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 (KDMS). 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.

Network notices

2022

Appropriate billing for annual sports physical exams, 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

Provider guidance for anesthesia modifier billing from KDMS – 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 – Jun. 21, 2022, PDF

Substance use disorder (SUD) inpatient and residential services prior authorization (PA) reinstatement – Jun. 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 KDMS – 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