Title 501 | Chapter 002 | Regulation 080E
501 KAR 2:080REG
A proposed version of this document exists.
STATEMENT OF EMERGENCY
501 KAR 2:080E
(1) This emergency administrative regulation is being promulgated pursuant to KRS 13A.190(1)(a)1. to meet an imminent threat to public health, safety, or welfare and (1)(a)2. to avoid an imminent loss of state funds. KRS 441.045(5)(a) requires the Department of Corrections (“DOC”) to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. In Campbell Cty., Kentucky, et al. v. Kentucky Dep’t of Corrections, et al., 23-CI-00068, the Franklin Circuit Court ruled that the Department’s definition of “routine care” under KRS 441.045 is inadequate. KRS 441.045(10) defines “necessary care,” but does not define “routine care.” This emergency administrative regulation adopts the statutory definition of “necessary care” and establishes additional definitions, including definitions of “routine care” and “care beyond routine”, criteria to distinguish routine care from care beyond routine, and processes for counties to seek reimbursement for care beyond routine and diagnostic services. This administrative regulation is being filed on an emergency basis to ensure the efficient provision of quality medical care to inmates and to avoid an imminent loss of state funds that would result from litigation costs that would occur if the changes created by the emergency administrative regulation do not immediately become effective.
(2)An ordinary administrative regulation is not sufficient because an ordinary regulation could not become effective before the need for routine care or care beyond routine of inmates arises and the state is exposed to litigation cost resulting from the Court’s finding that Department’s current definition is inadequate.
(3) This emergency administrative regulation will be replaced by an ordinary administrative regulation because the adopted definitions and criteria are new.
(4) The companion ordinary administrative regulation is identical to this emergency regulation.
(5) An emergency administrative regulation governing a portion of the same subject matter has not been filed within the previous nine months.
SCOTT JORDAN, Deputy Commissioner, on behalf of:
COOKIE CREWS, Commissioner
KEITH JACKSON, Secretary
ANDY BESHEAR, Governor
JUSTICE AND PUBLIC SAFETY CABINET
Department of Corrections
(New Emergency Administrative Regulation)
501 KAR 2:080E.Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.
Section 1.
Definitions(1)
(a)
"Care beyond routine" means necessary care that exceeds routine care due to the complexity, intensity, or specialization and requires resources not typically available through standard correctional or local outpatient care arrangements, including.1.
Inpatient hospitalization;2.
Emergency medical care requiring immediate transport and advanced intervention;3.
Surgical procedures, including outpatient surgery, that require general anesthesia, twilight sedation, or conscious sedation, or specialized surgical facilities or providers;4.
Specialty care requiring advanced or invasive treatment by specialists, including cardiology, oncology, neurology, or specialists in similar fields;5.
Dental treatment requiring specialized or extensive restorative, surgical, or other treatment that cannot reasonably be provided through routine dental services available within the correctional facility or through standard outpatient dental care;6.
Obstetrical or gynecological care requiring treatment or monitoring by a specialist for a diagnosed maternal or fetal condition that requires specialized testing, procedures, or a level of clinical monitoring beyond routine prenatal, postpartum, or gynecological care;7.
Advanced diagnostic services, including CT scans, MRIs, or other non-routine imaging or procedures;8.
High-cost or specialty pharmaceuticals, including biologics, chemotherapy agents, or medications requiring specialized administration or monitoring;9.
Long-term or intensive treatment, including dialysis, inpatient psychiatric care, or other services requiring sustained specialized intervention; and10.
Services that, based on professional clinical judgment, are not reasonably categorized as routine care under subsection (2) of this section.(b)
For purposes of this administrative regulation, services shall not be classified as care beyond routine solely because they were provided in an emergency department or hospital setting if, based on the clinical condition and treatment rendered, the care could have been safely and effectively provided within the jail or through standard outpatient services.(2)
"Diagnostic services" means medical testing and evaluation used to identify, assess, or monitor a medical condition, including laboratory testing, imaging, and other non-invasive assessments.(3)
"Necessary care" is defined in KRS 441.045(10).(a)
"Routine care" means necessary care that:1.
