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Kentucky plans April 1 launch for 1115 reentry waiver as DMS, DOC and MCOs finalize contracts and testing
Summary
Department for Medicaid Services staff told the Technical Advisory Committee they are finalizing provider agreements, enrollment and system testing ahead of an April 1 go‑live for the 1115 reentry waiver; DMS also reported a $1.4 million CAA grant to support initial implementation.
Department for Medicaid Services staff told the Technical Advisory Committee they are on track to begin the 1115 reentry waiver on April 1, with contracting, provider enrollment and systems testing still underway.
"I think we're just shy of 3 weeks for full implementation targeting again April 1," Angela Sparrow said, summarizing DMS's timeline and thanking managed care organizations for their work on standard provider agreements with the Department of Corrections (DOC) and the Department of Juvenile Justice (DJJ).
Why it matters: the waiver seeks to support prerelease and postrelease services coordinated through managed care organizations (MCOs). Sparrow said DOC and DJJ must be contracted with MCOs and that DMS and partners are completing credentialing, practitioner enrollments and readiness assessments so services and handoffs at release will function on day one.
What DMS reported: Sparrow described several near‑term activities — end‑to‑end walkthroughs with DOC and DJJ to test screening, Medicaid applications, prerelease enrollment in managed care, prerelease services and dispensing release medications; continued credentialing reviews with MCOs; and interfaces being tested between DOC/DJJ systems and DMS. She said readiness assessments required by the demonstration have been completed and that any remaining mitigation items are being addressed ahead of implementation.
On CMS oversight: Sparrow said DMS has an implementation plan pending with the Centers for Medicare & Medicaid Services (CMS) but that the state is permitted to move forward with implementation while that plan remains under review. She said DMS had a recent quarterly call with CMS and will submit annual reporting at month end.
Jails and CAA services: committee members asked whether county jails would need to contract directly with MCOs or could use alternative models. Sparrow said jails may require different approaches because their infrastructure often differs from DOC/DJJ and that planning through 2026 will determine whether jails contract with MCOs, contract with existing Medicaid providers, or use hybrid models. Sparrow said the CAA (community‑based) population for the program generally covers young adults up to age 21 and former foster‑care youth up to 26.
Funding support: in response to a question from a community representative, Sparrow said DMS received a Consolidated Appropriations Act (CAA) implementation notice earlier in the year and expects roughly $1,400,000 for the initial year (through 06/30) to support implementation; portions will be allocated to DOC and DJJ and some funds will be used for planning to onboard jails.
What to watch next: DMS plans to report early implementation numbers at the TAC's next meeting in May and will continue testing, credentialing and contract finalization with MCOs and corrections partners.
