Kentucky Revised Statutes Title XVII. Economic Security and Public Welfare § 205.5591.Medicaid providers using telehealth; duties of cabinet, Department for Medicaid Services, and managed care organizations; administrative regulations; policies and guidelines

(a) Within thirty (30) days after June 29, 2021:

(b) Require that specialty care be rendered by a health care provider who is recognized and actively participating in the Medicaid program;

(c) Require that any required prior authorization requesting a referral or consultation for specialty care be processed by the patient's primary care provider and that any specialist coordinate care with the patient's primary care provider; and

(d) Require a telehealth provider to be licensed in Kentucky, or as allowed under the standards and provisions of a recognized interstate compact, in order to receive reimbursement for telehealth services.

(a) Require a Medicaid provider to be physically present with a Medicaid recipient, unless the provider determines that it is medically necessary to perform those services in person;

(b) Require prior authorization, medical review, or administrative clearance for telehealth that would not be required if a service were provided in person;

(c) Require a Medicaid provider to be employed by another provider or agency in order to provide telehealth services that would not be required if that service were provided in person;

(d) Require demonstration that it is necessary to provide services to a Medicaid recipient through telehealth;

(e) Restrict or deny coverage of telehealth based solely on the communication technology or application used to deliver the telehealth services; or

(f) Require a Medicaid provider to be part of a telehealth network.

(a) Provide coverage for telehealth services that are not medically necessary; or

(b) Reimburse any fees charged by a telehealth facility for transmission of a telehealth encounter.