Is customary, predictable, and commonly provided within a correctional facility or through standard local outpatient providers;2.
Involves non-complex evaluation or treatment that does not require specialized facilities, advanced technology, or highly specialized providers; and3.
Can be delivered through standard correctional health care delivery systems, including on-site services or routinely accessible off-site outpatient services.(b)
Routine care includes:1.
Evaluation and treatment of minor or stable conditions, including infections, minor injuries, and common illnesses;2.
Chronic care management, including ongoing treatment of conditions such as hypertension, diabetes, asthma, or mental health conditions where the treatment does not require advanced or intensive intervention;3.
Outpatient medical, dental, and behavioral health services that are commonly available in the local community;4.
Prescription medications and medication management, excluding high-cost or specialty medications requiring specialized handling or authorization;5.
Basic diagnostic services, including laboratory testing and standard radiology such as X-rays; and6.
Follow-up care medically necessary based on the services described in this paragraph.(c)
Care shall not be classified as care beyond routine solely because:1.
The county or regional jail does not provide the service on site, its contracted healthcare provider does not offer the service, or the service is obtained from an outside provider; or2.
The county or regional jail's failure to timely provide routine care during the inmate's confinement resulted in the need for more extensive treatment that could reasonably have been prevented through timely provision of routine care.Section 2.
Reimbursement Criteria. For any state inmate held in the jail for which the county receives a per diem payment pursuant to KRS 532.100(7):(1)
Counties shall be responsible for the cost of routine care and diagnostic services.(2)
The Department shall reimburse counties for costs associated with necessary care beyond routine care and diagnostic services, consistent with KRS 441.045(5)(a).(3)
A county or regional jail seeking reimbursement under this administrative regulation shall submit a claim for reimbursement to the Department as follows:(a)
For reimbursement of costs associated with necessary care beyond routine and diagnostic services, a county or regional jail shall submit a Request for Authorization form as follows:1.
A county or regional jail shall submit a Request for Authorization form via email to the Department or its designated medical claims administrator at least seventy-two (72) hours before the medical service is scheduled, if feasible.2.
After receiving the Request for Authorization, the Department or its designated medical claims administrator will process and forward an appropriate claims billing form and authorization number to the county or regional jail point of contact.a.
Prior to submission for reimbursement, all claims shall be subject to repricing pursuant to KRS 441.045(14) by the Department or designated medical claims administrator.b.
No claim shall be eligible for reimbursement unless it has been repriced.3.
The county or regional jail shall be responsible for providing the Request for Authorization form to the outside provider when the patient is sent for medical services, when possible.4.
The outside provider shall deliver the approved medical services and send all qualified claims to the Department or its designated medical claims administrator for payment.(b)
For reimbursement of costs associated with necessary care beyond routine care and diagnostic services, when advanced authorization is not feasible, the county or regional jail shall submit the Request for Authorization form as soon as it becomes aware of the need for the necessary care beyond routine care and diagnostic services, and the claim shall be processed pursuant to this subsection of this administrative regulation.(c)
The Department may require documentation that the county or regional jail has paid, or is legally obligated to pay, the repriced amount prior to issuing reimbursement.(4)
The Department may deny or delay reimbursement for any claim that:(a)
Has not been properly repriced;(b)
Was submitted with an incomplete Request for Authorization form or a Request for Authorization form that lacks the required information; or(c)
Does not meet the criteria established in this administrative regulation.(5)
The Department may, at its discretion, take custody of a prisoner and hold that person in a state prison facility for the purpose of treating the medical conditions as set out in KRS 441.560.Section 3.
Review and Dispute Resolution.(1)
The Department shall review each submitted claim and issue a written determination approving, denying, or modifying the requested reimbursement.(2)
A county or regional jail may request reconsideration of a determination by submitting a written request to the Department within thirty (30) calendar days of the date the determination was issued. The request shall:(a)
Identify the specific claim or portion of the claim in dispute;(b)
State the basis for reconsideration, including any argument that the care qualifies as care beyond routine that is medically necessary; and(c)
Include any additional supporting documentation not previously submitted.(3)
The Department shall review the request for reconsideration and any additional documentation submitted.(a)
The Department may request additional information from the county or regional jail as necessary to complete its review.(b)
The Department shall issue a written reconsideration decision within forty-five (45) calendar days of receipt of a complete request.(4)
The reconsideration decision shall constitute the Department's final agency action.Section 4.
