{"data":{"id":"us-ky/krs-205.5371","jurisdiction":"us-ky","citation":"KRS 205.5371","heading":"Demonstrated community engagement -- Definitions for section.","body":"(1) (a) The cabinet shall, no later than January 1, 2027, for applicable individuals as\ndefined in 42 U.S.C. sec. 1396a(xx)(9), condition eligibility for enrollment or\ncontinued enrollment in the Medicaid program on demonstrated community\nengagement as defined in and required under 42 U.S.C. sec. 1396a(xx).\n(b) In the case of an applicable individual who is applying for enrollment in the\nMedicaid program, in order to be eligible for enrollment the individual shall\nbe required to demonstrate community engagement for the month\nimmediately preceding the month during which the individual applies for\nenrollment.\n(c) In the case of an applicable individual who is enrolled and receiving Medicaid\nbenefits, in order to remain eligible for continued enrollment, at the time of\neligibility redetermination, the individual shall be required to demonstrate\ncommunity engagement for three (3) months during the period of time since\nthe individual's most recent eligibility determination or redetermination.\n(2) Notwithstanding any provision of state law to the contrary, the cabinet shall not\nrequest an exemption, waiver, or any other delay, including but not limited to a\ngood-faith-effort exemption, in  implementing the requirements of 42 U.S.C. sec.\n1396a(xx) or subsection (1) of this section that may be available to the state under\n42 U.S.C. sec. 1396a(xx)(11) unless specifically authorized by the General\nAssembly to do so.\n(3) The cabinet shall begin,  no later than September 1, 2026, providing notice to all\napplicable individuals, as defined in 42 U.S.C. sec. 1396a(xx)(9), of the\nrequirement to demonstrate community engagement as established under 42 U.S.C.\nsec. 1396a(xx) and subsection (1) of this sec tion. Notice provided under this\nsubsection shall comply with the requirements of 42 U.S.C. sec. 1396a(xx)(8).\n(4) If at any time on or after April 14, 2026, the federal community engagement\nrequirements established in 42 U.S.C. sec. 1396a(xx) are abolishe d, repealed, or\notherwise diminished, the cabinet shall:\n(a) Immediately prepare and submit a waiver application to the federal Centers\nfor Medicare and Medicaid Services seeking authorization to condition the\neligibility of applicable individuals, as defi ned in subsection (5) of this\nsection, to enroll or continue to be enrolled in the Medicaid program on\ndemonstrated community engagement, as defined in subsection (5) of this\nsection; and\n(b) For applicable individuals, as defined in subsection (5) of this  section, and in\naccordance with subsection (1)(b) and (c) of this section, condition eligibility\nfor enrollment or continued enrollment in the Medicaid program on\ndemonstrated community engagement, as defined in subsection (5) of this\nsection, if authoriz ed to do so by the federal Centers for Medicare and\nMedicaid Services.\n(5) As used in subsection (4) of this section:\n(a) \"Applicable individual\" means an individual who is:\n1. At least nineteen (19) years of age but less than sixty -five (65) years of\nage;\n2. Eligible for enrollment or currently enrolled in the Medicaid program\nunder 42 U.S.C. sec. 1396a(a)(10)(A)(i)(VIII) or a waiver that provides\ncoverage that is equivalent to minimum essential coverage as described\nin Section 5000A(f)(1)(A) of the Internal Revenue Code of 1986; and\n3. Not:\na. Currently, or was not previously, placed in the foster care system\nif the individual is under twenty-six (26) years of age;\nb. Eligible for coverage under the Indian Health Service;\nc. A parent, guardian, caretaker relative, or family caregiver, as\ndefined in the RAISE Family Caregivers Act, Pub. L. No. 115 -\n119, of a dependent child thirteen (13) years of age or under or a\ndisabled individual;\nd. A disabled veteran with a disability rated as total under 38 U.S.C.\nsec. 1155;\ne. Medically frail or otherwise has special medical needs, including\nan individual:\ni. Who is blind or disabled;\nii. With a substance use disorder;\niii. With a disabling mental condition;\niv. With a physical, intellectual, or developmental disability that\nsignificantly impairs his or her ability to perform one (1) or\nmore activities of daily living; or\nv. With a serious or complex medical condition;\nf. An individual subjec t to work or community engagement\nrequirements imposed under the Supplemental Nutrition\nAssistance Program or Temporary Assistance for Needy Families,\nif the individual is in compliance with such requirements;\ng. An individual participating in a drug addiction or alcohol addiction\nrecovery program recognized by the secretary through the\npromulgation of administrative regulations in accordance with\nKRS Chapter 13A;\nh. An inmate at a public institution;\ni. Pregnant or eligible for coverage under KRS 205.592; or\nj. An individual experiencing a short-term hardship as defined by the\nsecretary through the promulgation of administrative regulations in\naccordance with KRS Chapter 13A; and\n(b) \"Demonstrated community engagement\" means satisfying one (1) or more of\nthe following conditions on a monthly basis:\n1. Working, as defined in 7 C.F.R. sec. 273.24, not less than eighty (80)\nhours;\n2. Completing not less than eighty (80) hours of community service;\n3. Participating in a work program, as defined in 7 C.F.R. sec. 273.24, for\nnot less than eighty (80) hours;\n4. Participating at least half -time in an education program recognized by\nthe secretary through the promulgation of administrative regulations in\naccordance with KRS Chapter 13A;\n5. Engaging in any combination of activities described in subparagraphs 1.,\n2., 3., and 4. of this paragraph for a total of not less than eighty (80)\nhours;\n6. Having a verifiable monthly income that is not less than applicable state\nminimum wage established in KRS 337.275 multiplied by eighty (80)\nhours; or\n7. Having a verifiable average monthly income over the previous six (6)\nmonths that is not less than applicable state minimum wage established\nin KRS 337.275 multiplied by eighty (80) hours if the individu al is a\nseasonal worker as described in Section 45R(d)(5)(B) of the Internal\nRevenue Code of 1986.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57021","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"b4cb960497a48eab2b751c3a14e115590b409aeb69137373027955aa14a613d8","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.5370","next":"us-ky/krs-205.5372"},"notice":"GroundRules: Original legal text. Not legal advice."}