UNOFFICIAL COPY 23 RS BR 1128
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AN ACT relating to Medicaid coverage for assisted living. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
ď˘Section 1. (1) The Department for Medicaid Services is hereby directed to, 3
no later than November 1, 2023, prepare and submit an application to the federal Centers 4
for Medicare and Medicaid Services for a Medicaid state plan amendment to establish an 5
assisted living community services option in the Commonwealth's Medicaid state plan. 6
(2) The Medicaid state plan amendment required by this section shall: 7
(a) At a minimum, provide coverage and financial support for personal care 8
assistance provided a Medicaid beneficiary in an assisted living community that has been 9
financed as such through the Kentucky Housing Corporation with low-income housing 10
tax credits awarded under Section 42 of the Internal Revenue Code; 11
(b) Require that an individual receive a clinical assessment for the purpose of 12
determining the most appropriate level of care for that individual before the individual 13
begins receiving Medicaid covered services in either a skilled nursing facility or an 14
assisted living community; 15
(c) Permit the Department for Medicaid Services or a managed care organization 16
with whom the department has contracted for the delivery of Medicaid Services to deny 17
coverage for skilled nursing facility care or assisted living care if the level of care to be 18
delivered in inconsistent with the individual's needs as determined by the clinical 19
assessment required by paragraph (b) of this subsection; 20
(d) To the extent permitted under federal law, provide coverage and financial 21
support for room and board expenses incurred by a Medicaid beneficiary in an assisted 22
living community; and 23
(e) Include a daily reimbursement rate for assisted living community services, 24
including personal care assistance, equal to no less than 50% of the otherwise applicable 25
reimbursement rate for skilled nursing facilities. 26
(3) No later than November 1, 2023, the Department for Medicaid Services shall 27 UNOFFICIAL COPY 23 RS BR 1128
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submit a copy of the state plan amendment application required by this section to the 1
Legislative Research Commission for referral to the committee or committees of 2
appropriate jurisdiction. 3