Kentucky HEALTH Legal Decision Guide for Beneficiaries

The Kentucky Cabinet for Health and Family Services (CHFS) is continuing to post updated guidance and resources on the Kentucky HEALTH website. To read the “Kentucky HEALTH Legal Decision Guide for Beneficiaries” please click here.

Recent Update on Vision and Dental

FRANKFORT, Ky. (July 19, 2018) -The Cabinet for Health and Family Services (CHFS) released the following statement on Kentucky HEALTH:

We had hoped for a quick federal re-approval that would allow the transformative Kentucky HEALTH program to start August 1, avoiding delayed access to services for beneficiaries and costly system changes. We have been working with CMS on the details of the re-approval process, including the status of dental and vision benefits, and have now received updated guidance that CMS will hold a 30-day federal comment and evaluation period, making it clear that the program will not begin as soon as we hoped.

Under Kentucky HEALTH, some beneficiaries would have been able to use their My Rewards Accounts to pay for routine vision and dental services. Due to the delay in implementation of the My Rewards program, there was no legal authority to pay for these services out of the My Rewards account. In order to mitigate the consequences of the judge’s ruling, and avoid a prolonged coverage gap prior to the re-approval of Kentucky HEALTH, we have begun the process to reinstate vision and dental coverage, as well as non-emergency transportation services, for those whose benefits were affected by the June 29 court action.

Unfortunately, changing benefits and coverage is not as easy as flipping a single switch. As Cabinet officials testified, system changes are risky and cannot be made overnight. The Cabinet has spent the last few weeks working on a temporary solution for restored benefits to be implemented by August 1. In addition, while dental, vision, and non-emergency medical transportation eligibility for those in the Alternative Benefit Plan will not show in the system until August 1, the Cabinet is close to completing a manual system work-around that will allow payment of claims incurred by any eligible Medicaid beneficiary for dental, vision, and nonemergency transportation services incurred during the month of July.

For questions regarding benefits or reimbursable claims for the month of July, beneficiaries should contact their Managed Care Organization.

Start of Kentucky HEALTH has been halted

Based on a recent legal decision, changes to Medicaid under Kentucky HEALTH will not begin on July 1, 2018 as planned.

What does this mean for me?

At this time, your medical benefits will continue as they are today with no change. However, if you received a notice saying you could access vision and dental services through a My Rewards Account, you will not have access to dental and vision benefits.  The legal decision has stopped the ability to use the My Rewards dollars in order to purchase dental and vision services.

What do I need to do?

You are not required to do anything at this time. You and your eligible family members can continue to access medically necessary and preventive healthcare services. If you have already paid your premium, you will get further information from Passport Health Plan.

What about Community Engagement?

If you received a notice dated July 1, 2018 saying you may have a community engagement requirement, you do not need to do anything right now.  There currently is no community engagement requirement.  Kentucky HEALTH was temporarily stopped, and did not start on July 1.  While the program has been temporarily stopped, you should not ignore the notice. In the event the requirement goes into effect, we want you to be prepared for the Kentucky HEALTH program and to know what you need to do to get your Medicaid benefits through Kentucky HEALTH.

Please visit www.kentuckyhealth.ky.gov for more information and further updates.

You can still participate!

The Kentucky HEALTH program offers support and resources for those interested in improving their incomes and health.  This ruling does not threaten the opportunities Kentucky HEALTH has already created. We look forward to offering these new resources to Kentuckians on a voluntary basis.

You can log on to CitizenConnect.ky.gov to take free online courses about health skills, life skills, and work skills. You can also visit KCC.ky.gov to find a career center near you, where a coach can help you find training, education, and job opportunities in your area. 

 

Thank you for allowing us to be a part of your healthcare team.

If you have questions related to Kentucky HEALTH or your Passport benefits, please call our Member Services Department at 1-800-578-0603. It is available from 7 am to 7 pm Eastern Time, Monday-Friday.