Kentucky
General Assembly

02/11/09	introduced in House
02/12/09	to Banking & Insurance (H)
02/23/09	posting waived
02/25/09	reported favorably, 1st reading, to Calendar with Committee Substitute
02/26/09	2nd reading, to Rules posted for passage in the Regular Orders of the Day for Friday, February 27, 2009
02/27/09	floor amendments (1) (2) (3) and (4) filed to Committee Substitute
03/03/09	3rd reading floor amendment (2) defeated passed 100-0 with Committee Substitute, floor amendment (1)
03/04/09	received in Senate
03/06/09	to Judiciary (S)
03/09/09	taken from committee 1st reading returned to Judiciary (S)
03/10/09	taken from committee 2nd reading returned to Judiciary (S)
03/11/09	reported favorably, to Rules as a Consent bill with Committee Substitute
03/12/09	posted for passage in the Consent Orders of the Day for Thursday, March 12, 2009 3rd reading, passed 38-0 with Committee Substitute received in House
03/13/09	posted for passage for concurrence in Senate Committee Substitute House concurred in Senate Committee Substitute passed 93-0 enrolled, signed by each presiding officer delivered to Governor
03/24/09	signed by Governor (Act ch. 76)

Amendment	House Committee Substitute 1
Summary	Retain original provisions; amend Section 1 to define "administrator", "auditing entity" and "insurer" and require compliance with the requirements of this Act if a provider agreement or contract "allows" rather than "requires" a pharmacy audit; amend the audit time limit requirement by excluding audits resulting from evidence of fraud from the time limit.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process

Amendment	House Floor Amendment 1
Sponsor	T. Thompson
Summary	Delete Kentucky licensure requirements for audit entity consulting pharmacist; allow an audit within the first 7 days of a month with consent of the pharmacy; authorize an appeal after the final audit report, rather than the preliminary audit report; and provide that the provisions of this Act do not apply to Medicaid investigative audits pursuant to KRS Chapter 205.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process

Amendment	House Floor Amendment 2
Sponsor	S. Brinkman
Summary	Delete 30-day audit notice requirement and substitute 7-day audit notice requirement; delete the provision that prohibits an auditing entity from receiving payment based on a percentage of the audit recovery amount.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process

Amendment	House Floor Amendment 3
Sponsor	J. Gooch Jr.
Summary	Delete the provision prohibiting recoupment of disputed funds by an auditing entity and in lieu thereof provide that recoupment shall be only by contractual agreement and shall not be made until the appeals process is complete; require that if an individual audit identifies a discrepancy in excess of $25,000, future payments to the pharmacy may be withheld pending finalization of the audit.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process

Amendment	House Floor Amendment 4
Sponsor	J. Gooch Jr.
Summary	Delete 30-day audit notice requirement and substitute a 7 day audit notice requirement.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process

Amendment	Senate Committee Substitute 1
Summary	Amend to exempt audits where there are allegations of fraud, willful misrepresentation, or abuse and to exempt audits conducted for a Medicaid managed care organization.
Index Headings	Insurance - Pharmacy, provider agreement, audits Insurance, Health - Pharmacy, audit requirements Insurance, Health - Pharmacy, recoupment of funds by insurer Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for Insurance, Health - Pharmacy, audit appeals process