Kentucky Administrative Regulations › Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES › Chapter 3 - Payment and Services › Section 907 KAR 3:160 - Specialized children's services clinics

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				205.557(1)(c),
				205.560,
				314.011(14),
				620.020(4),
				620.050
NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Health and
				Family Services, Department for Medicaid Services has responsibility to
				administer the Medicaid program.
				KRS
				205.520(3) authorizes the
				cabinet, by administrative regulation, to comply with a requirement that may be
				imposed, or opportunity presented, by federal law for the provision of medical
				assistance to Kentucky's indigent citizenry. This administrative regulation
				establishes the requirements for providers and reimbursement by the Medicaid
				program for services provided by a specialized children's services
				clinic.
Section 1. Definitions.
(1) "Affiliation agreement" means a written
			 agreement between a provider and a children's advocacy center to perform a
			 child medical evaluation.
(2)
			 "Approved behavioral health practitioner" means an independently licensed
			 practitioner who is:
(a) A
			 physician;
(b) A
			 psychiatrist;
(c) An advanced
			 practice registered nurse;
(d) A
			 physician assistant;
(e) A licensed
			 psychologist;
(f) A licensed
			 psychological practitioner;
(g) A
			 certified psychologist with autonomous functioning;
(h) A licensed clinical social
			 worker;
(i) A licensed professional
			 clinical counselor;
(j) A licensed
			 marriage and family therapist;
(k)
			 A licensed professional art therapist;
(l) A licensed clinical alcohol and drug
			 counselor; or
(m) A licensed
			 behavior analyst.
(3)
			 "Approved behavioral health practitioner under supervision" means an individual
			 under billing supervision of an approved behavioral health practitioner who is:
(a)
1. A
			 licensed psychological associate working under the supervision of a
			 board-approved licensed psychologist;
2. A certified psychologist working under the
			 supervision of a board-approved licensed psychologist;
3. A marriage and family therapy
			 associate;
4. A certified social
			 worker;
5. A licensed professional
			 counselor associate;
6. A licensed
			 professional art therapist associate;
7. A licensed clinical alcohol and drug
			 counselor associate;
8. A certified
			 alcohol and drug counselor; or
9. A
			 licensed assistant behavior analyst; and
(b) Employed by or under contract with the
			 same billing provider as the billing supervisor.
(4) "Child medical evaluation" is defined by
			 KRS
			 205.557(1)(c).
(5) "Children's advocacy center" is defined
			 in KRS
			 620.020(4).
(6) "Department" means the Department for
			 Medicaid Services or its designated agent.
(7) "Medically necessary" or "medical
			 necessity" means that a covered benefit is determined to be needed in
			 accordance with
			 907 KAR 3:130.
(8) "Sexual assault nurse examiner" or "SANE"
			 is defined in KRS
			 314.011(14).
(9) "Specialized children's services clinic"
			 means a clinic enrolled with the Kentucky Medicaid program that provides child
			 medical evaluations and that meets the requirements of Section 3 of this
			 administrative regulation.