New Enrollment, Revalidation or Maintenance (2024)

​​​​​​​​​​​​​​​​​​​​​​​​Paper forms no longer are accepted. Electronic submission through the Kentucky Medicaid Partner Portal Application (KY MPPA) is required for all applications, revalidation and maintenance items.

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CLIA Changes in Partner Portal

Effective Dec. 21 the following changes will be implemented regarding CLIA information:

New Section 1.15: Your CLIA number, address location NPI and Comments must be added and maintained in this new section.

Section 1.6: Additional Identifiers will no longer contain CLIA information.

Section 1.7: A physical address must be listed for each active CLIA number.

Section 8.0: Document upload is required for a newly added CLIA record.

Section 10.0: To Esign and Submit, active CLIA records require a physical address.

Provider News

In compliance with KRS 205.532, the Kentucky Department for Medicaid Services (DMS) implemented the KY MPPA system allowing all provider types to enroll, revalidate and perform maintenance electronically. The KY MPPA complies with all federal and state requirements, policies and procedures related to provider enrollment, revalidation and maintenance.

KY MPPA requires a provider email address to be associated with the provider KY Medicaid number (existing and new) and is required to secure accounts. The email address cannot be the credentialing contact email address, only the providers. Prescribing providers already use an email address for KASPER through KY Online Gateway. For these provider types, this is the preferred email.

Enrolling New Kentucky Medicaid Providers

Before enrolling:

1. Review the provider type summary for your provider type to understand the documentation required to enroll.
2. Review the training resources to help navigate theKY MPPA.
3. Download multifactor authentication software.
4. Create an account and start an application on the KY MPPA.

How long will the enrollment process take?

​​​The enrollment process may take up to 60 days or longer if the documentation or information is not complete or correct. Any outstanding accounts receivable must be settled before the application can be approved. Please refer to KRS 205.532 (4) (a) for more information on the enrollment timeline.

Current Kentucky Medicaid Provider

Do you need to make an update or revalidate your current Medicaid Provider information, such as:

You will need to updateor revalidate your account through the KY MPPA.

Updating a State License

When Kentucky Medicaid providers update their licenses, they must submit a copy of the license to Kentucky Medicaid through KY MPPA to keep their provider information updated.

Providers licensed through any of the licensing boards listed below that have updated their licenses through their respective boards at least 15 working days prior to the expiration date and no later than the last day to renew, will not be required to submit licensure verification to DMS until revalidation or maintenance is necessary. Otherwise, the license verification must be submitted to DMS through KY MPPA.

Kentucky Board of Nursing
Kentucky Board of Medical Licensure
Kentucky Board of Pharmacy
Kentucky Board of Dentistry
Kentucky Board of Examiners of Psychology
Kentucky Board of Speech-Language Pathology and Audiology
Kentucky Board of Licensure for Professional Art Therapists
Kentucky Board of Alcohol and Drug Counselors
Kentucky Applied Behavior Analyst Licensing Board
Kentucky Board of Licensed Professional Counselors
Kentucky Board of Licensure for Marriage and Family Therapists
Kentucky Board of Licensure for Occupational Therapy
Kentucky Board of Opthalmic Dispensers
Kentucky Board of Specialists in Hearing Instruments
Kentucky Board of Durable Medical Equipment Suppliers
Kentucky Board of Podiatry
Kentucky Board of Chiropractic Examiners

Note: Providers with out-of-state licenses must submit updated license information through theKY MPPA.

Helpful Links

• Provider Enrollment
• Subscribe to CHFS email updates
• ​Register for KY MPPA Account
• KY MPPA Home Page
• KY MPPA Newsletters​​

Additional Information

• Authorized Delegate Form
• Organization Administrator Set-Up Request Letter Template
• Request CA Linking to KY Medicaid ID Letter Template
• CA Linking to KY Medicaid ID Request Spreadsheet
• KOG Onboarding Tip Sheet
  

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What's New

​KOG Security Upgrade

Effective Oct. 1, 2022, you will notice changes when logging into KOG, such as:

1. The KOG Log In screen is upgraded.
2. You will be prompted to register a Multi-Factor Authentication (MFA) method, even if you did so prior to Oct. 1.
3. Two primary MFA methods are available:

• OKTA Verify (recommended)
• Symantec VIP​​​

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National Provider Identifier (NPI) Taxonomy

Certain claims or encounters require an NPI taxonomy when billing Kentucky Medicaid. Review the NPI taxonomy code guidance for instructions.

Clinical Laboratory Improvement Amendments (CLIA) Certificate Guidance

CLIA certificate Guidance

2023Provider Application Fee

The 2023application fee is ​$688effective Jan. 1, 2023.

Subscribeto provider enrollment email notices.

Report Fraud and Abuse

(800) 372-2970

For Assistance with KY MPPA

KY MPPA Contact Center: (877) 838-5085 Technical support - ext. 1
Program or policy inquiries - ext. 2

Regulations

KRS 205 Public Assistance
KRS 205.532 Definitions for KRS 205.532 to 205.536 907 KAR DMS Title page
907 KAR 1:671 Conditions of Medicaid provider participation; withholding overpayments, the administrative appeal process and sanctions
907 KAR 1:672 Provider enrollment, disclosure and documentation for Medicaid participation

Provider Resources

Application Fee if applicable to the provider type or submit proof of payment from Medicare or another state Medicaid agency.
DHS/INS Documentation
Fee and Rate Schedules
Fingerprint-based Criminal Background Check (FCBC)
Kentucky Medicaid Termination and Exclusion List
NPI/Taxonomy Code Verification
Provider Type Summaries
Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse
Screening Levels for Medicaid Providers

Partner Portal Information

Medicaid Partner Portal Application (KY MPPA)Medicaid Partner Portal Training
Newsletters and Release Notes
Organization Administrator Set-Up Request Letter Template

Managed Care Organizations

Aetna Better Health of Kentucky
Anthem Blue Cross and Blue Shield
Humana Healthy Horizons in Kentucky
Passport Health Plan by Molina Healthcare
United Health Care Community Plan
WellCare of Kentucky