Kentucky Statutes 205.557 – Medicaid reimbursement for advocacy center’s child medical evaluation — Waivers — Administrative regulations
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(1) For the purposes of this section:
(a) “Advanced practice registered nurse” has the same meaning as in KRS
314.011;
(b) “Children’s advocacy center” has the same meaning as in KRS § 620.020; (c) “Child medical evaluation” means an examination at a children’s
advocacy center to evaluate for child physical abuse, sexual abuse, or
neglect and to exclude other etiologies and evaluate the health and well-being of the child. A child medical evaluation shall include but not be limited to one (1) or more of the following:
1. A medical history taken from the child and a nonimplicated parent, guardian, or primary caretaker;
2. A comprehensive physical examination;
3. Laboratory services;
4. Photo documentation;
5. Follow-up evaluation; or
6. A mental health screening to determine the impact of the alleged abuse on the mental health status of the child and the need for mental health services;
(d) “Physician” has the same meaning as in KRS § 311.550; and
(e) “Sexual assault nurse examiner” has the same meaning as in KRS
314.011.
(2) The Cabinet for Health and Family Services and any managed care organization or other entity with whom the Department for Medicaid Services contracts for the delivery of Medicaid services shall provide Medicaid reimbursement for a child medical evaluation provided by a licensed physician, advanced practice registered nurse, or sexual assault nurse examiner employed or contracted by a children’s advocacy center if the children’s advocacy center is in compliance with the appropriate and necessary federal and state laws or regulations.
(3) Child medical evaluations provided by a licensed physician, advanced practice registered nurse, or sexual assault nurse examiner in a children’s advocacy center shall be reimbursed by the Department for Medicaid Services at the true and actual cost of the child medical evaluation.
(4) The Department for Medicaid Services shall apply for any waivers of federal laws or regulations necessary to implement this section.
(5) The cabinet shall promulgate administrative regulations in accordance with
KRS Chapter 13A to implement this section.
Effective:April 1, 2022
History: Created 2022 Ky. Acts ch. 75, sec. 16, effective April 1, 2022.
(a) “Advanced practice registered nurse” has the same meaning as in KRS
Terms Used In Kentucky Statutes 205.557
- Cabinet: means the Cabinet for Health and Family Services. See Kentucky Statutes 205.010
- Federal: refers to the United States. See Kentucky Statutes 446.010
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Nurse: means a person authorized to practice professional nursing under the laws of the Commonwealth. See Kentucky Statutes 205.510
- Physician: means a person authorized to practice medicine or osteopathy under the laws of the Commonwealth. See Kentucky Statutes 205.510
- State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
314.011;
(b) “Children’s advocacy center” has the same meaning as in KRS § 620.020; (c) “Child medical evaluation” means an examination at a children’s
advocacy center to evaluate for child physical abuse, sexual abuse, or
neglect and to exclude other etiologies and evaluate the health and well-being of the child. A child medical evaluation shall include but not be limited to one (1) or more of the following:
1. A medical history taken from the child and a nonimplicated parent, guardian, or primary caretaker;
2. A comprehensive physical examination;
3. Laboratory services;
4. Photo documentation;
5. Follow-up evaluation; or
6. A mental health screening to determine the impact of the alleged abuse on the mental health status of the child and the need for mental health services;
(d) “Physician” has the same meaning as in KRS § 311.550; and
(e) “Sexual assault nurse examiner” has the same meaning as in KRS
314.011.
(2) The Cabinet for Health and Family Services and any managed care organization or other entity with whom the Department for Medicaid Services contracts for the delivery of Medicaid services shall provide Medicaid reimbursement for a child medical evaluation provided by a licensed physician, advanced practice registered nurse, or sexual assault nurse examiner employed or contracted by a children’s advocacy center if the children’s advocacy center is in compliance with the appropriate and necessary federal and state laws or regulations.
(3) Child medical evaluations provided by a licensed physician, advanced practice registered nurse, or sexual assault nurse examiner in a children’s advocacy center shall be reimbursed by the Department for Medicaid Services at the true and actual cost of the child medical evaluation.
(4) The Department for Medicaid Services shall apply for any waivers of federal laws or regulations necessary to implement this section.
(5) The cabinet shall promulgate administrative regulations in accordance with
KRS Chapter 13A to implement this section.
Effective:April 1, 2022
History: Created 2022 Ky. Acts ch. 75, sec. 16, effective April 1, 2022.