KRS 205.6311: Substance use disorder treatment benefit -- Administrative regulations --

Contracts with Medicaid managed care organizations -- Annual report.

(1) The Department for Medicaid Services shall provide a substance use disorder

benefit consistent with fed eral laws and regulations which shall include a broad

array of treatment options for those with heroin and other substance use disorders.

(2) The department shall promulgate administrative regulations to implement this

section and to expand the behavioral health network to allow providers to provide

services within their licensure category.

(3) Providers of peer -mediated, recovery -oriented, therapeutic community models of

care shall have the opportunity to contract with managed care organizations to be

reimbursed for any portion of those services that are provided by licensed or

certified providers in accordance with approved billing codes.

(4) A Medicaid managed care organization shall:

(a) Authorize treatment for each diagnosis related to substance use dis order and

co-occurring mental health and substance use disorder covered by Medicaid

that is identified within the most updated edition of the Diagnostic and

Statistical Manual of Mental Disorders issued by the American Psychiatric

Association that meets the criteria for medical necessity and level of care; and

(b) Approve coverage and payment for continuing care at the appropriate level of

care.

(5) Beginning January 1, 2016, the Department for Medicaid Services shall provide an

annual report to the Legisla tive Research Commission detailing the number of

providers of substance use disorder treatment, the type of services offered by each

provider, the geographic distribution of providers, and a summary of expenditures

on substance use disorder treatment services provided by Medicaid.