Incorporation by Reference.(1)
"Request for Authorization," revised in August 2026, is incorporated by reference.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Justice and Public Safety Cabinet, Office of Legal Services, 125 Holmes Street, 2nd Floor, Frankfort, Kentucky 40601, phone (502) 564-3279, fax (502) 564-6686, Monday through Friday, 8 a.m. to 4:30 p.m. This material may be viewed on the Justice and Public Safety Cabinet website at https://justice.ky.gov/about/pages/lrcfilings.aspx.501 KAR 2:080E. Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.
SCOTT JORDAN, Deputy Commissioner, on behalf of:
COOKIE CREWS, Commissioner
APPROVED BY AGENCY: August 16, 2026
FILED WITH LRC: August 17, 2026 at 2:30 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this emergency administrative regulation shall be held Tuesday, October 27, 2026, at 9:00 a.m. at the Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until October 31, 2026. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Nathan Goens, Deputy General Counsel, Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601, phone (502) 564-8216, fax (502) 564-6686, email Justice.RegsContact@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Nathan Goens, Deputy General Counsel Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601 Phone: (502) 564-3279 Email: Justice.RegsContact@ky.gov
Subject Headings:
Corrections and Correctional Facilities, Prisons, Crimes and Punishments
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 441.045(5)(a) requires the Department of Corrections to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. KRS 197.020(1)(b)2. requires the Department to promulgate administrative regulations for the preservation of the health of prisoners. KRS 441.045(10) defines “necessary care.” This administrative regulation adopts the statutory definition, establishes additional definitions and criteria to distinguish routine care from care beyond routine, and creates a process for which counties can seek reimbursement for beyond routine care and diagnostic services, ensuring consistent application and alignment with legislative intent.
(b) The necessity of this administrative regulation:
This administrative regulation is needed to provide clarity to counties regarding when they can seek reimbursement for beyond routine care and diagnostic services.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 441.045(5)(a) requires the Department of Corrections to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. KRS 197.020(1)(b)2. requires the Department to promulgate administrative regulations for the preservation of the health of prisoners. KRS 196.035 gives authority to promulgate administrative regulations necessary or suitable for the proper administration of the functions of the cabinet or any division in the cabinet.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation will provide clarity to counties regarding when they can seek reimbursement for beyond routine care and diagnostic services.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This is a new regulation.
(b) The necessity of the amendment to this administrative regulation:
This is a new regulation.
(c) How the amendment conforms to the content of the authorizing statutes:
This is a new regulation.
(d) How the amendment will assist in the effective administration of the statutes:
This is a new regulation.
(3) Does this administrative regulation or amendment implement legislation from the previous five years?
No
(4) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This affects approximately 74 county and regional jails that house state inmates and their staff, approximately 50 Department of Corrections’ employees, including 12 Local Facilities staff, and approximately 7,000 state inmates in the jails.
