Kentucky Reproduction and Distribution Agreement
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How to fill out Reproduction And Distribution Agreement?
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Enrolling New Kentucky Medicaid Providers Review the provider type summary for your provider type to understand the documentation required to enroll. Review the training resources to help navigate the KY MPPA. Download multifactor authentication software. Create an account and start an application on the KY MPPA.
Apply for Medicaid Apply for traditional Medicaid only by calling the Kentucky Healthcare Customer Service line toll-free at (855) 459-6328 or contacting an application assister through the Kentucky Health Benefit Exchange website.
Enroll as a Medicaid Provider If you would like to request participation as an Anthem provider, visit the website or call 1 (800) 205-5870. If you would like to request participation as a Humana provider, visit the website or call 1 (800) 444-9137.
Kentucky Tax Registration (10A100) - Basic Kentucky tax registration can be completed online or via the Kentucky Tax Registration Application (10A100). Additional tax registrations may be required based on your industry, for more information visit the Kentucky Department of Revenue.
The KY Department for Medicaid Services also 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.
As of July 1, 2021, MedImpact is the pharmacy benefits manager for all Kentucky health plans offering coverage to Medicaid enrollees. As a result, MedImpact manages all prior authorization requests for medications. To submit a prior authorization request to MedImpact: Call 844-336-2676.
