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Committee approves Medicaid rule change requiring prior authorization for genetic tests
Summary
The committee approved staff amendments to 907 KAR 3005 and 3010 that require prior authorization for all genetic testing in Kentucky Medicaid, remove a prior restriction on sleep disorder service coverage, and change several provider- and fee-schedule rules; Medicaid staff said prior-authorizations are generally completed within two to five days.
Frankfort — The regulatory review committee voted to approve staff-suggested amendments to two Medicaid administrative regulations that will require prior authorization for all genetic testing for Medicaid recipients and make several other changes to provider definitions and reimbursement rules.
Justin Derringer, director of health care policy for the Department for Medicaid Services, told the committee the change will require medical necessity review—prior authorization—before genetic testing is performed, citing rising…
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