(5) Provide an analysis of how the entities identified in question (4) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (4) will have to take to comply with this administrative regulation or amendment:
The Department of Corrections will be required to review claims submitted by counties for reimbursement of necessary medical, dental, or psychological care beyond routine care and diagnostic services for state inmates housed in county and regional jails. County and regional jails that seek reimbursement will be required to submit complete claim packets in the manner prescribed by the Department. Before submitting claims for reimbursement, counties must submit the claims to a Department-designated medical claims administrator or other authorized entity for repricing pursuant to KRS 441.045(14). Counties must also provide required repricing forms or equivalent documentation and may be required to provide documentation showing that the county has paid, or is legally obligated to pay, the repriced amount. State inmates housed in county and regional jails will not be required to take any action to comply with this administrative regulation. The regulation governs reimbursement responsibilities between counties and the Department of Corrections and does not impose compliance obligations on inmates.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (4):
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services for state inmates housed in county and regional jails. County and regional jails may incur minimal, incidental administrative costs associated with preparing claim, obtaining repricing, and submitting required documentation for reimbursement. The regulation does not require counties to provide new categories of medical care; rather, it clarifies which medical costs remain the county’s responsibility as routine care and diagnostic services and which costs may be submitted to the Department for reimbursement as care beyond routine care and diagnostic services. State inmates housed in county and regional jails will not incur any cost to comply with this administrative regulation because the regulation does not require action by inmates and does not establish or increase any fee charged to inmates. The regulation addresses reimbursement between counties and the Department of Corrections for certain medical costs.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (4):
The regulation will allow for the efficient provision of quality medical care to inmates and for greater clarity for the Department of Corrections and county and regional jails as to what types of medical care for which the Department is responsible to counties for reimbursement.
(6) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
$12,000,000
(b) On a continuing basis:
$12,500,000 - $13,000,000 (7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: State general funds
(7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation or this amendment:
(8) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
An increase in funding will be necessary.
(9) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
The regulation does not establish, directly or indirectly, any fees.
(10) TIERING: Is tiering applied?
No. Tiering was not appropriate in this administrative regulation because the administrative regulation applies equally to all those individuals or entities regulated by it.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation:
. KRS 196.035, KRS 197.020
(2) State whether this administrative regulation is expressly authorized by an act of the General Assembly, and if so, identify the act:
Yes, KRS 196.035 and 197.020 expressly authorize the Department to promulgate this administrative regulation.
(3)(a) Identify the promulgating agency and any other affected state units, parts, or divisions:
Department of Corrections
(b) Estimate the following for each affected state unit, part, or division identified in (3)(a):
1. Expenditures:
For the first year:
$12,000,000
For subsequent years:
$12,500,000 - $13,000,000
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
0
For subsequent years:
0
(4)(a) Identify affected local entities (for example: cities, counties, fire departments, school districts):
This regulation will affect 74 county and regional jails that house state inmates and their staff.
(b) Estimate the following for each affected local entity identified in (4)(a):
1. Expenditures:
For the first year:
0
For subsequent years:
0
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
$12,000,000
For subsequent years:
$12,500,000 - $13,000,000
(5)(a) Identify any affected regulated entities not listed in (3)(a) or (4)(a):
This regulation will affect approximately 7,000 inmates in the jails.
(b) Estimate the following for each regulated entity identified in (5)(a):
1. Expenditures:
For the first year:
0
For subsequent years:
0
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
0
For subsequent years:
0
(6) Provide a narrative to explain the following for each entity identified in (3)(a), (4)(a), and (5)(a)
(a) Fiscal impact of this administrative regulation:
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,500,000 - $13,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services provided to state inmates housed in county and regional jails. County and regional jails may receive additional reimbursement from the Department for qualifying care beyond routine care and diagnostic services. State inmates housed in county and regional jails will not experience a fiscal impact from this administrative regulation. (b) Methodology and resources used to determine the fiscal impact: The fiscal cost estimate is based on claims processed at the Medicaid rate in FY23 through FY25 on behalf of jails by the Department’s medical contractor. Please note that the estimates are dependent on the number of states inmates housed in county and regional jails each year.
(b) Methodology and resources used to reach this conclusion:
(7) Explain, as it relates to the entities identified in (3)(a), (4)(a), and (5)(a):
(a) Whether this administrative regulation will have a "major economic impact", as defined by KRS 13A.010(14):
Yes
(b) The methodology and resources used to reach this conclusion:
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,000,000 to $13,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services provided to state inmates housed in county and regional jails in the first year, with increasing payments in subsequent years. Cost estimate exceeds $500,000 per year, so the regulation will have a “major economic impact.”501 KAR 2:080E. Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.
