2014 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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