Kentucky Administrative Regulations Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES
Here’s a refined overview of Kentucky Administrative Regulations Title 907 — the Cabinet for Health and Family Services, Department for Medicaid Services:
📘 Title 907 Organization & Status
According to the official Kentucky legislature site, Title 907 is divided into multiple chapters, each focusing on a distinct Medicaid-related program or service area. Key chapters and their latest revision dates are:
Chapter 1 – Medicaid Services (various sections; last updated June 17, 2025) (apps.legislature.ky.gov)
Chapter 3 – Payment and Services (e.g., physician payment, telehealth) – last updated June 23, 2025 (apps.legislature.ky.gov)
Chapter 4 – Kentucky Children's Health Insurance Program – last updated March 12, 2025 (apps.legislature.ky.gov)
Chapter 5 – Program Integrity – last updated December 15, 2021 (apps.legislature.ky.gov)
Chapter 6 – Electronic Health Record Incentive Payments – last updated February 13, 2025 (apps.legislature.ky.gov)
Chapter 7 – Certified Provider Requirements – last updated June 17, 2025 (apps.legislature.ky.gov)
Chapter 8 – Occupational, Physical & Speech Therapy – last updated March 12, 2025 (apps.legislature.ky.gov)
Chapter 9 – Psychiatric Residential Treatment Facility Services – last updated March 12, 2025 (apps.legislature.ky.gov)
Chapter 10 – Hospital Service Coverage & Reimbursement – last updated June 17, 2025 (apps.legislature.ky.gov)
Chapter 11 – Early and Periodic Screening (EPSDT) – last updated March 12, 2025 (apps.legislature.ky.gov)
Chapter 12 – Supports for Community Living Waiver – last updated May 30, 2025 (apps.legislature.ky.gov)
Chapter 13 – Private Duty Nursing – last updated March 12, 2025 (apps.legislature.ky.gov)
Chapter 14 – Healthcare-Acquired Conditions & Provider Preventable Conditions – last updated February 13, 2025 (apps.legislature.ky.gov)
Chapter 15 – Behavioral Health – last updated March 28, 2025 (apps.legislature.ky.gov)
Chapter 16 – HCBS 1915(i) State Plan Initiatives – Proposed, latest update July 1, 2025 (apps.legislature.ky.gov)
Chapter 17 – Managed Care – last updated March 26, 2025 (apps.legislature.ky.gov)
Chapter 18 – Veterans Affairs Nursing Facilities – last updated December 15, 2021 (apps.legislature.ky.gov)
Chapter 20 – Medicaid Eligibility – last updated May 30, 2025 (apps.legislature.ky.gov)
Chapter 23 – Outpatient Pharmacy Program – last updated March 12, 2025 (apps.legislature.ky.gov)
🔍 Key Features in Selected Chapters
Chapter 1 – Medicaid Services
This extensive chapter includes sections covering provider participation, payment rules for services like ambulatory surgery, home health, pediatric facilities, organ transplants, hearing/vision, vaccination, hospice, cost-sharing prohibition, appeals, and more (regulations.justia.com).
Chapter 3 – Payment & Services
Details on physician reimbursement, supplemental primary care payments, telehealth coverage, non-emergency transport, brain injury waivers, tobacco cessation, emergency/suspended services during emergencies, and more (regulations.justia.com).
Chapter 11 – EPSDT (Early & Periodic Screening)
Section 907 KAR 11:034 outlines EPSDT requirements: definitions, screening protocols, diagnostic/treatment coverage (including "by report"), provider participation, prior authorization, and appeal procedure. It emphasizes medically necessary special services for Medicaid-eligible children under 21 (apps.legislature.ky.gov).
Chapter 17 – Managed Care
Regulation 907 KAR 17:020 mandates that MCOs cover all Title 907 services (except certain exceptions like some nursing facility care), allows select services without referral (e.g., vision, dental, family planning, behavioral health), and requires continuity when transferring enrollees (alfboss.com).
Chapter 1 (Section 1:604) – No Cost-sharing
Section 907 KAR 1:604 explicitly prohibits any cost-sharing or copayments by recipients or providers within Medicaid and managed care entities (law.cornell.edu).
✅ How to Access Full Texts
Kentucky Legislature (official): Provides full text for each chapter and regulation; best for the latest version.
Cornell/LII: Offers handy navigation by chapter and section (law.cornell.edu).
Justia / Casetext: Public archives (may not reflect the very latest updates) (casetext.com).
🔄 Summary
Title 907 offers a comprehensive regulatory foundation for Medicaid services in Kentucky. It spans coverage policies, provider rules, payment systems, managed care frameworks, program integrity, and pediatric care mandates. Most chapters were updated through mid‑2025—highlighting ongoing adjustments in Medicaid policy.
📌 Next Steps
Let me know if you'd like:
Deep dives into a specific section (e.g., telehealth, EPSDT requirements, managed care rules)
Access to full regulation text or recent amendments
Comparison of proposed Chapter 16 changes vs. current policy
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