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Senate Bill 20

Actions | Amendments

Last Action	signed by Governor (Acts, ch. 55)
Title	AN ACT relating to Medicaid provider appeals and declaring an emergency.
Bill Documents	Bill
Impact Statements	Fiscal Note
Bill Request Number	131
Sponsors	R. Alvarado, J. Bowen, D. Carroll, J. Higdon, S. Humphries, D. Thayer, R. Webb, S. West, W. Westerfield, M. Wilson, M. Wise
Summary of Original Version	Create new sections of KRS Chapter 205 to define terms, and permit a provider that has exhausted an internal appeals process of a Medicaid managed care organization (MCO) to be entitled to an administrative appeals hearing; require an MCO to send a final determination letter; establish proceedings for an administrative appeals hearing; establish a mechanism for attorneys' fees; establish a fee for the party that does not prevail to cover costs of the proceeding; clarify that this bill applies to all MCO contracts enacted on or after July 1, 2016; amend KRS 13B.020 to include the provider appeals process as a type of administrative hearings to be conducted by the CHFS.
Index Headings of Original Version	Effective Dates, Emergency - BR 131, Medicaid provider appeals Health and Medical Services - MCO provider appeals process Legislative Research Commission - State rate for reasonable and necessary attorneys' fees Physicians and Practitioners - MCO provider appeals process Medicaid - MCO provider appeals process Administrative Regulations and Proceedings - Medicaid Services, Medicaid managed care organization appeals State Agencies - Medicaid Services, Medicaid managed care organization appeals
Proposed Amendments	Senate Committee Substitute 1 Senate Committee Substitute 2
Votes	Vote History

Actions

Top | Amendments

01/06/16	introduced in Senate
01/07/16	to Health & Welfare (S)
01/13/16	reported favorably, 1st reading, to Calendar
01/14/16	2nd reading, to Rules taken from Rules recommitted to Appropriations & Revenue (S)
01/26/16	reported favorably, to Rules with Committee Substitute (1)
02/10/16	taken from Rules recommitted to Health & Welfare (S) reported favorably, to Rules with Committee Substitute (2) posted for passage in the Regular Orders of the Day for Wednesday, February 10, 2016 3rd reading Committee Substitute (1) withdrawn passed 37-0 with Committee Substitute (2)
02/11/16	received in House
02/16/16	to Health & Welfare (H)
03/17/16	posted in committee
03/22/16	reported favorably, 1st reading, to Consent Calendar
03/23/16	2nd reading, to Rules
03/24/16	posted for passage in the Consent Orders of the Day for Friday, March 25, 2016
03/25/16	taken from the Consent Orders of the Day, placed in the Regular Orders of the Day
03/28/16	3rd reading, passed 99-0 received in Senate enrolled, signed by President of the Senate
03/29/16	enrolled, signed by Speaker of the House delivered to Governor
04/08/16	signed by Governor (Acts, ch. 55)

Proposed Amendments

Top | Actions

Amendment	Senate Committee Substitute 1
Summary	Retain original provisions of the bill except to require the Cabinet for Health and Family Services to conduct hearings instead of the Office of the Attorney General; change the time to make a decision from 30 to 60 days; require the hearing officer to determine administrative costs to be reimbursed; increase the fee for the party not prevailing from $100 to $250; declare an EMERGENCY.
Index Headings	Effective Dates, Emergency - BR 131, Medicaid provider appeals Health and Medical Services - MCO provider appeals process Legislative Research Commission - State rate for reasonable and necessary attorneys' fees Physicians and Practitioners - MCO provider appeals process Medicaid - MCO provider appeals process Administrative Regulations and Proceedings - Medicaid Services, Medicaid managed care organization appeals State Agencies - Medicaid Services, Medicaid managed care organization appeals

Amendment	Senate Committee Substitute 2
Summary	Retain original provisions of the bill except to require the cabinet to promulgate administrative regulations to implement the external independent third party review; permit reasonable fees up to $1,000; declare an EMERGENCY.
Index Headings	Effective Dates, Emergency - BR 131, Medicaid provider appeals Health and Medical Services - MCO provider appeals process Legislative Research Commission - State rate for reasonable and necessary attorneys' fees Physicians and Practitioners - MCO provider appeals process Medicaid - MCO provider appeals process Administrative Regulations and Proceedings - Medicaid Services, Medicaid managed care organization appeals State Agencies - Medicaid Services, Medicaid managed care organization appeals

Last updated: 1/16/2019 3:08 PM (EST)