Kentucky Statutes 281.872 – Program coordinators’ duties relating to eligibility for participation in human service transportation delivery program — Resolution of complaints — Penalties
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(1) The cabinet shall employ a pool of program coordinators. Each program coordinator shall be a state employee and reside in the cabinet.
(2) The program coordinator shall initially investigate all complaints regarding recipients, subcontractors, and the broker for the area and attempt to immediately resolve the problem. All complaints relating to Medicaid fraud or abuse shall be forwarded by the cabinet to the Cabinet for Health and Family Services. The program coordinator shall further be responsible for assisting a person with a complaint as required in subsection (4) of this section.
(3) The program coordinator shall investigate issues of eligibility that result in a person being denied transportation, determine the status of the person’s case, and attempt to immediately resolve the matter in order for the person to continue to receive transportation services. A broker shall not deny any person transportation services until the program coordinator resolves the question of the person’s eligibility and verifies to the broker that the person is actually ineligible to receive transportation services. A broker who violates the provisions of this subsection shall be fined one thousand dollars ($1,000) and shall be subject to his or her contract being revoked by the cabinet. The program coordinator shall coordinate information about eligibility to participate in the human service transportation delivery program between the cabinet, the Cabinet for Health and Family Services, and the Education and Labor Cabinet. The cabinet shall ensure each program coordinator has direct computer access to all relevant databases used by all state agencies to administer the human service transportation delivery program. The Department for Medicaid Services shall provide each program coordinator with a monthly eligibility list for the area.
(4) If a program coordinator is unable to resolve a complaint against a broker or subcontractor to the satisfaction of the person lodging the complaint on the same business day the complaint is made, the program coordinator shall immediately act to assist the person in contacting the appropriate state agency to resolve the complaint. The program coordinator shall ensure that the cabinet, the Cabinet for Health and Family Services, and the Education and Labor Cabinet strictly adhere to the provisions of 42 C.F.R. § governing a person’s right to appeal the denial of service or failure for a complaint to be acted upon promptly. The cabinet shall be required to inform in writing, every person who has either been denied transportation or who has failed to have a complaint resolved in a prompt manner under the human service transportation delivery program, of their right to a hearing to be held in the county where the person lives, and the process to follow to obtain a hearing.
(5) All brokers and subcontractors shall be prohibited from retaliating or attempting retribution in any way against any person using the human service transportation delivery program who files a complaint. A broker or subcontractor who is determined by the cabinet to have violated the provisions of this subsection, after an investigation and hearing conducted by the cabinet, shall have his or her contract revoked by the cabinet within ninety (90) days of
the hearing and shall be prohibited from participating in the human service transportation delivery program for five (5) years from the date of the cabinet’s determination.
Effective:July 1, 2022
History: Amended 2022 Ky. Acts ch. 236, sec. 108, effective July 1, 2022. — Amended 2009 Ky. Acts ch. 11, sec. 66, effective June 25, 2009. — Amended
2006 Ky. Acts ch. 211, sec. 128, effective July 12, 2006. — Amended 2005 Ky. Acts ch. 99, sec. 64, effective June 20, 2005. — Created 2000 Ky. Acts ch. 346, sec. 4, effective July 14, 2000.
(2) The program coordinator shall initially investigate all complaints regarding recipients, subcontractors, and the broker for the area and attempt to immediately resolve the problem. All complaints relating to Medicaid fraud or abuse shall be forwarded by the cabinet to the Cabinet for Health and Family Services. The program coordinator shall further be responsible for assisting a person with a complaint as required in subsection (4) of this section.
Terms Used In Kentucky Statutes 281.872
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Broker: means a person selected by the cabinet through a request for proposal process to coordinate human service transportation delivery within a specific delivery area. See Kentucky Statutes 281.010
- Cabinet: means the Kentucky Transportation Cabinet. See Kentucky Statutes 281.010
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Contract: A legal written agreement that becomes binding when signed.
- Department: means the Department of Vehicle Regulation. See Kentucky Statutes 281.010
- Fraud: Intentional deception resulting in injury to another.
- Human service transportation delivery: means the provision of transportation services to any person that is an eligible recipient in one (1) of the following state programs:
(a) Nonemergency medical transportation under KRS Chapter 205. See Kentucky Statutes 281.010 - State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
- Subcontractor: means a person who has signed a contract with a broker to provide human service transportation delivery within a specific delivery area and who meets human service transportation delivery requirements, including proper operating authority. See Kentucky Statutes 281.010
(3) The program coordinator shall investigate issues of eligibility that result in a person being denied transportation, determine the status of the person’s case, and attempt to immediately resolve the matter in order for the person to continue to receive transportation services. A broker shall not deny any person transportation services until the program coordinator resolves the question of the person’s eligibility and verifies to the broker that the person is actually ineligible to receive transportation services. A broker who violates the provisions of this subsection shall be fined one thousand dollars ($1,000) and shall be subject to his or her contract being revoked by the cabinet. The program coordinator shall coordinate information about eligibility to participate in the human service transportation delivery program between the cabinet, the Cabinet for Health and Family Services, and the Education and Labor Cabinet. The cabinet shall ensure each program coordinator has direct computer access to all relevant databases used by all state agencies to administer the human service transportation delivery program. The Department for Medicaid Services shall provide each program coordinator with a monthly eligibility list for the area.
(4) If a program coordinator is unable to resolve a complaint against a broker or subcontractor to the satisfaction of the person lodging the complaint on the same business day the complaint is made, the program coordinator shall immediately act to assist the person in contacting the appropriate state agency to resolve the complaint. The program coordinator shall ensure that the cabinet, the Cabinet for Health and Family Services, and the Education and Labor Cabinet strictly adhere to the provisions of 42 C.F.R. § governing a person’s right to appeal the denial of service or failure for a complaint to be acted upon promptly. The cabinet shall be required to inform in writing, every person who has either been denied transportation or who has failed to have a complaint resolved in a prompt manner under the human service transportation delivery program, of their right to a hearing to be held in the county where the person lives, and the process to follow to obtain a hearing.
(5) All brokers and subcontractors shall be prohibited from retaliating or attempting retribution in any way against any person using the human service transportation delivery program who files a complaint. A broker or subcontractor who is determined by the cabinet to have violated the provisions of this subsection, after an investigation and hearing conducted by the cabinet, shall have his or her contract revoked by the cabinet within ninety (90) days of
the hearing and shall be prohibited from participating in the human service transportation delivery program for five (5) years from the date of the cabinet’s determination.
Effective:July 1, 2022
History: Amended 2022 Ky. Acts ch. 236, sec. 108, effective July 1, 2022. — Amended 2009 Ky. Acts ch. 11, sec. 66, effective June 25, 2009. — Amended
2006 Ky. Acts ch. 211, sec. 128, effective July 12, 2006. — Amended 2005 Ky. Acts ch. 99, sec. 64, effective June 20, 2005. — Created 2000 Ky. Acts ch. 346, sec. 4, effective July 14, 2000.