STATEMENT OF EMERGENCY
501 KAR 2:080E
(1) This emergency administrative regulation is being promulgated pursuant to KRS 13A.190(1)(a)1. to meet an imminent threat to public health, safety, or welfare and (1)(a)2. to avoid an imminent loss of state funds. KRS 441.045(5)(a) requires the Department of Corrections (“DOC”) to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. In Campbell Cty., Kentucky, et al. v. Kentucky Dep’t of Corrections, et al., 23-CI-00068, the Franklin Circuit Court ruled that the Department’s definition of “routine care” under KRS 441.045 is inadequate. KRS 441.045(10) defines “necessary care,” but does not define “routine care.” This emergency administrative regulation adopts the statutory definition of “necessary care” and establishes additional definitions, including definitions of “routine care” and “care beyond routine”, criteria to distinguish routine care from care beyond routine, and processes for counties to seek reimbursement for care beyond routine and diagnostic services. This administrative regulation is being filed on an emergency basis to ensure the efficient provision of quality medical care to inmates and to avoid an imminent loss of state funds that would result from litigation costs that would occur if the changes created by the emergency administrative regulation do not immediately become effective.
(2)An ordinary administrative regulation is not sufficient because an ordinary regulation could not become effective before the need for routine care or care beyond routine of inmates arises and the state is exposed to litigation cost resulting from the Court’s finding that Department’s current definition is inadequate.
(3) This emergency administrative regulation will be replaced by an ordinary administrative regulation because the adopted definitions and criteria are new.
(4) The companion ordinary administrative regulation is identical to this emergency regulation.
(5) An emergency administrative regulation governing a portion of the same subject matter has not been filed within the previous nine months.
SCOTT JORDAN, Deputy Commissioner, on behalf of:
COOKIE CREWS, Commissioner
KEITH JACKSON, Secretary
ANDY BESHEAR, Governor
JUSTICE AND PUBLIC SAFETY CABINET
Department of Corrections
(New Emergency Administrative Regulation)
501 KAR 2:080E.Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.
Section 1.
Definitions(1)
(a)
"Care beyond routine" means necessary care that exceeds routine care due to the complexity, intensity, or specialization and requires resources not typically available through standard correctional or local outpatient care arrangements, including.1.
Inpatient hospitalization;2.
Emergency medical care requiring immediate transport and advanced intervention;3.
Surgical procedures, including outpatient surgery, that require general anesthesia, twilight sedation, or conscious sedation, or specialized surgical facilities or providers;4.
Specialty care requiring advanced or invasive treatment by specialists, including cardiology, oncology, neurology, or specialists in similar fields;5.
Dental treatment requiring specialized or extensive restorative, surgical, or other treatment that cannot reasonably be provided through routine dental services available within the correctional facility or through standard outpatient dental care;6.
Obstetrical or gynecological care requiring treatment or monitoring by a specialist for a diagnosed maternal or fetal condition that requires specialized testing, procedures, or a level of clinical monitoring beyond routine prenatal, postpartum, or gynecological care;7.
Advanced diagnostic services, including CT scans, MRIs, or other non-routine imaging or procedures;8.
High-cost or specialty pharmaceuticals, including biologics, chemotherapy agents, or medications requiring specialized administration or monitoring;9.
Long-term or intensive treatment, including dialysis, inpatient psychiatric care, or other services requiring sustained specialized intervention; and10.
Services that, based on professional clinical judgment, are not reasonably categorized as routine care under subsection (2) of this section.(b)
For purposes of this administrative regulation, services shall not be classified as care beyond routine solely because they were provided in an emergency department or hospital setting if, based on the clinical condition and treatment rendered, the care could have been safely and effectively provided within the jail or through standard outpatient services.(2)
"Diagnostic services" means medical testing and evaluation used to identify, assess, or monitor a medical condition, including laboratory testing, imaging, and other non-invasive assessments.(3)
"Necessary care" is defined in KRS 441.045(10).(a)
"Routine care" means necessary care that:1.
Is customary, predictable, and commonly provided within a correctional facility or through standard local outpatient providers;2.
Involves non-complex evaluation or treatment that does not require specialized facilities, advanced technology, or highly specialized providers; and3.
Can be delivered through standard correctional health care delivery systems, including on-site services or routinely accessible off-site outpatient services.(b)
Routine care includes:1.
