State Plan and Amendments

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The Medicaid State Plan is an agreement between the Commonwealth of Kentucky and the federal government describing how we administer our Medicaid program. It gives assurance that Kentucky will abide by federal rules and may claim federal matching funds for its program.  The state plan sets out groups to be covered, services, methodologies for reimbursing providers and state program administrative activities.

When Kentucky plans to make changes to its program policies or operations, the state Department for Medicaid Services must submit a state plan amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) for review and approval. We also submit SPAs to request approval for program changes, make corrections or update our Medicaid plan with new information.

By law, a state request to CMS to approve a proposed state plan, a SPA or a waiver must be approved, disapproved or additional information requested within 90 days of receipt. Otherwise, the request is considered approved. If CMS requests additional information, the 90- day clock stops and the state must respond to the additional information request. After the state responds, CMS has 90 days to either approve or deny the original request.

Legal Disclaimer - The state plan on this website is for informational purposes only and is not legally binding. The official plan is maintained by the Department for Medicaid Services, Office of the Commissioner.


Directed Payments​

Directed payment programs were created by CMS through the Managed Care Final Rule in 2016. These programs generally:

  • Allows states with managed care programs to make enhanced payments to providers to advance the goals of the Medicaid program.
  • Designed to advance at least one goal of the State Medicaid program's quality strategy with appropriate oversite to evaluate progress on the goals. 
  • Require enhanced payments to be made for specific MCO services rendered.
  • Must be approved by CMS on an annual basis.​​

State Plan Amendments

State Plan Amendment

Contact Information