House Bill 5

Actions | Amendments
Last Action Vetoed
Title AN ACT relating to the prompt payment of Medicaid claims and declaring an emergency.
Bill Documents Bill
Impact Statements Fiscal Note
Bill Request Number 489
Sponsors G. Stumbo, T. Riner, D. Butler, L. Combs, W. Coursey, R. Crimm, B. Damron, J. DeCesare, M. Denham, J. Donohue, K. Hall, R. Huff, K. Imes, J. Jenkins, M. King, M. Marzian, T. McKee, D. Meade , S. Overly, D. Owens, R. Palumbo, T. Pullin, R. Quarles, B. Rowland, A. Simpson, R. Smart, F. Steele, W. Stone, J. Tilley, B. Waide, S. Westrom, A. Wuchner, B. Yonts
Summary of Original Version Create a new section of KRS Chapter 205 to grant the commissioner of the Department of Insurance the power to enforce Kentucky's prompt payment laws as they relate to disputes between the Department of Medicaid Services, Medicaid recipients, providers of care to Medicaid recipients, or a managed care company contracted with the Department of Medicaid Services to provide care to Medicaid recipients; allow a Medicaid recipient or provider to file a claim with the DOI for a failure to comply with Kentucky's prompt payment statutes; permit interest to be charged for nonpayment and provide for additional penalties for nonpayment; create a new section of Subtitle 02 of KRS Chapter 304 to grant the commissioner of the DOI authority to enforce Kentucky's prompt payment laws as they relate to disputes between the DMS, Medicaid recipients, providers of care to Medicaid recipients, or a managed care company contracting with the DMS to provide care to Medicaid recipients; require the DOI to establish an internal appeals and hearing process for review of prompt payment claims; guarantee that currently existing unpaid "clean" or "less than clean" claims or any claims that arise after the effective date of the bill and before the implementation of hearing regulations shall be guaranteed interest payments and that each day shall continue to count as a separate violation even without a hearing process established; EMERGENCY.
Index Headings of Original Version Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process
Proposed Amendments House Committee Substitute 1
House Floor Amendment 1
House Floor Amendment 2
House Floor Amendment 3
House Floor Amendment 4
House Floor Amendment 5
House Floor Amendment 6
Votes Vote History
Governor's Veto Message Veto

Actions

Top | Amendments
02/07/13
  • introduced in House
02/11/13
  • to Health & Welfare (H)
02/13/13
  • posted in committee
02/21/13
  • reported favorably, 1st reading, to Calendar with Committee Substitute
  • floor amendment (1) filed to Committee Substitute, floor amendment (2-title) filed
02/22/13
  • 2nd reading, to Rules
  • posted for passage in the Regular Orders of the Day for Monday, February 25, 2013
  • floor amendment (3) filed to Committee Substitute
02/25/13
  • floor amendments (4) and (5) filed to Committee Substitute
02/26/13
  • floor amendment (6) filed to Committee Substitute
02/27/13
  • 3rd reading, passed 99-0 with Committee Substitute, floor amendments (2-title) (5) and (6)
02/28/13
  • received in Senate
03/05/13
  • to Appropriations & Revenue (S)
03/06/13
  • taken from Appropriations & Revenue (S)
  • 1st reading
  • returned to Appropriations & Revenue (S)
03/12/13
  • taken from Appropriations & Revenue (S)
  • 2nd reading
  • returned to Appropriations & Revenue (S)
03/25/13
  • reported favorably, to Rules as a Consent Bill
  • posted for passage in the Consent Orders of the Day for Monday, March 25, 2013
  • 3rd reading, passed 37-0
  • received in House
  • enrolled, signed by each presiding officer
  • delivered to Governor
04/05/13
  • Vetoed

Proposed Amendments

Top | Actions
Amendment House Committee Substitute 1
Impact Statements Fiscal Note
Summary Delete original provisions; amend KRS 304.17A-730 to require the commissioner of the Department of Insurance to enforce Kentucky's prompt payment laws as they relate to disputes between the providers of care to Medicaid recipients and Medicaid Managed care organizations and Medicaid recipients and the MCOs; allow a Medicaid recipient or provider to file a claim with the DOI for a failure to comply with Kentucky's prompt payment statutes; allow a hearing to be requested when the claim is denied or after 30 days of nonpayment; allow a hearing to be requested for a claim designated as "less than clean" after 120 days of nonpayment; allow multiple claims to be reviewed in one complaint; allow the DOI to charge a filing fee to cover its reasonable expenses; allow the DOI to investigate issues arising through the report process; require eligible claims to be filed within 30 days, require a ruling within 30 days if no hearing and 60 days if a hearing; encourage reporting form documents be forwarded to State Auditor for review; exempt fee-for-service Medicaid; permit interest rate of 14% to be charged for nonpayment and provide for additional penalties for nonpayment; require the commissioner of the DOI authority to enforce Kentucky's prompt payment laws as they relate to disputes between the DMS, Medicaid recipients, providers of care to Medicaid recipients, or a managed care company contracting with the DMS to provide care to Medicaid recipients; require the DOI to establish an internal appeals and hearing process for review of prompt payment claims; guarantee that currently existing unpaid "clean" or "less than clean" claims or any claims that arise after the effective date of the bill and before the implementation of hearing regulations shall be guaranteed interest payments and that each day shall continue to count as a separate violation even without a hearing process established; EMERGENCY.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 1
Sponsor G. Stumbo
Summary Retain original provisions except delete emergency clause.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 2
Sponsor G. Stumbo
Summary Make title amendment.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 3
Sponsor T. Pullin
Summary Amend Section 1 to require the commissioner of the Department of Insurance to enforce private managed care plan network adequacy requirements for Medicaid MCOs for purposes of prompt payment.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 4
Sponsor G. Stumbo
Summary Retain provisions of HCS, however clarify that the program shall be implemented and operational within 60 days of the effective date of the Act.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 5
Sponsor J. Lee
Summary Add and amend KRS 304.17A-722 to require all insurers to report quarterly information on prompt payment of clean claims, including the number of original claims and corrected claims received by the insurer from a provider, its billing agent, or designee, including the number of times a claim is corrected and resubmitted; require the Department of Insurance to promulgate administrative regulations to require quarterly reporting of pharmacy claims administration by all insurers or entities providing the service by contract with the insurer; require insurers to submit quarterly prompt payment reports no later than 90 days, rather than 180 days, following the close of the reporting quarter.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Amendment House Floor Amendment 6
Sponsor G. Stumbo
Summary Retain original provisions, except require the disputes to be adjudicated by the DOI to concern disputes between providers and MCOs; require the program to be implemented and operational within 60 days of the effective date of the bill; delete emergency clause.
Index Headings Health and Medical Services - Claims by Medicaid managed care company, prompt payment of administrative process
Physicians and Practitioners - Claims by Medicaid managed care company, prompt payment of administrative process
Public Medical Assistance - Claims by Medicaid managed care company, prompt payment of administrative process
Medicaid - Claims by Medicaid managed care company, prompt payment of administrative process
Fiscal Note - Claims by Medicaid managed care company, prompt payment of administrative process

Last updated: 1/16/2019 3:24 PM (EST)