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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.

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