Kentucky Women’s Cancer Screening Program

LHD Provider Contract TrainingMarch 22, 2011

PHPR

• DPH added the PHPR link to the KWCSP Contract Rate Sheet, thereby eliminating the need to include or attach the PHPR section to the contract

• The link below will take you to the current version of the Kentucky Public Health Practice Reference. The Cancer Screening/Follow-Up Section, found in Volume 1 at this link, is to be utilized by the provider when providing services to cancer screening patients referred by the health department.

http://www.chfs.ky.gov/dph/info/dpqi/PHPR.htm

Mammography & Pap Requirements

• DPH plans to add the Pap and Mammography requirements to the PHPR Cancer Screening Section, thereby eliminating the need to attach them separately since they will be a part of the PHPR

• Until this tenative addition to the PHPR, the recommended requirement forms will be available to you on the L Drive

General Provider Requirements

• Wording related to timely notification by the provider to the LHD medical personnel concerning abnormal cancer screening results has been moved to the Mammography and Pap Requirements, allowing the General Provider Requirements to be removed from the provider contracts.

Contract Body

• LHDs will be permitted to include negotiated rates elsewhere within the contract, however, LHDs will need to assure that these rates match the rates on the negotiated rate sheet

• LHDs will be permitted to combine services from multiple cost centers within the same contract body. However, only include KWCSP services on the KWCSP Contract Rate Sheet.

Focus of Contract Review

• Focus of the KWCSP program staff contract review process will be the negotiated rate sheet that will need to be included with each contract

• The negotiated rate sheet should only include the KWCSP services for that specific contracted provider

Approved CPT Codes

• CPT Codes that are not on the KWCSP Approved CPT Codes list found beginning on page 20 of the current Cancer Screening Follow-up Section of the PHPR, cannot be covered by the KWCSP