Ky. Rev. Stat. § 205.8453

Responsibility for control of fraud and abuse

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It shall be the responsibility of the Cabinet for Health and Family Services and the Department for Medicaid Services to control recipient and provider fraud and abuse by: (1) Informing recipients and providers as to the proper utilization of medical services and methods of cost containment; (2) Establishing appropriate checks and audits within the Medicaid Management Information System to detect possible instances of fraud and abuse; (3) Sharing information and reports with other departments within the Cabinet for Health and Family Services, the Office of the Attorney General, and any other agencies that are responsible for recipient or provider utilization review; and (4) Instituting other measures necessary or useful in controlling fraud and abuse. Effective: June 20, 2005 History: Amended 2005 Ky. Acts ch. 99, sec. 276, effective June 20, 2005. -- Amended 1998 Ky. Acts ch. 426, sec. 223, effective July 15, 1998. -- Created 1994 Ky. Acts ch. 96, sec. 2, effective July 15, 1994; and ch. 316, sec. 2, effective July 15, 1994.

Notes of Decisions

Cited in 3 cases (2 in the last 5 years), 2007–2023 · leading case: Follett v. Gateway Regional Health System, Inc.

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Follett v. Gateway Regional Health System, Inc. (2007) kyctapp · cites it 2× “Further, KRS 205.8453 makes the Cabinet for Health and Family Services and the Department for Medicaid Services responsible for controlling provider fraud and abuse.”

Commonwealth of Kentucky, Cabinet for Health & Family Services v. Renee Gill (2022) kyctapp · cites it 4× “” The circuit court further explained: While it is true that KRS 205.8453[6] gives the Cabinet the responsibility to, among other things, “control recipient and provider fraud and abuse” nothing in that statute nor in anything cited by Movant gives the Cabinet a present…”

Commonwealth of Kentucky, Cabinet for Health and Family Services v. Clay Duncan (2023) kyctapp “KRS 205.8453. In light of the foregoing, it is certainly understandable that the Cabinet had concerns of fraud and had an interest in being heard.”

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