KRS § 205.513 Eligibility determinations and redeterminations.
The cabinet must redetermine certain Medicaid eligibility cases every six months starting January 1, 2027, review specified data sources, issue an appealable initial ineligibility finding in some cases, and decide eligibility for Medicaid-covered nonemergency medical transportation services.
205.513 Eligibility determinations and redeterminations. (1) Beginning January 1, 2027, the cabinet shall, in accordance with 42 U.S.C. sec. 1396a(e)(14)(L), conduct Medicaid eligibility redeterminations once every six (6) months for individuals who are: (a) Described in 42 U.S.C. sec. 1396a(e)(14)(L)(i)(I) and (II); and (b) Not exempted under 42 U.S.C. sec. 1396a(e)(14)(L)(ii). (2) When conducting eligibility determinations and redeterminations, including but not limited to redeterminations required under subsection (1) of this section, the cabinet shall: (a) Access and review information from all available federal and state data systems that may contain information related to eligibility for enrollment or continued enrollment in the Medicaid program, including but not limited to: 1. The Public Assistance Reporting Information System, or PARIS; 2. The Transformed Medicaid Statistical Information System, or T-MSIS; 3. The T-MSIS Analytic Files, or TAF; and 4. All data described in KRS 205.178; (b) Except as provided in KRS 205.200(11) and to the extent permitted under federal law, issue an initial finding of ineligibility that may be appealed by the individual through the cabinet's established appeals process if the cabinet finds or reviews inconsistent or contradictory data from the various data sources the cabinet is required to review under paragraph (a) of this subsection and any data source reflects that the individual whose eligibility is being determined or redetermined is ineligible to enroll in or continue to be enrolled in the Medicaid program; and (c) Assess and make a determination regarding the individual's eligibility for Medicaid-covered nonemergency medical transportation services. Effective: April 14, 2026 History: Created 2026 Ky. Acts ch. 179, sec. 5, effective April 14, 2026.