| Last Action | floor amendment (1) filed to Committee Substitute |
|---|---|
| Title | AN ACT relating to Medicaid managed care organization provider payments. |
| Bill Documents |
Bill
|
| Impact Statements | Fiscal Note |
| Bill Request Number | 1877 |
| Sponsors | B. Leeper, W. Blevins Jr., M. Wilson |
| Summary of Original Version | Amend KRS 205.522 to define terms; permit an enrollee of a medicaid managed care organization (MCO) to assign rights to appeal an action by an MCO relating to care received by an enrollee; establish an enrollee's right to a state fair hearing when an enrollee or assignee appeals an MCO's action relating to care received or proposed to be given to an enrollee; require an action by an MCO to state the reason for an action with specificity; state that the MCO shall pay for services rendered while an appeal was pending if a hearing officer reverses a decision to deny, reduce, or terminate health care services. |
| Index Headings of Original Version |
Fiscal Note - Medicaid managed care organization, appeal rights Health and Medical Services - Medicaid managed care organization, appeal rights Hospitals and Nursing Homes - Medicaid managed care organization, appeal rights Public Medical Assistance - Medicaid managed care organization, appeal rights Medicaid - Medicaid managed care organization, appeal rights |
| Proposed Amendments |
Senate Committee Substitute 1 Senate Floor Amendment 1 |
| 02/26/14 |
|
|---|---|
| 02/28/14 |
|
| 03/12/14 |
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| 03/13/14 |
|
| 03/18/14 |
|
| Amendment | Senate Committee Substitute 1 |
|---|---|
| Impact Statements | Fiscal Note |
| Summary | Retain original provisions except make a hearing officer's ruling subject only to judicial appeal following a state fair hearing conducted pursuant to the bill, and state that any subject may be addressed in a state fair hearing and require compliance with a federal regulation when a decision to deny authorization of services is reversed. |
| Index Headings |
Fiscal Note - Medicaid managed care organization, appeal rights Health and Medical Services - Medicaid managed care organization, appeal rights Hospitals and Nursing Homes - Medicaid managed care organization, appeal rights Public Medical Assistance - Medicaid managed care organization, appeal rights Medicaid - Medicaid managed care organization, appeal rights |
| Amendment | Senate Floor Amendment 1 |
|---|---|
| Sponsor | B. Leeper |
| Summary | Retain provisions of the SCS, however require the agency head to issue a final order within 25 days or the hearing officer's opinion will become final; require an MCO to pay for all disputed services and interest within 30 days upon exhaustion of all appeals. |
| Index Headings |
Fiscal Note - Medicaid managed care organization, appeal rights Health and Medical Services - Medicaid managed care organization, appeal rights Hospitals and Nursing Homes - Medicaid managed care organization, appeal rights Public Medical Assistance - Medicaid managed care organization, appeal rights Medicaid - Medicaid managed care organization, appeal rights |
Last updated: 8/27/2019 6:52 PM (EDT)