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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 30 of 155 42. Qualifying Criteria for Pre-Release Services. To qualify to receive services under this component of the demonstration, an individual must meet the following qualifying criteria:

a. Meet the definition of an inmate of a public institution, as specified in 42 CFR 435.1010, and be incarcerated in a correctional facility specified in STC 40; b. Have been determined eligible for Medicaid or CHIP or be otherwise eligible for CHIP if not for their incarceration status; c. Have an expected release date within 60 days. 43. Scope of Pre-Release Services. The pre-release services authorized under the Reentry Demonstration Initiative include the following services to be detailed in the implementation Plan required under STC 49.

a) The covered pre-release services are:

i. Case management to assess and address physical and behavioral health needs, and health-related social needs;

ii. MAT for all types of SUDs as clinically appropriate, including coverage for medications in combination with counseling/behavioral therapies; and

iii. A 30-day supply of all prescription medications and over-the-counter drugs (as clinically appropriate), provided to the individual immediately upon release from the correctional facility, consistent with approved Medicaid or CHIP state plan coverage authority and policy.

b) The expenditure authority for pre-release services through this initiative constitutes a limited exception to the federal claiming prohibition for medical assistance furnished to inmates of a public institution at clause (A) following section 1905(a) of the Act (“inmate exclusion rule”). Similarly, for CHIP, the expenditure authority for pre- release services constitutes a limited exception to the general exclusion of children who are inmates of a public institution from the definition of a targeted low-income child under section 2110(b)(2)(A) of the Act (“child exclusion rule”). Benefits and services for inmates of a public institution that are not approved in the Reentry Demonstration Initiative as described in these STCs and accompanying protocols, and not otherwise covered under the inpatient exception to the inmate exclusion rule or an exception in section 2110(b)(7) of the Act to the child exclusion rule, effective January 1, 2025, remain subject to the inmate exclusion rule or the child exclusion rule, as applicable. Accordingly, other benefits and services covered under the Kentucky Medicaid or CHIP State Plan(s), as relevant, that are not included in the above-described pre-release services (e.g., EPSDT treatment services) benefit for qualifying Medicaid or CHIP individuals are not available to qualifying individuals through the reentry demonstration initiative.