Evaluation and treatment of minor or stable conditions, including infections, minor injuries, and common illnesses;2.
Chronic care management, including ongoing treatment of conditions such as hypertension, diabetes, asthma, or mental health conditions where the treatment does not require advanced or intensive intervention;3.
Outpatient medical, dental, and behavioral health services that are commonly available in the local community;4.
Prescription medications and medication management, excluding high-cost or specialty medications requiring specialized handling or authorization;5.
Basic diagnostic services, including laboratory testing and standard radiology such as X-rays; and6.
Follow-up care medically necessary based on the services described in this paragraph.(c)
Care shall not be classified as care beyond routine solely because:1.
The county or regional jail does not provide the service on site, its contracted healthcare provider does not offer the service, or the service is obtained from an outside provider; or2.
The county or regional jail's failure to timely provide routine care during the inmate's confinement resulted in the need for more extensive treatment that could reasonably have been prevented through timely provision of routine care.Section 2.
Reimbursement Criteria. For any state inmate held in the jail for which the county receives a per diem payment pursuant to KRS 532.100(7):(1)
Counties shall be responsible for the cost of routine care and diagnostic services.(2)
The Department shall reimburse counties for costs associated with necessary care beyond routine care and diagnostic services, consistent with KRS 441.045(5)(a).(3)
A county or regional jail seeking reimbursement under this administrative regulation shall submit a claim for reimbursement to the Department as follows:(a)
For reimbursement of costs associated with necessary care beyond routine and diagnostic services, a county or regional jail shall submit a Request for Authorization form as follows:1.
A county or regional jail shall submit a Request for Authorization form via email to the Department or its designated medical claims administrator at least seventy-two (72) hours before the medical service is scheduled, if feasible.2.
After receiving the Request for Authorization, the Department or its designated medical claims administrator will process and forward an appropriate claims billing form and authorization number to the county or regional jail point of contact.a.
Prior to submission for reimbursement, all claims shall be subject to repricing pursuant to KRS 441.045(14) by the Department or designated medical claims administrator.b.
No claim shall be eligible for reimbursement unless it has been repriced.3.
The county or regional jail shall be responsible for providing the Request for Authorization form to the outside provider when the patient is sent for medical services, when possible.4.
The outside provider shall deliver the approved medical services and send all qualified claims to the Department or its designated medical claims administrator for payment.(b)
For reimbursement of costs associated with necessary care beyond routine care and diagnostic services, when advanced authorization is not feasible, the county or regional jail shall submit the Request for Authorization form as soon as it becomes aware of the need for the necessary care beyond routine care and diagnostic services, and the claim shall be processed pursuant to this subsection of this administrative regulation.(c)
The Department may require documentation that the county or regional jail has paid, or is legally obligated to pay, the repriced amount prior to issuing reimbursement.(4)
The Department may deny or delay reimbursement for any claim that:(a)
Has not been properly repriced;(b)
Was submitted with an incomplete Request for Authorization form or a Request for Authorization form that lacks the required information; or(c)
Does not meet the criteria established in this administrative regulation.(5)
The Department may, at its discretion, take custody of a prisoner and hold that person in a state prison facility for the purpose of treating the medical conditions as set out in KRS 441.560.Section 3.
Review and Dispute Resolution.(1)
The Department shall review each submitted claim and issue a written determination approving, denying, or modifying the requested reimbursement.(2)
A county or regional jail may request reconsideration of a determination by submitting a written request to the Department within thirty (30) calendar days of the date the determination was issued. The request shall:(a)
Identify the specific claim or portion of the claim in dispute;(b)
State the basis for reconsideration, including any argument that the care qualifies as care beyond routine that is medically necessary; and(c)
Include any additional supporting documentation not previously submitted.(3)
The Department shall review the request for reconsideration and any additional documentation submitted.(a)
The Department may request additional information from the county or regional jail as necessary to complete its review.(b)
The Department shall issue a written reconsideration decision within forty-five (45) calendar days of receipt of a complete request.(4)
The reconsideration decision shall constitute the Department's final agency action.Section 4.
