Prior Authorizations in Kentucky
- Ivy Livengood
- Jun 9
- 2 min read
As we gear up for prior authorizations to return in KY, I'm doing my very best to keep you all informed. This post contains all of the most recent correspondence that I have received from each Managed Care Organization.
If you are new here and have no idea what I'm talking about: Prior Authorizations are going back into effect for behavioral health services in KY.
What are Prior Authorizations? A process in which insurance companies evaluate and approve specific medical services, treatments, or medications in advance to ensure they meet criteria for medical necessity.
Aetna Better Health of Kentucky
PA Effective Date(s): June 25th AND July 1st, 2025 (depends on the selected service)
Provider Notification- June 3rd, 2025
This notice is to clarify upcoming changes related to Targeted Case Management (TCM) services.
Effective July 1, 2025, prior authorization will be required for all individuals receiving TCM services. This requirement applies to any claim representing a new month of service (whether on a rolling or calendar month) beginning on or after July 1, 2025.
Please note that prior authorization requirements will resume for all other services on June 25, 2025. Please see our previously published network notice here:
Training & Support:
To support our providers through this process, ABHKY will host provider training opportunities, during Virtual Office Hours (VOH), on the prior authorization process both before and after the June 25, 2025 effective date.
Virtual Office Hours Schedule & Registration Links:
June 04, 2025 @ 10:00am est. - Prior Authorization & Utilization Management Review
June 11, 2025 @ 10:00am est. - Understanding Upcoming Prior Authorization (PA) Requirements
June 18, 2025 @ 10:00am est. - Prior Authorization & Utilization Management Review
June 25, 2025 @ 10:00am est. - Understanding Upcoming Prior Authorization (PA) Requirements
July 02, 2025 @ 10:00am est. - Prior Authorization & Utilization Management Review · July 09, 2025 @ 10:00am est. - Understanding Upcoming Prior Authorization (PA) Requirements
July 16, 2025 @ 10:00am est. - Prior Authorization & Utilization Management Review
July 23, 2025 @ 10:00am est. - Understanding Upcoming Prior Authorization (PA) Requirements
Humana
PA Effective Date: July 1st, 2025
Passport Molina
PA Effective Date: July 1st, 2025
United Healthcare
PA Effective Date: June 25th, 2025
WellCare
I have not received any updated information in regards to PA's. WellCare is hosting a virtual session to discuss implementation of PA's. The meeting details are below.
Friday, June 20th 1-2pm (EDT)
Microsoft Teams meeting
Join on your computer or mobile app
Join with a video conferencing device
Video Conference ID: 118 268 235 1
Or call in (audio only)
+1 816-702-6560,,384887552# United States, Kansas City
Phone Conference ID: 384 887 552#
Comments