Kentucky has a home care waiver with a waitlist (HCB Waiver) and one without (Michelle P. Waiver). The MPW is the higher-volume no-waitlist pathway for agencies serving individuals with IDD. Therap is Kentucky's EVV aggregator — hard edits have been active since January 2025, meaning claims without Therap visit records are automatically denied. Five MCOs administer Kentucky Medicaid. State enrollment through KY MPPA comes first; MCO credentialing comes second. Both are required before billing. Here is the Kentucky operator's guide.
Kentucky operates several 1915(c) HCBS waiver programs administered by the Cabinet for Health and Family Services (CHFS) Department for Medicaid Services. For most home care agencies focusing on the elderly and physically disabled, the HCB Waiver and Michelle P. Waiver are the primary programs. SCL (Supports for Community Living) focuses on IDD and also has a waitlist.
The HCB (Home and Community-Based) Waiver serves elderly and physically disabled adults who need nursing facility level of care. As of February 2025, it has a waitlist. State Fiscal Year 2026 (starting July 1, 2025) added 500 new HCB slots. Income limit is 300% of FBR (~$2,901/month in 2025). Asset limit $2,000 for individuals.
Services include personal care, homemaker, adult day, respite, home modifications, emergency response, and community transition. The wait time for HCB varies by applicant urgency. Contact information: ADRC or kynect (kynect.ky.gov).
The Michelle P. Waiver serves individuals with intellectual and developmental disabilities who need an NF or ICF/IID level of care but can be supported in the community. MPW has no waitlist. SFY26 added 500 new MPW slots effective July 1, 2025.
MPW provides services similar to SCL including community living supports, personal assistance, day programs, respite, and behavioral support. To be an MPW provider, agencies must already be enrolled as an SCL or HCB Waiver provider — there are no standalone MPW-only providers in Kentucky. This creates an enrollment sequencing requirement for agencies targeting this population.
Income limit: 300% FBR (~$2,901/month). Applied through kynect or ADRC.
January 2025 — Hard EVV edits activated in Kentucky. Claims without matching EVV data in Therap are automatically denied. This caused a significant increase in denials for agencies that had not completed Therap integration or whose EVV data had gaps, mismatches, or submission delays. The transition to hard edits is permanent — there is no grace period mode. If your claims are being denied due to EVV mismatches, the issue is in your Therap data or your EVV vendor's integration with Therap.
Therap is Kentucky's state-designated EVV aggregator. Kentucky uses an open model — agencies choose their own EVV system. But all visit data must flow to Therap before claims are processed. Your EVV vendor must have a completed integration with Therap. If your vendor only integrates with HHAeXchange or Sandata, that integration will not work for Kentucky — you need Therap integration specifically.
EVV data must match the claim on all required data elements: service type, member identity, date, location, caregiver identity, and start/end times. Mismatches on any element — including a caregiver clocking in from the wrong address or using manual entry without an appropriate reason code — can trigger denials.
Kentucky requires two separate enrollment processes, each a prerequisite for the next.
| MCO | Notes |
|---|---|
| Aetna Better Health of Kentucky | CVS Health subsidiary. Provider services through aetnabetterhealth.com/kentucky |
| Anthem Blue Cross and Blue Shield | Large statewide presence. Provider portal at anthem.com/provider/kentucky |
| Humana CenterWell | Humana's Kentucky Medicaid plan. Provider services at humana.com |
| Molina Healthcare (Passport Health Plan) | Molina acquired Passport Health Plan. Original Louisville-based nonprofit now part of Molina national network |
| United Healthcare Community Plan | UHC's Kentucky Medicaid plan. Provider portal at UHCprovider.com |
| WellCare of Kentucky | Centene subsidiary. Provider services through wellcare.com/kentucky |
Note: Six plans are listed — Kentucky has been contracting with multiple plans that vary by contract period. Verify currently active MCOs for your specific member population and service counties with CHFS DMS before prioritizing credentialing efforts.
No. MPW has no waitlist. It serves individuals with IDD who need NF or ICF/IID level of care. SFY26 (starting July 1, 2025) added 500 new MPW slots. To participate in MPW, your agency must already be enrolled as an HCB Waiver or SCL Waiver provider — there are no standalone MPW-only providers. The no-waitlist structure makes MPW a more consistent referral pipeline than the HCB Waiver, which does have a waitlist. Agencies planning to serve both populations should sequence their HCB or SCL enrollment first so that MPW participation follows naturally.
Therap is Kentucky's state-designated EVV aggregator. All visit data — from any EVV system — must reach Therap before a claim can be processed. Hard EVV edits activated in January 2025, meaning claims without matching Therap visit records are automatically denied. If you use HHAeXchange, Sandata, or any other EVV platform, that platform must have a completed integration with Therap specifically — not with a generic state aggregator. Agencies experiencing denials due to EVV mismatches need to (1) verify their EVV vendor has Therap integration and (2) ensure caregivers are capturing all required data elements correctly at clock-in and clock-out.
No. State MPPA enrollment gives you a Kentucky Medicaid provider ID and the legal right to provide waiver services. But most waiver service claims go to the member's MCO — not fee-for-service to DMS. Without MCO credentialing, the MCO cannot pay you. You would be delivering services without the ability to get reimbursed by the member's payer. State enrollment and MCO credentialing are both required and serve different functions. MPPA must be completed first (MCOs require your Medicaid ID), then credential with each MCO serving your target counties and populations.
Kentucky agencies managing KY MPPA state enrollment, MCO credentialing across five plans, Therap EVV integration, and waiver authorization tracking are running significant simultaneous complexity. CareBravo delivers Therap-integrated EVV compliance, MCO billing, and authorization management as completed operational work.