MedicaidPrior AuthMedium impact
Backdating of 1915(c) HCBS Waiver Prior Authorizations
Kentucky Medicaid·KY·Provider Letter
Effective date
Mar 4, 2024
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid is restricting backdating of prior authorizations for 1915(c) Home and Community Based Services waivers to extraordinary circumstances only. Providers must verify authorizations before delivering services and utilize existing systems (MWMA, MMIS) to monitor authorization status and expiration dates.
Action Required
Immediately: Billing team must establish procedures to verify all 1915(c) HCBS waiver authorizations in MWMA or MMIS before service delivery. Check Message Center in MWMA regularly for 30-day expiration notices. For participants undergoing Medicaid eligibility redeterminations, monitor the 90-day grace period and contact 1915cWaiverHelpDesk@ky.gov if closure restart is needed. Failure to obtain valid authorization will result in claim denials and limited backdating options.