Kentucky panel hears concerns over Medicaid waiver wait list, 70% rate implementation

Commissioner Lisa Lee of the Kentucky Department for Medicaid Services told the General Assembly’s Budget Review Subcommittee on Health and Family Services that Kentucky’s Medicaid program is governed by Title XIX of the Social Security Act and is the state’s largest health program.

Lee said the department administers six 1915(c) home- and community-based waivers that let people who meet nursing-facility or intermediate-care level of care remain in their homes. "Without these waiver programs, the individuals would be in a facility," she said.

The department offered several program counts: about 485,000 Medicaid expansion members, more than 600,000 children eligible for Medicaid or Kentucky Children’s Health Insurance Program, roughly 69,000 enrolled providers, and $18.5 billion in Medicaid expenditures in 2024. Lee said the unduplicated wait list across all waivers is 13,933 individuals.

The committee focused on the cabinet’s recent implementation of a rate study developed by Guidehouse. Lee described the study as necessary because many waiver services are not…