From time to time, we send our provider partners information via network notice. These notices cover information from us as well as from the Kentucky Department for Medicaid Services (Kentucky DMS). You’ll find below network notices we’ve issued since 2020. We list these network notices in the order we issued them. Please note: The date we reference is the date of issuance and not necessarily the effective date.

We also post on this webpage current and previous editions of our provider newsletter, New Horizons.

Visit our prior authorization webpage for prior authorization guidance. We strongly urge our providers to review this guidance, as it outlines changes to existing procedures and provides information on when the changes go into effect.

Medicaid public health emergency (PHE) unwinding information

Consumer alert: What to know if someone calls a Medicaid recipient about short-term health insurance products, PDF

On Jan. 30, 2023, the Biden administration announced that the PHE is set to end on May 11, 2023. This announcement gave states 101 days to prepare for the PHE unwinding. Regardless of when this PHE ends, due to a new federal law, Kentucky will begin annual renewals in April 2023 and will continue renewals over 12 months.

Learn more about the PHE unwinding from the Cabinet for Health and Family Services , PDF

Learn more about the Medicaid revalidation process , PDF

Network notices

2023

DMS Telehealth Guidance Network Notice, PDF

Required Forms: Notice, Completion, Retention and Claim Submission, PDF

Humana Healthy Horizons in Kentucky Humana Coverage Policy Updates - effective August 18, 2023, PDF

Emergency department E/M claim reimbursement policy update, PDF

Fee schedule – 90 day notice – effective Aug. 14, 2023, PDF

Substance use disorder (SUD) inpatient and residential services prior authorization (PA) reinstatement – effective Mar. 31, 2023, PDF

Humana Healthy Horizons in Kentucky coverage policy updates – effective Mar. 27, 2023, PDF

Annual sports physical exam, PDF

Annual MCG clinical guideline update, PDF

Neonatal Intensive Care Unit (NICU) DRG claims payment policy – effective July 1, 2023, PDF

Clinical trial attestation form requirement – effective May 10, 2023, PDF

Kentucky Medicaid Bypass Communication for Commercial Insurance – effective May 1, 2023, PDF

Kentucky Medicaid Bypass for Commercial Insurance Code List – effective May 1, 2023, PDF

Kentucky Medicaid Bypass for Commercial Insurance Attestation Form – effective May 1, 2023, PDF

Humana Healthy Horizons in Kentucky coverage policy updates – effective March 27, 2023, PDF

Out-of-network claims payment policy update – effective March 3, 2023, PDF

Humana Healthy Horizons in Kentucky coverage policy updates – effective Feb. 20, 2023, PDF

Provider relations on-site visits with primary care physicians – effective Jan 1., 2023, PDF

2022

Adult benefit expansion for Kentucky Medicaid fee-for-service and Managed Care Organization (MCO) enrollees – Dec. 1, 2022, PDF

Enrollee eligibility redetermination and Compass enhancements - Nov. 14, 2022, PDF

Emergency department E/M reimbursement – Oct. 3, 2022, PDF

Colorectal cancer screening awareness - Sept. 23, 2022, PDF

Medicaid bypass code list for Medicare non-covered codes implementation policy - Sept. 8, 2022, PDF

PT/OT/ST Preauthorization notice – Sept. 1, 2022, PDF

Provider guidance for anesthesia modifier billing from Kentucky DMS – Aug. 2, 2022 , PDF

Grievance and appeal time frame change – July 26, 2022, PDF

Billing requirements according to the SUD 1115 Waiver – July 25, 2022, PDF

Medicaid bypass lists for Medicare non-covered codes – June 21, 2022, PDF

Substance use disorder (SUD) inpatient and residential services prior authorization (PA) reinstatement – June 7, 2022, PDF

Neonatal Intensive Care Unit (NICU) claims payment policy – May 2, 2022, PDF

Required documentation: Notice, completion, retention and claim submission – Jan. 1, 2022 , PDF

2021

PCP-enrollee relationships: Proactive status monitoring and involuntary dismissals – Dec. 14. 2021 , PDF

Provider annual compliance training deadline notice – Oct. 8, 2021, PDF

Provider requirement to report incarceration guidance from Kentucky DMS – Sept. 2, 2021 , PDF

Provider appeal time frame for medical necessity determination – Jan. 1, 2020 (posted Aug. 31, 2021), PDF

Interim billing requirements for enrollee disenrollment after inpatient admission – July 1, 2021 , PDF

MedImpact single pharmacy benefit manager notice – July 1, 2021, PDF

Kentucky Revised Statute: 205.6312 – June 29, 2021, PDF

Durable Medical Equipment (DME) Claims Payment Policy update – June 21, 2021, PDF

No-show or cancellation fees for Medicaid members guidance from KDMS – May 21, 2021 , PDF

Kentucky Medicaid Bypass List for Commercial Insurance Non-covered Codes – May 1, 2021, PDF

State-supplied vaccines policy – May 1, 2021, PDF

Updated Retrospective Review Policy – March 1, 2021, PDF

Required forms: Notice, completion, retention and claim submission – Feb. 11, 2021 , PDF

Reminder of department IMD requirements and Humana reimbursement policy – Feb. 1, 2021 , PDF

Kentucky Medicaid Regulation: 902 KAR 2:020 Reportable Disease Surveillance – Jan. 1, 2021 , PDF

Out-of-Network Claims Payment Policy update – Jan. 1, 2021, PDF

2020

Medicaid Bypass List for Medicare non-covered codes – Dec. 15, 2020, PDF

Acupuncture value-added service notification – Dec. 1, 2020 , PDF

Doula value-added service notification – Dec. 1, 2020 , PDF

Reminder: Claim submission requirements update – Dec. 1, 2020 , PDF

Claim dispute process network notification – Nov. 1, 2020 , PDF

Incontinent supply reimbursement – Oct. 1, 2020 , PDF

Introducing Humana Healthy Horizons® in Kentucky – Sept. 1, 2020 , PDF

Updated Retrospective Review Policy – Aug. 7, 2020, PDF

Out-of-network Claims Payment Policy update – Aug. 1, 2020, PDF

Medicaid and CHIP Provider Relief Fund application deadline extended to Aug. 3, 2020 – July 31, 2020, PDF

Provider Relief Fund for Medicaid and CHIP distribution webinar – July 8, 2020, PDF

Timely filing change – July 1, 2020 , PDF

Humana Urine Drug Testing (UDT) Policy – July 1, 2020, PDF

Urine Drug Testing Policy from KDMS – July 1, 2020, PDF

Kentucky New Horizon provider newsletter

Current edition of the Kentucky New Horizon provider newsletter, PDF

Previous editions of the Kentucky New Horizon provider newsletter, PDF