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Resources: Kentucky Medicaid Changes, PDPM CMI and more
7/1/24 Kentucky Medicaid Changes
Bedhold days reimbursed at a maximum of 30 days per calendar year due to hospitalization.
Bedhold days reimbursed at a maximum of 10 days during a calendar year for leaves of absence other than hospitalization.
ALL Bedhold days reimbursed at 75% of the facility’s rate. Regardless of the SNF census being above 95% or greater for the calendar quarter.
Click here to see Current Regulation 065.
Click here to see Proposed Regulation 065.
Kentucky Medicaid Ancillary Add On as of July 1, 2024
Effective July 1, 2024, ancillary services will be included in the per diem rate calculations and will not be paid outside the per diem rate.
Ancillary services include the following:
• Speech Therapy
• Occupational Therapy
• Physical Therapy
• Oxygen Services
• Laboratory
• X-ray
The ancillary add on will be calculated every July 1. Effective July 1, 2024, the ancillary add on will be calculated as the Medicaid ancillary payments from the prior year divided by Medicaid days. Effective July 1, 2025 and after, the ancillary add on will be calculated as the prior year Medicaid ancillary charges divided by the total Medicaid days, limited to the posted ancillary fee schedule amounts per unit.
Myers & Stauffer will be sending out the final Ancillary Add-on Supplemental Schedule the week of July 29th.
Click here to see Proposed Regulation 065.
PDPM CMI
For rates effective July 1, 2024, the PDPM case-mix index shall be phased in using the following schedule:
