{"data":{"id":"us-ky/krs-205.6311","jurisdiction":"us-ky","citation":"KRS 205.6311","heading":"Substance use disorder treatment benefit -- Administrative regulations --","body":"Contracts with Medicaid managed care organizations -- Annual report.\n(1) The Department for Medicaid Services shall provide a substance use disorder\nbenefit consistent with fed eral laws and regulations which shall include a broad\narray of treatment options for those with heroin and other substance use disorders.\n(2) The department shall promulgate administrative regulations to implement this\nsection and to expand the behavioral health network to allow providers to provide\nservices within their licensure category.\n(3) Providers of peer -mediated, recovery -oriented, therapeutic community models of\ncare shall have the opportunity to contract with managed care organizations to be\nreimbursed for any portion of those services that are provided by licensed or\ncertified providers in accordance with approved billing codes.\n(4) A Medicaid managed care organization shall:\n(a) Authorize treatment for each diagnosis related to substance use dis order and\nco-occurring mental health and substance use disorder covered by Medicaid\nthat is identified within the most updated edition of the Diagnostic and\nStatistical Manual of Mental Disorders issued by the American Psychiatric\nAssociation that meets the criteria for medical necessity and level of care; and\n(b) Approve coverage and payment for continuing care at the appropriate level of\ncare.\n(5) Beginning January 1, 2016, the Department for Medicaid Services shall provide an\nannual report to the Legisla tive Research Commission detailing the number of\nproviders of substance use disorder treatment, the type of services offered by each\nprovider, the geographic distribution of providers, and a summary of expenditures\non substance use disorder treatment services provided by Medicaid.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=44001","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:04Z","sha256":"5848f8c79a0cad86ab8cbe924ce8d0ec047d1fce9631d326ba14ad763b169564","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.6310","next":"us-ky/krs-205.6312"},"notice":"GroundRules: Original legal text. Not legal advice."}