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KRS 205.632

Pilot project to create coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or community action agency

Effective: July 15, 2016 History: Created 2016 Ky

(1) As used in this section:

(a) "Department" means the Department for Medicaid Services;

(b) "Evidence-based best practices" means the integration of the best available research with clinical expertise in the context of patient characteristics and patient and family caregiver preferences;

(c) "Qualified medical provider" means a credentialed and enrolled Medicaid- participating healthcare provider, hospital, rural health center, or licensed home health agency as defined in KRS 216.935; and (d) "Telemonitoring services" means services that require scheduled remote monitoring of data related to a patient's health where the monitoring is conducted at the patient's place of residence or other site determined by the department.

(2) Not later than July 1, 2017, the department shall establish a pilot project in which it creates coverage provisions and reimbursement criteria for telemonitoring services based on evidence-based best practices provided by a qualified medical provider or a community action agency as defined in KRS 273.410.

(3) In order to effectuate the pilot project, the department may:

(a) Submit a state plan amendment, waiver, or waiver amendment for approval to the Centers for Medicare and Medicaid Services in order to provide coverage for medically necessary telemonitoring services performed for a Medicaid beneficiary;

(b) Request funding from the General Assembly to support telemonitoring services rendered by a qualified medical provider or a community action agency under this section;

(c) Ensure that clinical information gathered by a qualified medical provider or a community action agency while providing telemonitoring services is shared with the patient's treating health care professionals; and (d) Promulgate administrative regulations in accordance with KRS Chapter 13A for the implementation and administration of this section.

Official source: Kentucky General Assembly. Reproduced from public-domain Kentucky statutes; confirm against the official source for the current text. Not legal advice.