Programs of All-Inclusive Care for the Elderly (PACE) organizations are Kentucky Medicaid provider type 19. To enroll and bill Kentucky Medicaid, a PACE organization must:
- Submit a letter of intent to Kentucky Medicaid.
- Meet the requirements outlined in Section 6 of 907 KAR 3:250.
- Have a signed, three-way agreement with the Centers for Medicare and Medicaid Services (CMS) and Kentucky Medicaid.
When an individual enrolls in PACE, the PACE organization becomes their sole source of services. PACE organizations develop a team that coordinates and/or delivers an individual's preventive, acute, and long-term care needs.
PACE organizations must meet the coverage provisions of 907 KAR 3:250 to provide covered services. Any services performed must fall within the scope of practice for the provider. Listing of a service in an administrative regulation is not a guarantee of payment. Providers must follow Kentucky Medicaid regulations.
To be eligible for PACE, an individual must:
Verify Medicaid eligibility by calling the automated voice response system at (800) 807-1301 or visit the web-based KYHealth-Net System.
PACE organizations are reimbursed per 907 KAR 3:250.
Duplication of Service
The department will not reimburse for a service provided to a beneficiary by more than one provider of any program in which the same service is covered during the same time period.