205.8477 Disclosure requirements for Medicaid providers, fiscal agents, and

327 words·~1 min read·/ky/205-8477

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

managed care entities -- Disclosure requirements for owners and investors of

health facilities and health services -- When disclosure must be provided.

(1)Each Medicaid provider, other than an individual practitioner or group of

practitioners, fiscal agent that processes or pays vendor claims on behalf of the

Medicaid agency, and managed care entity shall file a disclosure with the Cabinet

for Health and Family Services in accordance with 42 C.F.R. sec. 455.104.

(2)Each owner of or direct financial investor in any health facility or health service

which dispenses or supplies drugs, medicines, medical devices, or durable medical

equipment to a patient shall file a disclosure with the Cabinet for Health and Family

Services of the names and addresses of any immediate family member who is

authorized under state law to prescribe drugs or medicines or medical devices or

equipment.

(3)Each provider shall, as a condition of participation in the Medical Assistance

Program, file a disclosure with the Cabinet for Health and Family Services in

accordance with 42 C.F.R. sec. 455.105 relating to business transactions and in

accordance with 42 C.F.R. sec. 455.106 relating to information on persons

convicted of crimes.

(4)Disclosures required under this statute shall be provided at any of the following

times or as otherwise provided by law:

(a)Upon submitting a provider application;

(b)Upon executing a provider agreement;

(c)Upon request of the Cabinet for Health and Family Services during a

provider's revalidation of enrollment;

(d)Within thirty-five

(35)days after any change in ownership of a health facility

or health service, fiscal agent, or managed care entity;

(e)Upon the submission of a proposal in accordance with the state's procurement

process by a fiscal agent or by a managed care entity;

(f)Upon execution, renewal, or extension of a contract by the state with a fiscal

agent or a managed care entity; or

(g)Upon written request within thirty-five

(35)days by the Cabinet for Health

and Family Services.