KY NEMT 1915(b) Approval Letter.pdf

DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Services

7500 Security Boulevard, Mail Stop S2-26-12

Baltimore, Maryland 21244-1850

Managed Care Group

March 28, 2025

Lisa Lee

Commissioner

Kentucky Department for Medicaid Services

275 East Main Street, 6WA

Frankfort, KY 40621-0001

Re: Kentucky 1915(b) Waiver KY-0006.R05.00

Dear Commissioner Lee:

We are writing to inform you that the Centers for Medicare & Medicaid Services (CMS) is approving Kentucky’s request to Renew its 1915(b) Waiver, CMS control number KY-

0006.R05.00 titled Human Service Transportation Delivery Program. This waiver allows

Kentucky to provide non-emergency transportation (NEMT) services to eligible Medicaid beneficiaries. This 1915(b) waiver is authorized under sections 1915(b)(1) and 1915(b)(4) of the

Social Security Act (the Act) and provides a waiver of the following section of Title XIX:

• Section 1902(a)(1) Statewideness

• Section 1902(a)(10)(B) Comparability

• Section 1902(a)(23) Freedom of Choice

Our decision on the 1915(b) waiver is based on the evidence submitted to CMS demonstrating that the state’s proposal is consistent with the purposes of the Medicaid program, will meet all statutory and regulatory requirements for assuring beneficiaries’ access to and quality of services, and will be a cost-effective means of providing services to those beneficiaries in

Kentucky’s Medicaid population.

This 1915(b) waiver is effective for a two year period beginning April 1, 2025 through March

31, 2027. The state may request renewal of this authority by providing evidence and documentation of satisfactory performance and oversight. Kentucky’s request that this authority be renewed should be submitted to CMS no later than January 1, 2027.

Kentucky will be responsible for documenting the applicable cost-effectiveness and quality in subsequent renewal requests for this authority. On a quarterly basis, the state is required to submit to CMS the previous quarter’s member months by approved MEG on the attached

“1915(b) Worksheet for State Reporting of Member Months.” The report is due 30 days after the end of each quarter and should be submitted to the DMCO Actions mailbox, MCGDMCOActions@cms.hhs.gov. The State should also conduct its own quarterly calculations

Commissioner Lee letter using Tab D6 of the approved 1915(b) Waiver Cost Effectiveness Worksheets and request an amendment to the waiver should the State discover the waiver’s actual costs are exceeding projections. Additionally, the State must submit a waiver amendment to reflect any major changes impacting the program, including changes in waivers/statutory authority needed, type/number of delivery systems, geographic areas, populations, services, quality/access, monitoring plan.

If you have any questions regarding the 1915(b) waiver, please contact Elizabeth Lazzaro at

(410) 786-8759 or via email at Elizabeth.Lazzaro@cms.hhs.gov.

Sincerely, Trina Roberts

Managed Care Group cc: Justin Dearinger, Division of Health Care Policy, KY

Eddie Newsome, Division of Health Care Policy, KY

Becky Downey, Division of Health Care Policy, KY

Sidney Staton, Financial Management Group, CMS

Barbara Dasheiff, Financial Management Group, CMS

Enclosure: 1915(b) Worksheet for State Reporting of Member Months file:///C:/Box/Box/DMCO/Branch%20C/KY/1915(b)/KY%2006%20Kentucky%20HSTD%20(NEMT)/KY-0006.R05.00/Approval/Approved%20Action/Elizabeth.Lazzaro@cms.hhs.gov