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.)