify the reported gaps.
If the Department for Behavioral Health, Developmental and Intellectual
Disabilities verifies gaps in IMPACT Plus services or lack of access to IMPACT
Plus services, IMPACT Plus providers may be utilized for additional IMPACT Plus
services and additional IMPACT Plus providers may be utilized.
Effective: June 25, 2013
History: Created 2013 Ky. Acts ch. 118, sec. 9, effective June 25, 2013.
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