Updated Program Information

Kentucky HEALTH 1115 Medicaid Waiver Update

The Cabinet for Health and Family Services (CHFS) released the following statement on Kentucky HEALTH:
We had hoped for a quick federal re-approval that would allow the transformative Kentucky HEALTH program to start August 1, avoiding delayed access to services for beneficiaries and costly system changes. We have been working with CMS on the details of the re-approval process, including the status of dental and vision benefits, and have now received updated guidance that CMS will hold a 30-day federal comment and evaluation period, making it clear that the program will not begin as soon as we hoped.


Under Kentucky HEALTH, some beneficiaries would have been able to use their My Rewards Accounts to pay for routine vision and dental services. Due to the delay in implementation of the My Rewards program, there was no legal authority to pay for these services out of the My Rewards account. In order to mitigate the consequences of the judge’s ruling, and avoid a prolonged coverage gap prior to the re-approval of Kentucky HEALTH, we have begun the process to reinstate vision and dental coverage, as well as non-emergency transportation services, for those whose benefits were affected by the June 29 court action.


Unfortunately, changing benefits and coverage is not as easy as flipping a single switch. As Cabinet officials testified, system changes are risky and cannot be made overnight. The Cabinet has spent the last few weeks working on a temporary solution for restored benefits to be implemented by August 1. In addition, while dental, vision, and non-emergency medical transportation eligibility for those in the Alternative Benefit Plan will not show in the system until August 1, the Cabinet is close to completing a manual system work-around that will allow payment of claims incurred by any eligible Medicaid beneficiary for dental, vision, and nonemergency transportation services incurred during the month of July.


For questions regarding benefits or reimbursable claims for the month of July, beneficiaries should contact their Managed Care Organization.

Important Update about Kentucky HEALTH

Based on a June 29, 2018 legal decision, changes to Medicaid under Kentucky HEALTH did not begin on July 1, 2018 as planned.

Based on recent conversations with Centers for Medicare & Medicaid Services (CMS), we are confident that we are on the path towards implementing Kentucky HEALTH - our innovative, transformative program that will strengthen Medicaid by engaging beneficiaries in their own health outcomes.

 
CMS notified the Cabinet that it would pursue a 30-day federal comment period, but has not given any clear direction on a timeline, or likelihood of approval after the comment period.
 
The Cabinet is confident that Kentucky HEALTH is well within the discretion of the U.S. Department of Health and Human Services (HHS) to approve, and we will continue to target our preparations for re-approval on the earliest possible date.
 
In an ongoing effort to keep all stakeholders, beneficiaries, providers, and other partners informed about Medicaid and the Kentucky HEALTH program, the Cabinet for Health and Family Services will continue to update and post guidance and resources regarding Medicaid benefits will be regularly updated on this page.
 
We want to take this opportunity to remind everyone that benefits for pregnant women, children, former foster youth up to age 26, and individuals who are medically frail have not changed.  The Cabinet continues to work with providers, our Managed Care Organizations (MCOs), and community partners to address questions as they arise.

PATH Community Engagement Update

If you received a notice dated July 1, 2018 saying you may have a community engagement requirement, you do not need to do anything right now.  There currently is no community engagement requirement.  Kentucky HEALTH was temporarily stopped, and did not start on July 1.  While the program has been temporarily stopped, you should not ignore the notice. In the event the requirement goes into effect, we want you to be prepared for the Kentucky HEALTH program and to know what you need to do to get your Medicaid benefits through Kentucky HEALTH. 

What does this court ruling mean for me?

As of July 1, 2018, your medical benefits will continue as they were prior to July 1, 2018 with no change.

What do I need to do?
You are not required to do anything at this time. You and your eligible family members can continue to access medically necessary and preventive healthcare services. If you have already paid your premium, you will get further information from your Managed Care Organization. 

You can still participate!
The Kentucky HEALTH program offers support and resources for those interested in improving their income and health. This ruling does not threaten the opportunities Kentucky HEALTH has already created. We look forward to offering these new resources to Kentuckians on a voluntary basis. 

You can log on to CitizenConnect.ky.gov to take free online courses about health skills, life skills, and work skills. You can also visit KCC.ky.gov to find a career center near you, where a coach can help you find training, education, and job opportunities in your area.

Lastly, the Stakeholder Forum scheduled for July 12, 2018 will be rescheduled. We will provide updated information as soon as possible.

Program Information:


Thank you for allowing us to be a part of your healthcare team.
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Actualización importante sobre Kentucky HEALTH

En base a la decisión legal emitida el 29 de junio de 2018, los cambios a Medicaid bajo el nombre Kentucky HEALTH no comenzaron el 1 de julio de 2018 como se había planeado.  

En base a conversaciones recientes con los Centros de Servicios de Medicare y Medicaid (CMS, por sus siglas en inglés), confiamos en que estamos en camino a la implementación de Kentucky HEALTH, nuestro programa innovador y transformador que fortalecerá Medicaid al involucrar a los beneficiarios en sus propios resultados de salud.
 
CMS le informó al Gabinete que aplicará un período de comentarios de 30 días a nivel federal; sin embargo, no ha dado una dirección clara aún sobre la fecha o las probabilidades de aprobación después del período de comentarios.
 
El Gabinete confía en que Kentucky HEALTH puede ser aprobado por el Departamento de Salud y Servicios Humanos de los EE. UU. (HHS), y seguiremos preparándonos para la nueva aprobación lo antes posible.
 
Para mantener a todas las partes interesadas, beneficiarios, proveedores y otros grupos aliados informados sobre Medicaid y el programa Kentucky HEALTH, el Gabinete para Servicios de Salud y Familia continuará actualizando y publicando información y recursos sobre los beneficios de Medicaid en la página de Información actualizada sobre el programa que se encuentra en www.KentuckyHEALTH.ky.gov.
 
Queremos aprovechar esta oportunidad para recordarles a todos que los beneficios no han cambiado para las mujeres embarazadas, los niños, los jóvenes previamente en crianza temporal hasta la edad de 26 años, y las personas que han sido determinadas como médicamente frágiles. El Gabinete continúa trabajando junto con los proveedores, nuestras Organizaciones de Atención Médica Administrada (MCO) y los grupos comunitarios asociados para responder a preguntas a medida que éstas surjan.
 

¿Qué significa esto para mí?

Esto significa que por ahora, sus beneficios médicos continuarán sin ningún cambio, tal como estaban antes del 1 de julio de 2018. 
 
¿Qué necesito hacer?

No tiene que hacer nada por ahora. Usted y sus familiares elegibles pueden continuar teniendo acceso a los servicios de atención médica preventiva y médicamente necesarios. Si ya pagó su prima, recibirá más información de su Organización de atención médica administrada (MCO, por sus siglas en inglés).
 
¡Aún puede participar!

El programa Kentucky HEALTH ofrece apoyo y recursos para aquellos interesados en mejorar sus ingresos y su salud. Esta decisión legal no interrumpe las oportunidades que Kentucky HEALTH ya ha creado para usted. Esperamos ofrecer estos nuevos recursos a los residentes de Kentucky de forma voluntaria.
 
Puede ir a CitizenConnect.ky.gov para tomar cursos en línea gratuitos sobre habilidades de salud, habilidades para la vida y habilidades de trabajo. También puede visitar KCC.ky.gov para encontrar un centro de empleos cercano, donde un guía puede ayudarlo a encontrar oportunidades de capacitación, educación y trabajo en su área.
 
Gracias por permitirnos ser parte de su equipo del cuidado de salud.