{"data":{"id":"us-ky/krs-205.648","jurisdiction":"us-ky","citation":"KRS 205.648","heading":"Plan amendment, waiver, or alternative payment model for services of","body":"certified community health workers -- Reimbursement -- Services provided --\nNot be considered duplicative -- Administrative regulations and approvals.\n(1) As used in this se ction, \"certified community health worker\" has the same meaning\nas in KRS 309.460.\n(2) (a) By January 1, 2023, the Department for Medicaid Services shall seek approval\nfrom the federal Centers for Medicare and Medicaid Services for a state plan\namendment, waiver, or alternative payment model, including public -private\npartnerships, for services delivered by certified community health workers.\n(b) Any state plan amendment, waiver, or alternative payment sought by the\nDepartment for Medicaid Services pursuant to paragraph (a) of this subsection\nshall provide reimbursement for services described in subsection (3) of this\nsection when provided by a certified community health worker who is\nemployed and supervised by a Medicaid participating provider who is\nemployed by:\n1. An alcohol and other drug treatment entity;\n2. A behavioral health services organization;\n3. A community mental health center;\n4. A federally qualified health center or a federally qualified health center\nlook-alike;\n5. A health system consisting of either at least one (1) hospital and at least\none (1) group of physicians or more than one (1) group of physicians;\n6. A hospital;\n7. A local health department;\n8. A primary care clinic;\n9. A rural health clinic; or\n10. Another Medicaid participating provider approved by the Department\nfor Medicaid Services.\n(3) A certified community health worker may provide the following services:\n(a) Direct preventative services or services designed to slow the progression of\nchronic diseases, including screenings for basic human needs and referrals to\nappropriate services and agencies to meet those needs;\n(b) Health promotion education to prevent illness or disease, including the\npromotion of healthy behaviors to increase awareness and  prevent the\ndevelopment of illness or disease;\n(c) Facilitation between a beneficiary and a provider when cultural factors, such\nas language, socioeconomic status, or health literacy, become a barrier to\nproperly understanding treatment options or treatment plans;\n(d) Diagnosis-related patient education regarding self -management of physical,\ndental, or mental health; and\n(e) Any other service approved by the Department for Medicaid Services.\n(4) Certified community health workers shall not enroll as indepe ndent Medicaid\nparticipating providers.\n(5) If a Medicaid managed care organization contracted by the Department for\nMedicaid Services for the delivery of Medicaid services employs a certified\ncommunity health worker, the services provided by that certifie d community health\nworker shall not be considered to be duplicative of services, and shall not provide a\nbasis to deny services or reimbursement for services, provided by a certified\ncommunity health worker employed by an entity described in subsection (2) (b) of\nthis section.\n(6) The Department for Medicaid Services shall, in accordance with KRS Chapter 13A,\npromulgate administrative regulations necessary to carry out the provisions of this\nsection and obtain all necessary approvals from the federal Centers  for Medicare\nand Medicaid Services.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=52719","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:04Z","sha256":"d77505a7a9142864cb60f4ada4c664e957072946b91c85091e5af9f45f0f9211","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.647","next":"us-ky/krs-205.6481"},"notice":"GroundRules: Original legal text. Not legal advice."}