• There must be at least one group member with an active KY Medicaid Provider Number in each provider group.

• After entering the KY Medicaid Provider Number and the requested Provider Linkage Date, click the “Verify Provider NPI and Name” button to verify the Provider is active with KY Medicaid.

• At least one provider’s effective date has to be equal to or before the Group’s requested effective date.

• After data entry, click “Add to Grid” to add the provider to the grid. Repeat this process until all providers have been added to the grid.

• MAP 347 form is only needed for adding new group members.

• For DHS/INS providers who want to link to a new group the I-123 document upload is required

End Date:

In KY MPPA, some records cannot be deleted. To add a new record, the previous record must have an End Date added in order to keep the history on file. To add an End Date to a record, click the "Edit" button and add an End Date. If a new record is added to the grid, the active dates of the new record cannot overlap existing record dates.

Substance Use Disorder (SUD) PT 03 Behavioral Health Service Organization (BHSO) Tier Selections:  

There are three tiers available for selection:  Tier 1 Mental Health, Tier 2 Outpatient SUD, and Tier 3 Residential SUD.  Can select one, two or all tiers based on services provided. Must select at least one Tier.

• All Tiers

• Must answer required question “Are you currently accredited by a Nationally Recognized Accreditation Organization?”

• If Yes, will need to select at least one of the following certifications on 2.3 Certification screen:  08 Joint Commission, 14 Commission on Accreditation of Rehab Facility, 18 Council on Accreditation of Services for Families and Children, or Other.  Certification must be Active.

• If No, must have initiated accreditation with a recognized organization prior to today’s date.  Must enter name of Accreditation Organization and initiated date.  Initiated date cannot be greater than today.  

• Tier 2: Outpatient SUD

• Must also answer required question “Are you a licensed Narcotic Treatment Program (NTP)?”

• If Yes, enter required NTP address and hours of operation on 1.15 NTP and Medication Station Addresses screen.

• If No, no action required.

• Must answer “Do you operate a Non-Methadone Clinic at the same location?”  If answer Yes, will receive warning message to “Please enroll Non-Methadone clinic as separate entity”.

Substance Use Disorder (SUD) PT 66 Behavioral Health Multi-Specialty Group Selections:  

• Must answer required question “Are you providing Substance Use Disorder Treatment (SUD)?”

• If Yes, must have Outpatient Alcohol and Other Drug Entity (AODE) license.

• If No, no action required.

Special Characters:

• The following Special Characters cannot be used in the situations below. Field properties will not allow the following characters in the box:

 For First Name, Business Name, Other name (if any):    | + \ '

 For Last Name field:    | + \ ', and numbers are not allowed

 For Comment Boxes:     <  >  ^  ~ ` + | \ / ¬ £

 For Address fields:    | + ! @ # $ ^ * ( ) ? / \ " < > & : ; _

• If you copy and paste an excluded special character, an error message will display after clicking Save & Next

• Remove excluded characters from pasted information or uploaded text in the document

Save & Next:

• When finished, click Save & Next to save the information and proceed to the next page

• Click Back to go to the previous screen without saving

• Click Exit to return to the dashboard without saving

• Note that if the information is not saved, you will lose the data on the current page