{"data":{"id":"us-ky/krs-205.5591","jurisdiction":"us-ky","citation":"KRS 205.5591","heading":"Medicaid providers using telehealth -- Duties of cabinet, Department for","body":"Medicaid Services, and managed care organizations -- Administrative\nregulations -- Policies and guidelines.\n(1) For purposes of this section, \"equivalent\" has the  same meaning as in KRS\n304.17A-138.\n(2) The cabinet shall provide oversight, guidance, and direction to Medicaid providers\ndelivering care using telehealth.\n(3) The Department for Medicaid Services shall:\n(a) Within thirty (30) days after June 29, 2021:\n1. Promulgate administrative regulations in accordance with KRS Chapter\n13A to establish requirements for telehealth coverage and\nreimbursement rates, which shall be equivalent to coverage requirements\nand reimbursement rates for the same service provided i n person unless\nthe telehealth provider and the department or a managed care\norganization contractually agree to a lower reimbursement rate for\ntelehealth services; and\n2. Create, establish, or designate the claim forms, records required, and\nauthorization procedures to be followed in conjunction with this section\nand KRS 205.559;\n(b) Require that specialty care be rendered by a health care provider who is\nrecognized and actively participating in the Medicaid program;\n(c) Require that any required prior aut horization requesting a referral or\nconsultation for specialty care be processed by the patient's primary care\nprovider and that any specialist coordinate care with the patient's primary care\nprovider; and\n(d) Require a telehealth provider to be licensed i n Kentucky, or as allowed under\nthe standards and provisions of a recognized interstate compact, in order to\nreceive reimbursement for telehealth services.\n(4) In accordance with KRS 211.336, the Department for Medicaid Services and any\nmanaged care organization with whom the department contracts for the delivery of\nMedicaid services shall not:\n(a) Require a Medicaid provider to be physically present with a Medicaid\nrecipient, unless the provider determines that it is medically necessary to\nperform those services in person;\n(b) Require prior authorization, medical review, or administrative clearance for\ntelehealth that would not be required if a service were provided in person;\n(c) Require a Medicaid provider to be employed by another provider or agency in\norder to provide telehealth services that would not be required if that service\nwere provided in person;\n(d) Require demonstration that it is necessary to provide services to a Med icaid\nrecipient through telehealth;\n(e) Restrict or deny coverage of telehealth based solely on the communication\ntechnology or application used to deliver the telehealth services; or\n(f) Require a Medicaid provider to be part of a telehealth network.\n(5) Nothing in this section shall be construed to require the Medicaid program or a\nMedicaid managed care organization to:\n(a) Provide coverage for telehealth services that are not medically necessary; or\n(b) Reimburse any fees charged by a telehealth facility  for transmission of a\ntelehealth encounter.\n(6) The cabinet, in implementing KRS 211.334 and 211.336, shall maintain telehealth\npolicies and guidelines to providing care that ensure that Medicaid -eligible citizens\nwill have safe, adequate, and efficient m edical care, and that prevent waste, fraud,\nand abuse of the Medicaid program.\n(7) In order to comply with the deadline for the promulgation of administrative\nregulations established in subsection (3) of this section, the Department for\nMedicaid Services m ay promulgate emergency administrative regulations in\naccordance with KRS 13A.190.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=52665","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"e0ec4599a39d920dcf15ba51345e72e8d39a312d7373f0250ed216e6ac9a0f39","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.559","next":"us-ky/krs-205.560"},"notice":"GroundRules: Original legal text. Not legal advice."}