Incorporation by Reference.(1)
"Request for Authorization," revised in August 2026, is incorporated by reference.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Justice and Public Safety Cabinet, Office of Legal Services, 125 Holmes Street, 2nd Floor, Frankfort, Kentucky 40601, phone (502) 564-3279, fax (502) 564-6686, Monday through Friday, 8 a.m. to 4:30 p.m. This material may be viewed on the Justice and Public Safety Cabinet website at https://justice.ky.gov/about/pages/lrcfilings.aspx.501 KAR 2:080E. Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.
SCOTT JORDAN, Deputy Commissioner, on behalf of:
COOKIE CREWS, Commissioner
APPROVED BY AGENCY: August 16, 2026
FILED WITH LRC: August 17, 2026 at 2:30 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this emergency administrative regulation shall be held Tuesday, October 27, 2026, at 9:00 a.m. at the Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until October 31, 2026. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Nathan Goens, Deputy General Counsel, Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601, phone (502) 564-8216, fax (502) 564-6686, email Justice.RegsContact@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Nathan Goens, Deputy General Counsel Justice and Public Safety Cabinet, 125 Holmes Street, Frankfort, Kentucky 40601 Phone: (502) 564-3279 Email: Justice.RegsContact@ky.gov
Subject Headings:
Corrections and Correctional Facilities, Prisons, Crimes and Punishments
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 441.045(5)(a) requires the Department of Corrections to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. KRS 197.020(1)(b)2. requires the Department to promulgate administrative regulations for the preservation of the health of prisoners. KRS 441.045(10) defines “necessary care.” This administrative regulation adopts the statutory definition, establishes additional definitions and criteria to distinguish routine care from care beyond routine, and creates a process for which counties can seek reimbursement for beyond routine care and diagnostic services, ensuring consistent application and alignment with legislative intent.
(b) The necessity of this administrative regulation:
This administrative regulation is needed to provide clarity to counties regarding when they can seek reimbursement for beyond routine care and diagnostic services.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 441.045(5)(a) requires the Department of Corrections to reimburse counties for the cost of “necessary medical, dental, or psychological care, beyond routine care and diagnostic services” for state inmates housed in county jails. KRS 197.020(1)(b)2. requires the Department to promulgate administrative regulations for the preservation of the health of prisoners. KRS 196.035 gives authority to promulgate administrative regulations necessary or suitable for the proper administration of the functions of the cabinet or any division in the cabinet.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation will provide clarity to counties regarding when they can seek reimbursement for beyond routine care and diagnostic services.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This is a new regulation.
(b) The necessity of the amendment to this administrative regulation:
This is a new regulation.
(c) How the amendment conforms to the content of the authorizing statutes:
This is a new regulation.
(d) How the amendment will assist in the effective administration of the statutes:
This is a new regulation.
(3) Does this administrative regulation or amendment implement legislation from the previous five years?
No
(4) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This affects approximately 74 county and regional jails that house state inmates and their staff, approximately 50 Department of Corrections’ employees, including 12 Local Facilities staff, and approximately 7,000 state inmates in the jails.
(5) Provide an analysis of how the entities identified in question (4) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (4) will have to take to comply with this administrative regulation or amendment:
The Department of Corrections will be required to review claims submitted by counties for reimbursement of necessary medical, dental, or psychological care beyond routine care and diagnostic services for state inmates housed in county and regional jails. County and regional jails that seek reimbursement will be required to submit complete claim packets in the manner prescribed by the Department. Before submitting claims for reimbursement, counties must submit the claims to a Department-designated medical claims administrator or other authorized entity for repricing pursuant to KRS 441.045(14). Counties must also provide required repricing forms or equivalent documentation and may be required to provide documentation showing that the county has paid, or is legally obligated to pay, the repriced amount. State inmates housed in county and regional jails will not be required to take any action to comply with this administrative regulation. The regulation governs reimbursement responsibilities between counties and the Department of Corrections and does not impose compliance obligations on inmates.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (4):
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services for state inmates housed in county and regional jails. County and regional jails may incur minimal, incidental administrative costs associated with preparing claim, obtaining repricing, and submitting required documentation for reimbursement. The regulation does not require counties to provide new categories of medical care; rather, it clarifies which medical costs remain the county’s responsibility as routine care and diagnostic services and which costs may be submitted to the Department for reimbursement as care beyond routine care and diagnostic services. State inmates housed in county and regional jails will not incur any cost to comply with this administrative regulation because the regulation does not require action by inmates and does not establish or increase any fee charged to inmates. The regulation addresses reimbursement between counties and the Department of Corrections for certain medical costs.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (4):
The regulation will allow for the efficient provision of quality medical care to inmates and for greater clarity for the Department of Corrections and county and regional jails as to what types of medical care for which the Department is responsible to counties for reimbursement.
