Identifying Medically Frail Individuals – A Kentucky Medicaid Case Study

For states considering community engagement or work requirements for Medicaid expansion populations, being able to appropriately identify individuals who should be exempt from such requirements due to medical or other serious conditions is imperative. This paper focuses on the development of such identification in the Commonwealth of Kentucky’s Medicaid program, as a case study that could be useful in other states.

On January 12, 2018, the Center for Medicare and Medicaid Services (CMS) approved Kentucky’s 1115 demonstration waiver. As part of this waiver, Kentucky has elected to provide the Medicaid expansion adult population with an Alternative Benefit Plan, or ABP, that differs from the traditional state Medicaid benefit package. In addition, the Kentucky 1115 waiver includes a community engagement requirement provision and member premiums up to 4% of income. Read entire article here.

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