External User Service LinksThe Centers for Medicare & Medicaid Services (CMS) has setup the External User Services (EUS) help desk. As part of quality customer support, the support site is a dedicated on-line resource to support users of several CMS systems listed below. Show
Identity & Access Management System (I&A)Create one account with the Identity & Access Management System to manage access to PECOS,
NPPES and EHR incentive programs, manage staff, and authorize others to access your information. National Plan and Provider Enumeration System (NPPES)The National Plan and Provider Enumeration System (NPPES) assigns the National Provider Identifier (NPI) which are unique identifiers mandated by the Health Insurance Portability and Accountability Act
of 1996 (HIPAA). Provider Enrollment, Chain, and Ownership System (PECOS)PECOS supports the Medicare Provider and Supplier enrollment process by allowing registered users to securely and electronically submit and manage Medicare enrollment information. Identity Management System (IDM)Identity Management System (IDM) has been established to provide our Business Partners a means to apply for and receive a single User ID they can use to access many CMS applications. Provider Statistical and Reimbursement System (PS&R)The Provider and Statistical Reimbursement (PS&R) System is a key tool for institutional healthcare providers, Fiscal Intermediaries (FIs), Medicare
Administrative Contractors (MACs) and CMS. The system accumulates statistical and reimbursement data applicable to the processed and finalized Medicare Part A claims. This data is summarized in various reports, which are used by providers to prepare Medicare cost reports, and by FIs and MACs during the audit and settlement process. Access to the PS&R website is gained through IDM account creation, used to request application roles. Access to the Medicare Cost Report e-Filer website is also
gained through the IDM system and PS&R application. CMS Preclusion ListThe CMS Preclusion List was created for employees of private health
plans with Medicare Part C and/or Part D contracts. All functionality is accessed at . . . Public Notice2023 Medicaid Managed Care Quality Strategy Draft Public NoticeThe CHFS Department for Medicaid Services, in accordance with §438.340, at least every three years must draft and implement a written quality strategy for assessing and improving the quality of
health care and services provided by Medicaid managed care organizations. The strategy is available for public comment before submitting to the Centers for Medicare and Medicaid Services for review. The Medicaid and Children’s Health Insurance Program Managed Care Quality Toolkit was used to develop the strategy. Review the public notice Ambulance services reimbursement changesIn accordance with 42 CFR 447.205, the Kentucky Department for Medicaid Services provides public notice of changes to ambulance services reimbursement language in its state plan effective Jan. 1, 2022. The state plan language change aligns with KRS 205.5601-5603 reflecting the methodology for increasing Medicaid reimbursement for ground ambulance services. Review the public notice Mandatory Medicaid state plan coverage of medication-assisted treatmentThe Kentucky Department for Medicaid Services issued a public notice of updates to the state plan related to medication-assisted treatment for individuals with opioid use disorder. Review the public notice Ambulance supplemental payment programThe Kentucky Department for Medicaid Services has issued public notice of changes to the ambulance services reimbursement language in its State Plan effective July 1, 2021. Review the entire public notice Visit the Public Notice page to see all public notices. What's NewFlood Recovery Resources The Department for Medicaid Services has compiled a list of resources for members in flood-affected areas of eastern Kentucky. The list includes contact information for state services,
shelter information and how to help flood survivors. To make a financial donation to the relief effort, please visit the Team Eastern Kentucky Flood Relief Fund website. Baby Formula Shortage ResourcesResources are available for Medicaid members affected by the baby formula shortage. The Department for Public Health has published a guide to local and national resources to help Kentuckians find formula. Behavioral Health Code List Now Available A list of behavioral health codes that are reimbursable by Kentucky Medicaid is now available. Work continues on Kentucky Mobile Crisis
Intervention Planning Grant projectKentucky continues its work on a grant to expand and strengthen services for individuals experiencing behavioral health crises. Currently, a thorough review is underway of the availability and delivery of mobile crisis services in Kentucky. Review the KY mobile crisis intervention needs assessment or visit the
Behavioral health initiatives page for more information. DMS begins work on Kentucky Mobile Crisis Intervention Planning Grant ProjectKentucky has received a grant to expand and strengthen services for individuals experiencing behavioral health crises. Review the MCI grant announcement for information on the grant and how to get involved. Providers wanted for the Programs of All-inclusive Care for the Elderly (PACE)DMS will begin coverage for PACE providers in 2022. DMS has enrolled several providers but more are needed. Please review the PACE provider page for more information. Reinstatement of Prior Authorization for SUD Residential and Inpatient Services Under the current KY HEALTH SUD 1115 Demonstration authority, the state is required to implement utilization management approaches to ensure an independent process for reviewing placement in residential treatment settings and interventions appropriate for the diagnosis and level of care. The KY State
Plan requires individuals to be assessed and meet dimensional admission criteria for approval of residential level-of-care placement in accordance with current ASAM treatment criteria for addictive, substance-related and co-occurring conditions. Prior authorization will be reinstated effective July 1, 2022 for SUD residential and inpatient treatment services,
including ASAM Levels 3.1, 3.5, 3.7 and 4.0. Correcting Medicaid Member Incarceration Status Errors Kentucky Medicaid has a new form providers can use to help members who are incorrectly listed as incarcerated in KYHealthNet. Please review the guidance for reporting incarceration errors and the new MAP-INC form for more information. Administrative Regulations FiledVisit the DMS Regulation page for recently filed regulations. CMS health care quality core set chart packsEach year the Centers for Medicare and Medicaid Services publishes core measures of the quality-of-care and health outcomes for adults participating in Medicaid and children enrolled in the Medicaid Children’s Health Insurance Program. Please view:
Cost Report Update(July 14, 2020) The Centers for Medicare and Medicaid Services authorized the delay of some Medicare cost reports. The KY Department for Medicaid Services grants the same extension to providers who received an extension approval through CMS or the designated Medicare administrative contractor. Please call (502) 564-8196 if you have any questions and ask for the staff referenced below based on provider type.
Never miss the latest newsSubscribe to receive email notices regarding KY Medicaid. Connect with DMS on Social Media
 How do you contact CMS?Telephone numbers and web link information related to specific Medicare questions.. Medicare Service Center: 800-MEDICARE (800-633-4227). Medicare Service Center TTY: 877-486-2048.. Report Medicare Fraud & Abuse: 800-HHS-TIPS (1-800-447-8477). Medicare.gov.. Medicare Helpful Contacts Page.. Medicare Fraud & Abuse.. What phone number is 800 633 4227?1-800-MEDICARE (1-800-633-4227)
For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.
Is CMS Centers for Medicare and Medicaid Services Legitimate?The Bottom Line. The Centers for Medicare & Medicaid Services is a federal agency that administers the nation's major healthcare programs including Medicare, Medicaid, and CHIP. It collects and analyzes data, produces research reports, and works to eliminate instances of fraud and abuse within the healthcare system.
What is the function of the Center for Medicare and Medicaid Services?The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace.
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