(6) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
$12,000,000
(b) On a continuing basis:
$12,500,000 - $13,000,000 (7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: State general funds
(7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation or this amendment:
(8) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
An increase in funding will be necessary.
(9) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
The regulation does not establish, directly or indirectly, any fees.
(10) TIERING: Is tiering applied?
No. Tiering was not appropriate in this administrative regulation because the administrative regulation applies equally to all those individuals or entities regulated by it.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation:
. KRS 196.035, KRS 197.020
(2) State whether this administrative regulation is expressly authorized by an act of the General Assembly, and if so, identify the act:
Yes, KRS 196.035 and 197.020 expressly authorize the Department to promulgate this administrative regulation.
(3)(a) Identify the promulgating agency and any other affected state units, parts, or divisions:
Department of Corrections
(b) Estimate the following for each affected state unit, part, or division identified in (3)(a):
1. Expenditures:
For the first year:
$12,000,000
For subsequent years:
$12,500,000 - $13,000,000
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
0
For subsequent years:
0
(4)(a) Identify affected local entities (for example: cities, counties, fire departments, school districts):
This regulation will affect 74 county and regional jails that house state inmates and their staff.
(b) Estimate the following for each affected local entity identified in (4)(a):
1. Expenditures:
For the first year:
0
For subsequent years:
0
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
$12,000,000
For subsequent years:
$12,500,000 - $13,000,000
(5)(a) Identify any affected regulated entities not listed in (3)(a) or (4)(a):
This regulation will affect approximately 7,000 inmates in the jails.
(b) Estimate the following for each regulated entity identified in (5)(a):
1. Expenditures:
For the first year:
0
For subsequent years:
0
2. Revenues:
For the first year:
0
For subsequent years:
0
3. Cost Savings:
For the first year:
0
For subsequent years:
0
(6) Provide a narrative to explain the following for each entity identified in (3)(a), (4)(a), and (5)(a)
(a) Fiscal impact of this administrative regulation:
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,500,000 - $13,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services provided to state inmates housed in county and regional jails. County and regional jails may receive additional reimbursement from the Department for qualifying care beyond routine care and diagnostic services. State inmates housed in county and regional jails will not experience a fiscal impact from this administrative regulation. (b) Methodology and resources used to determine the fiscal impact: The fiscal cost estimate is based on claims processed at the Medicaid rate in FY23 through FY25 on behalf of jails by the Department’s medical contractor. Please note that the estimates are dependent on the number of states inmates housed in county and regional jails each year.
(b) Methodology and resources used to reach this conclusion:
(7) Explain, as it relates to the entities identified in (3)(a), (4)(a), and (5)(a):
(a) Whether this administrative regulation will have a "major economic impact", as defined by KRS 13A.010(14):
Yes
(b) The methodology and resources used to reach this conclusion:
The Department of Corrections estimates that implementation of this administrative regulation will result in approximately $12,000,000 to $13,000,000 in additional reimbursement payments to county and regional jails for necessary medical, dental, or psychological care beyond routine care and diagnostic services provided to state inmates housed in county and regional jails in the first year, with increasing payments in subsequent years. Cost estimate exceeds $500,000 per year, so the regulation will have a “major economic impact.”501 KAR 2:080E. Reimbursement for Medical Care Provided to State Inmates Housed in County and Regional Jails.