Page 1 of 1 205.634 Payments prohibited to out-of-state health facility providing services without required certificate of need -- Nonreimbursement of out-of-state <br>providers of residential care for children -- Exception -- Administrative <br>regulations. (1) No medical assistance payments shall be made under this chapter to any out-of-state health facility or health service providing services within the geographic boundaries <br>of the Commonwealth who does not have a certificate of need if the health facility <br>or health service would be required to obtain a certificate of need under KRS <br>Chapter 216B if the facility or service were located within the geographic <br>boundaries of the Commonwealth. (2) The Department for Medicaid Services and the Department for Community Based Services shall not reimburse an out-of-state provider of residential care for children <br>whose care is paid by state general funds or state administered federal funds, unless <br>the Department for Medicaid Services or the Department for Community Based <br>Services or a designated agent thereof has determined that there is no provider <br>within the Commonwealth that is capable and willing to provide comparable <br>services at a comparable cost per child to those that would be delivered by the out-<br>of-state provider. An exception may be made if: <br>(a) The identified in-state resource is farther away from the child's parent or guardian than a similar out-of-state resource; or (b) The services offered by the out-of-state resource is deemed by either department or a designated agent thereof to be more appropriate for the <br>individual child than the services offered by the in-state provider. (3) Prior to promulgating administrative regulations governing the determination of the availability of providers of residential care within the Commonwealth, the <br>Department for Medicaid Services and the Department for Community Based <br>Services shall establish uniform conditions, requirements, and exceptions for the <br>determination of the availability of providers of residential care within the <br>Commonwealth. (4) Each department shall promulgate an administrative regulation in accordance with KRS Chapter 13A that contains the uniform conditions, requirements, and <br>exceptions for the determination of the availability of providers of residential care <br>within the Commonwealth established under subsection (3) of this section. Effective: July 14, 2000 <br>History: Amended 2000 Ky. Acts ch. 14, sec. 35, effective July 14, 2000. -- Amended 1998 Ky. Acts ch. 527, sec. 5, effective July 15, 1998. -- Created 1996 Ky. Acts <br>ch. 371, sec. 35, effective July 15, 1996.
Page 1 of 1 205.634 Payments prohibited to out-of-state health facility providing services without required certificate of need -- Nonreimbursement of out-of-state <br>providers of residential care for children -- Exception -- Administrative <br>regulations. (1) No medical assistance payments shall be made under this chapter to any out-of-state health facility or health service providing services within the geographic boundaries <br>of the Commonwealth who does not have a certificate of need if the health facility <br>or health service would be required to obtain a certificate of need under KRS <br>Chapter 216B if the facility or service were located within the geographic <br>boundaries of the Commonwealth. (2) The Department for Medicaid Services and the Department for Community Based Services shall not reimburse an out-of-state provider of residential care for children <br>whose care is paid by state general funds or state administered federal funds, unless <br>the Department for Medicaid Services or the Department for Community Based <br>Services or a designated agent thereof has determined that there is no provider <br>within the Commonwealth that is capable and willing to provide comparable <br>services at a comparable cost per child to those that would be delivered by the out-<br>of-state provider. An exception may be made if: <br>(a) The identified in-state resource is farther away from the child's parent or guardian than a similar out-of-state resource; or (b) The services offered by the out-of-state resource is deemed by either department or a designated agent thereof to be more appropriate for the <br>individual child than the services offered by the in-state provider. (3) Prior to promulgating administrative regulations governing the determination of the availability of providers of residential care within the Commonwealth, the <br>Department for Medicaid Services and the Department for Community Based <br>Services shall establish uniform conditions, requirements, and exceptions for the <br>determination of the availability of providers of residential care within the <br>Commonwealth. (4) Each department shall promulgate an administrative regulation in accordance with KRS Chapter 13A that contains the uniform conditions, requirements, and <br>exceptions for the determination of the availability of providers of residential care <br>within the Commonwealth established under subsection (3) of this section. Effective: July 14, 2000 <br>History: Amended 2000 Ky. Acts ch. 14, sec. 35, effective July 14, 2000. -- Amended 1998 Ky. Acts ch. 527, sec. 5, effective July 15, 1998. -- Created 1996 Ky. Acts <br>ch. 371, sec. 35, effective July 15, 1996.
Page 1 of 1 205.634 Payments prohibited to out-of-state health facility providing services without required certificate of need -- Nonreimbursement of out-of-state <br>providers of residential care for children -- Exception -- Administrative <br>regulations. (1) No medical assistance payments shall be made under this chapter to any out-of-state health facility or health service providing services within the geographic boundaries <br>of the Commonwealth who does not have a certificate of need if the health facility <br>or health service would be required to obtain a certificate of need under KRS <br>Chapter 216B if the facility or service were located within the geographic <br>boundaries of the Commonwealth. (2) The Department for Medicaid Services and the Department for Community Based Services shall not reimburse an out-of-state provider of residential care for children <br>whose care is paid by state general funds or state administered federal funds, unless <br>the Department for Medicaid Services or the Department for Community Based <br>Services or a designated agent thereof has determined that there is no provider <br>within the Commonwealth that is capable and willing to provide comparable <br>services at a comparable cost per child to those that would be delivered by the out-<br>of-state provider. An exception may be made if: <br>(a) The identified in-state resource is farther away from the child's parent or guardian than a similar out-of-state resource; or (b) The services offered by the out-of-state resource is deemed by either department or a designated agent thereof to be more appropriate for the <br>individual child than the services offered by the in-state provider. (3) Prior to promulgating administrative regulations governing the determination of the availability of providers of residential care within the Commonwealth, the <br>Department for Medicaid Services and the Department for Community Based <br>Services shall establish uniform conditions, requirements, and exceptions for the <br>determination of the availability of providers of residential care within the <br>Commonwealth. (4) Each department shall promulgate an administrative regulation in accordance with KRS Chapter 13A that contains the uniform conditions, requirements, and <br>exceptions for the determination of the availability of providers of residential care <br>within the Commonwealth established under subsection (3) of this section. Effective: July 14, 2000 <br>History: Amended 2000 Ky. Acts ch. 14, sec. 35, effective July 14, 2000. -- Amended 1998 Ky. Acts ch. 527, sec. 5, effective July 15, 1998. -- Created 1996 Ky. Acts <br>ch. 371, sec. 35, effective July 15, 1996.
