Kentucky Statutes 205.632 – Pilot project to create coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or community action agency
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(1) As used in this section:
(a) “Department” means the Department for Medicaid Services;
(b) “Evidence-based best practices” means the integration of the best available research with clinical expertise in the context of patient characteristics and patient and family caregiver preferences;
(c) “Qualified medical provider” means a credentialed and enrolled Medicaid- participating healthcare provider, hospital, rural health center, or licensed home health agency as defined in KRS § 216.935; and
(d) “Telemonitoring services” means services that require scheduled remote monitoring of data related to a patient’s health where the monitoring is conducted at the patient’s place of residence or other site determined by the department.
(2) Not later than July 1, 2017, the department shall establish a pilot project in which it creates coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or a community action agency as defined in KRS § 273.410.
(3) In order to effectuate the pilot project, the department may:
(a) Submit a state plan amendment, waiver, or waiver amendment for approval to the Centers for Medicare and Medicaid Services in order to provide coverage for medically necessary telemonitoring services performed for a Medicaid beneficiary;
(b) Request funding from the General Assembly to support telemonitoring services rendered by a qualified medical provider or a community action agency under this section;
(c) Ensure that clinical information gathered by a qualified medical provider or a community action agency while providing telemonitoring services is shared with the patient’s treating health care professionals; and
(d) Promulgate administrative regulations in accordance with KRS Chapter 13A
for the implementation and administration of this section.
Effective: July 15, 2016
History: Created 2016 Ky. Acts ch. 126, sec. 1, effective July 15, 2016.
(a) “Department” means the Department for Medicaid Services;
Terms Used In Kentucky Statutes 205.632
- Action: includes all proceedings in any court of this state. See Kentucky Statutes 446.010
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
(b) “Evidence-based best practices” means the integration of the best available research with clinical expertise in the context of patient characteristics and patient and family caregiver preferences;
(c) “Qualified medical provider” means a credentialed and enrolled Medicaid- participating healthcare provider, hospital, rural health center, or licensed home health agency as defined in KRS § 216.935; and
(d) “Telemonitoring services” means services that require scheduled remote monitoring of data related to a patient’s health where the monitoring is conducted at the patient’s place of residence or other site determined by the department.
(2) Not later than July 1, 2017, the department shall establish a pilot project in which it creates coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or a community action agency as defined in KRS § 273.410.
(3) In order to effectuate the pilot project, the department may:
(a) Submit a state plan amendment, waiver, or waiver amendment for approval to the Centers for Medicare and Medicaid Services in order to provide coverage for medically necessary telemonitoring services performed for a Medicaid beneficiary;
(b) Request funding from the General Assembly to support telemonitoring services rendered by a qualified medical provider or a community action agency under this section;
(c) Ensure that clinical information gathered by a qualified medical provider or a community action agency while providing telemonitoring services is shared with the patient’s treating health care professionals; and
(d) Promulgate administrative regulations in accordance with KRS Chapter 13A
for the implementation and administration of this section.
Effective: July 15, 2016
History: Created 2016 Ky. Acts ch. 126, sec. 1, effective July 15, 2016.