Essette Provider Portal
Kentucky Medicaid Utilization Management Program
In June 2023, The Cabinet for Health and Family Services (CHFS) and Department for Medicaid Services (DMS) announced the implementation of a Utilization Management (UM) program for Kentucky’s Fee-For-Service (FFS) members. The new UM program is Essette. Kentucky SNFs will use this program for Prior Authorizations for ancillaries (Oxygen, Physical Therapy, Occupational Therapy and Speech Language). The program is optional to use but will be at the facilities advantage to have an electronic program vs faxing.
The tentative Go Live date is 11/13/2023.
Reminder: 30 Days of Bedhold for Kentucky Medicaid
In June 2023, CMS granted approval for Kentucky Department of Medicaid Services to extend the bed hold and bed reserve reimbursement through the unwinding period. Providers will continue to be paid for 30 days of bed hold and 75% of the NF rate if occupancy is less than 95% through the unwinding process.