{"data":{"id":"us-ky/krs-205.634","jurisdiction":"us-ky","citation":"KRS 205.634","heading":"Payments prohibited to out -of-state health facility providing services","body":"without required certificate of need -- Nonreimbursement of out -of-state\nproviders of residential care for children -- Exception -- Administrative\nregulations.\n(1) No medical assistance payments shall be made under this chapter to any out-of-state\nhealth facility or health service providing services within the geographic boundaries\nof the Commonwealth who does not have a certificate of need if the health facility\nor health service w ould be required to obtain a certificate of need under KRS\nChapter 216B if the facility or service were located within the geographic\nboundaries of the Commonwealth.\n(2) The Department for Medicaid Services and the Department for Community Based\nServices shall not reimburse an out -of-state provider of residential care for children\nwhose care is paid by state general funds or state administered federal funds, unless\nthe Department for Medicaid Services or the Department for Community Based\nServices or a desi gnated agent thereof has determined that there is no provider\nwithin the Commonwealth that is capable and willing to provide comparable\nservices at a comparable cost per child to those that would be delivered by the out -\nof-state provider. An exception may be made if:\n(a) The identified in -state resource is farther away from the child's parent or\nguardian than a similar out-of-state resource; or\n(b) The services offered by the out -of-state resource is deemed by either\ndepartment or a designated agent thereof  to be more appropriate for the\nindividual child than the services offered by the in-state provider.\n(3) Prior to promulgating administrative regulations governing the determination of the\navailability of providers of residential care within the Commonweal th, the\nDepartment for Medicaid Services and the Department for Community Based\nServices shall establish uniform conditions, requirements, and exceptions for the\ndetermination of the availability of providers of residential care within the\nCommonwealth.\n(4) Each department shall promulgate an administrative regulation in accordance with\nKRS Chapter 13A that contains the uniform conditions, requirements, and\nexceptions for the determination of the availability of providers of residential care\nwithin the Commonwealth established under subsection (3) of this section.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=7775","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:04Z","sha256":"09b5fd029d83f108f409a4c2e2a34a67fc77ac364067c928982509c46800dc38","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.6338","next":"us-ky/krs-205.635"},"notice":"GroundRules: Original legal text. Not legal advice."}