Title 907 | Chapter 001 | Regulation 260


907 KAR 1:260.Coordination of benefits between the Medicaid Program and the Crime Victims Compensation Board.

Section 1.

General Principles.

(1)

The Medicaid Program is the payor of last resort and complies with the requirement shown in 907 KAR 1:005, Nonduplication of payments. Any provisions contained in this administrative regulation are subordinate to the provisions of 907 KAR 1:005 and shall not be construed in a manner which contravenes the policies contained in 907 KAR 1:005.

(2)

The cabinet recognizes that the Crime Victims Compensation Board ("the board") has discretion in the making of awards or grants, and that until an award or grant is made by the board, third-party liability pursuant to 907 KAR 1:005 cannot be presumed to exist.

(3)

In the event the board makes a grant or award to a Medicaid eligible individual for Medicaid covered services, the amount payable by the Medicaid program shall be reduced by the amount of the assumed third-party obligation; if the board makes no grant or award for Medicaid covered services, Medicaid program payments for covered services shall be made in accordance with usual program policy.

Section 2.

Procedures to Ensure Nonduplication of Payments. The following methodology shall be used by the Medicaid program to ensure that duplication of claims between Medicaid and the board is reduced to the greatest extent possible.

(1)

When the board notifies the cabinet of a claim(s) which has been filed, the cabinet shall determine if the crime victim(s) is covered under the Medicaid program and advise the board appropriately.

(2)

When the board notifies the cabinet of all itemized medical charges for which a Medicaid eligible victim is seeking compensation, the cabinet shall advise the board as to whether the medical service is covered under the Medicaid program.

HISTORY: (10 Ky.R. 1230; eff. 6-28-1984; 11 Ky.R. 292; eff. 9-11-1984; 856; eff. 12-11-1984; 1208; eff. 3-12-1985; 1682; eff. 6-4-1985; 12 Ky.R. 284; eff. 9-10-1985; 1084; eff. 1-3-1986; 1546; eff. 4-17-1986; Recodified from 904 KAR 1:260, 5-2-1986; 18 Ky.R. 1646; eff. 1-10-1992; Crt eff. 7-23-2018.)

7-Year Expiration: 7/23/2025

Last Updated: 12/15/2021


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