Kentucky's Office of Inspector General (OIG) certifies personal services agencies (non-medical home care) and licenses home health agencies. Medicaid waiver home care, such as attendant care in the Home and Community Based (HCB) waiver, is paid by the Department for Medicaid Services (DMS): the Medicaid health plans are not responsible for services to people in 1915(c) waiver programs. The change now: from fall 2026, DMS takes fee-for-service prior authorization requests, such as for home health and private duty nursing, only through its Essette web portal; waiver prior authorizations stay in the Medicaid Waiver Management Application (MWMA).
Red means act now, amber means read it this month, grey is for the record.
Any 1915(c) waiver claim, traditional or participant-directed, for a service that must use EVV is denied if there is no matching visit in EVV. This applies whether you use Therap or a third-party system that feeds the Therap aggregator.
DMS will stop accepting phone, fax and mail prior authorization requests. Providers must use the Essette Provider Portal, reached through a KYID account, for members in fee-for-service Medicaid; home health and private duty nursing both need prior authorization. First-time users must complete training. Reconsideration and hearing requests can still go by mail. DMS's 2023 letter said the portal excludes 1915(c) waiver providers, who use MWMA.
Oversight of participant-directed services is moving from DAIL to each waiver's operating agency in phases, expected to be complete by January 1, 2027. HCB stays with DAIL. Critical incidents, mortality reviews, inability to access services and involuntary terminations were set to move to the operating agencies in MWMA on July 1, 2026.
DMS announced a 4% cut to many provider rates, including home health and the HCB, Michelle P., SCL and Model II waivers, from August 1, 2026. On July 23 it said the cut has been reversed and rates stay at current levels. DMS calls this a temporary solution.
Under House Bill 2 (2026), people on the HCB or Michelle P. waitlist who want to stay on it must send a Provider Attestation signed by a physician, physician assistant, advanced practice registered nurse (APRN) or licensed psychologist by January 31, 2027. People already getting waiver services are not affected.
Dates taken from the rules and notices as we read them.
The cabinet says it expects to finish the move by this date.
People who do not send the Provider Attestation can be removed from the waitlist, after at least three contact attempts and a final 60-day notice.
Every state follows the same outline, so you always know where to look. Open a section for the detail.
Sometimes two official documents say different things. Here is what we went with, why, and what each document says, so you can judge for yourself.
The regulation is what we hold as in force. The approved waiver (from August 1, 2025) adds a 'DMS Certified Agency' type, but says its certificate is 'to be defined' in regulation. The version of 907 KAR 7:010 we hold (last certified January 30, 2023) does not include it, and we hold nothing showing it has been amended since. Ask DAIL before counting on the new type.
The regulation sets the requirement. OIG's application checklist asks for dates of a 'two-step Tuberculin Skin Test', which the rule does not require for everyone. If OIG asks for it, you may want to have it on file.
Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Yes — a personal services agency certificate.
Kentucky calls it certification. No personal services agency may be operated, maintained or advertised without a certificate from the Office of Inspector General (KRS 216.712, 906 KAR 1:180). Cleaning-, laundry-, shopping- or transportation-only businesses, individuals serving no more than three clients at once, and already-licensed health providers are not covered.
$500 to apply, then $350 every year.
Send the $500 fee and form OIG-1180 to apply. Recertify every year by sending $350 and the application at least 60 days before your certificate expires. A change of more than 25% in ownership must be reported within 30 days, with a $350 fee.
Not with that certificate alone.
907 KAR 7:010 lets these certified waiver providers give HCB services (other than participant-directed services): adult day health care centers, home health agencies, centers for independent living, public health departments, home delivered meal providers, and area agencies on aging and independent living. The approved HCB waiver (August 1, 2025) adds a 'DMS Certified Agency' type whose certificate is 'to be defined' in regulation; the version of 907 KAR 7:010 we hold does not include it. Ask DAIL before you plan on it.
Criminal, two registries, drug test and TB.
Before a manager or direct-care worker starts: a criminal record check, the Nurse Aide and Home Health Aide Abuse Registry, the caregiver misconduct registry, a substance abuse test and a TB risk assessment. You may not employ someone convicted of a crime defined in KRS 216.710(3), listed on either registry, or who tests positive for an illegal drug. Job applications must say state law requires a criminal background check.
No, it is voluntary for private employers.
906 KAR 1:190 sets up KARES as a voluntary program for private long-term care employers, including personal services agencies and home health agencies. If you join, the cabinet fee is up to $30 a check plus State Police and FBI fees, and new hires can work provisionally for up to 60 days after fingerprinting, with supervision.
Yes: six hours, then three a year.
Staff who care for clients with symptoms of Alzheimer's disease or other dementia must complete six hours of cabinet-approved training and three hours every year. The agency needs its curriculum approved and must give certificates of completion. Fines are up to $500 a day.
Only help with self-administration.
Workers may remind, hand over, open and help a client take medication that a designated representative or an outside licensed professional prepared, preset in an organizer or single doses. They may not give injections, eye, ear or nose drops, tube or nebulizer medicines, or mix or calculate doses.
Yes; claims are denied without it.
Since January 1, 2026, a 1915(c) waiver claim for an EVV service (such as HCB attendant care) with no matching EVV visit is denied. Home health and private duty nursing claims have needed EVV since January 1, 2025. Therap is the state system; other systems must feed the Therap aggregator.
No, not for people in a waiver.
Under 907 KAR 17:020, the health plans (MCOs) are not responsible for services given to someone in a 1915(c) waiver program; DMS pays for waiver services. For other plan members, home health and private duty nursing can be provided through the plan.
$7.26 per 15 minutes.
907 KAR 7:015 sets $7.26 per 15-minute unit for traditional and participant-directed attendant care, as the base rate from January 1, 2025; DMS pays the lower of your billed charge or this limit. Agencies that signed DMS's 85% pass-through attestation by May 1, 2024 can keep a 50% add-on rate ($9.00 per 15 minutes). The waiver limits attendant care to 45 hours a week, or $200 a day, alone or with adult day health care.
The official link for each document. Our own dated copies will sit next to them, so a document is still here when a state moves its website.
69 documents — showing the newest 25