107 KAR 1:040. Cooperation with Kentucky Medical Assistance Act.

 

      RELATES TO: KRS 346.130(3), 346.140(1)(b), (c), 205.510-205.630

      STATUTORY AUTHORITY: KRS 346.040

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 346.130(3) authorizes the Crime Victims Compensation Board to make awards to crime victims for medical or other services necessary as a result of the injury on which the claim is based. KRS 346.140(1) requires that any award made shall be reduced by certain amounts, including (b) any payments received or to be received by the claimant as a result of the injury under insurance programs mandated by law and (c) from public funds. The purpose of KRS 205.510 through 205.630 (known as the "Medical Assistance Act") is to provide medical care to Kentucky's indigent citizenry as an essential function, duty or responsibility of the state government. This administrative regulation sets out the manner in which the Kentucky Medical Assistance Plan in the Cabinet for Human Resources and the Crime Victims Compensation Board will cooperate so as to avoid any possible overlap or duplication in payments to crime victims who are Medicaid-eligibles.

 

      Section 1. The following provisions will govern the manner in which the Kentucky Medical Assistance Plan in the Cabinet for Human Resources and the Crime Victims Compensation Board will work together so as to avoid any possible overlap or duplication in payments to crime victims who are Medicaid-eligibles.

      (1) A copy of every claim form filed with the board shall be sent to the Kentucky Medical Assistance Program (KMAP), Cabinet for Human Resources;

      (2) The KMAP will determine which crime victims are covered under that program and so advise the board;

      (3) For victims who are covered by Medical Assistance, the board will provide the KMAP staff with a list of all itemized medical charges for which the victim seeks compensation;

      (4) The KMAP will notify the board which services are covered;

      (5) The board, or any board member, in making an award to a Medicaid-eligible victim will exclude from consideration for such award any medical bill submitted by or on behalf of a Medicaid-eligible crime victim for any procedure covered under the KMAP; and

      (6) In the event the board should make an award to a victim who is an eligible Medical Assistance recipient for a KMAP-covered service, the KMAP, as final payor, will not be responsible for the payment of any portion of that claim. (11 Ky.R. 665; eff. 11-13-84.)