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Kentucky Medicaid Weekly Update

Posted December 18, 2019

On December 16, 2019 Governor Andy Beshear signed an executive order sustaining the Medicaid expansion that will continue coverage for 479,000 Kentuckians. On the same day, the Governor also signed an executive order that ending the Section 1115 waiver or Kentucky HEALTH program created under former Governor Matt Bevin.

The Kentucky HEALTH 1115 Waiver executive order terminates 1115 Waiver components including:

  • Work requirements or community engagement for able-bodied adults between the ages of 19 and 64
  • Monthly premiums
  • Mandated reporting requirements and failing to meet these thresholds that would have resulted in lockout periods, and denial of health care coverage for six months
  • Expanded SUD coverage although DMS hopes to continue coverage of some SUD services through a State Plan but it most likely will not include expanded days in mental health facilities

Although the Kentucky HEALTH 1115 Waiver is eliminated, protests to the MCO contract awards are ongoing.

Anthem Kentucky and Passport Health Plan submitted their appeals to the state protesting their exclusion from the Medicaid contracts issued two weeks ago by former Governor Matt Bevin.

At some point, the Cabinet Secretary (or designee) will issue a written determination of the protest. A protest can be sustained or denied. If the protest is sustained, remedies include canceling the solicitation, canceling the award, rescoring the bidders or offerors, or other remedies.

Meanwhile it is business as usual for all the current MCOs.

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