Kentucky Medicaid Prior Authorization Guidance Extended through April 30, 2021.

The Cabinet for Health and Family Services Department of Medicaid Services extended the guidance regarding prior authorizations that was initially effective February 1, 2021.  Medicaid Fee-for-Service (FFS) and Managed Care Organizations (MCOs) will not require prior authorizations (PAs) for all inpatient Medicaid services provided by Kentucky Medicaid enrolled inpatient hospitals.  Additionally, FFS and MCOs will not require PAs for Medicaid covered substance use and behavioral health services.  PAs may still be required for outpatient and other Medicaid services, except for individuals with a COVID diagnosis.  This guidance will remain in effect through April 30, 2021.  DMS will re-evaluate this guidance at the end of March and will give 30 days’ notice of any changes.