Tag: Kentucky
MCO bill becomes law in Kentucky
April 5, 2019HME News Staff
FRANKFORT, Ky. - Kentucky Gov. Matt Bevin has signed into law a bill that streamlines DME regulations and reimbursement policy for the managed care organizations managing the state's Medicaid program.The bill ensures that MCOs:Reimburse DME suppliers by at least 90% of the rate set by the Kentucky Medicaid program;Requires that specialty items not listed on the current fee schedule be reimbursed at the manufacturer's suggested retail price minus 18% or at invoice cost plus 20% when there is no MSRP,...
MCO bill clears Kentucky House
February 22, 2019HME News Staff
FRANKFORT, Ky. - A bill that would hold managed care organizations more accountable passed the Kentucky House of Representatives on Thursday 100-0, VGM reports. The bill, H.B. 224, would ensure that DME providers are paid at the rate set by the Kentucky Medicaid program and would ensure that when they receive prior authorizations their claims can't be denied for “lack of medical necessity.” Stakeholders, including members of KMESA, had been lobbying hard to move the bill in the past couple...
KMESA calls for support of MCO-related bill
February 14, 2019HME News Staff
FRANKFORT, Ky. - KMESA is asking HME providers in Kentucky to support HB 224. Introduced last week by State Rep. Kim Moser, the bill seeks to ensure that DME providers are paid at the rate set by Kentucky Medicaid. It would also require that, should a patient transfer from one Medicaid managed care organization to another, services that are currently being provided under a PA will be honored by the new MCO; and require MCOs to cover, at a minimum, the same quantities of supplies covered under the...
Kentucky: Providers can bill for diabetes
January 23, 2011Theresa Flaherty, Managing Editor
LOUISVILLE, Ky. - Providers here learned in December that they will be able to bill Medicaid for diabetes supplies again, but some major unknowns loomed.
In July, the state had announced—via a website posting—that it planned to move all diabetes supplies and testing equipment from the DME benefit to the pharmacy benefit, effective Aug. 1. The move would have allowed the state to take advantage of manufacturer's rebates worth approximately $2 million a year.
Providers succeeded...
Kentucky: State proposes diabetes switch
September 26, 2010Theresa Flaherty, Managing Editor
LOUISVILLE, Ky. - A couple of Medicaid changes that came out of seemingly nowhere had providers crying foul in August.
In a July 27 notice "buried" on its website, Kentucky Medicaid issued an "emergency administrative regulation" to move all diabetes testing equipment and related supplies from the DME benefit to the pharmacy benefit. Effective date? Aug. 1.
"We did not receive a notice letter," said Teresa Camfield, executive director of the Kentucky Medical Equipment Suppliers Association...