205.5373 Department's duties when limited in ability to disenroll individuals from

224 words·~1 min read·/ky/205-5373

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

state medical assistance program.

(1)When the Department for Medicaid Services receives federal funding for the state's

medical assistance program which is contingent on temporary maintenance of effort

restrictions, such as those restrictions imposed under Pub. L. No. 116-127 sec.

6008, or is for any reason limited in its ability to disenroll individuals from the

state's medical assistance program, the department shall:

(a)Continue to conduct eligibility redeterminations as in the normal course of

business; and

(b)Act on those redeterminations to the fullest extent permitted under federal

law.

(2)Following the expiration of any federally imposed restrictions described in

subsection

(1)of this section, the department shall conduct a full audit in which the

department shall:

(a)Within sixty

(60)days, request approval from the federal Centers for Medicare

and Medicaid Services to conduct and act on eligibility redeterminations for

each individual who was enrolled during the period of federally imposed

restrictions and has been enrolled for more than three

(3)months; and

(b)Within twelve

(12)months:

1. Complete and act on eligibility redeterminations for all cases that have

not had a redetermination within the previous twelve

(12)months; and

2. Complete and act on eligibility redeterminations for individuals

described in paragraph

(a)of this subsection, if the department receives

the federal approval requested pursuant to this paragraph

(a)of this

subsection.