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. (1) As used in this section: (a) (b) (c) (d) "Department" means the Department for Medicaid Services; "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; "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 "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. Effective: July 15, 2016 History: Created 2016 Ky. Acts ch. 126, sec. 1, effective July 15, 2016.
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