| Last Action | 03/01/21: to Health & Welfare (S) |
|---|---|
| Title | AN ACT relating to pharmacy benefits in the Medicaid program and declaring an emergency. |
| Bill Documents |
Current/Final
Introduced |
| Bill Request Number | 1058 |
| Sponsors | S. Sheldon, D. Bentley, K. Banta, A. Bowling, R. Bridges, D. Frazier Gordon, N. Kirk-McCormick, D. Lewis, S. Lewis, C. Massey, B. McCool, B. Reed, N. Tate, W. Thomas |
| Summary of Original Version | Create a new section of KRS 205.510 to 205.560 to define terms; require the Department for Medicaid Services to contract with an independent entity to monitor all Medicaid pharmacy benefit claims; establish eligibility requirements for an entity seeking to contract with the department to monitor pharmacy benefit claims; establish requirements for analyzing and monitoring claims; EMERGENCY. |
| Index Headings of Original Version |
Drugs and Medicines - Medicaid pharmacy benefits, independent monitoring Effective Dates, Emergency - Medicaid pharmacy benefits, independent monitoring Pharmacists - Medicaid pharmacy benefits, independent monitoring Public Medical Assistance - Medicaid pharmacy benefits, independent monitoring Medicaid - Medicaid pharmacy benefits, independent monitoring Administrative Regulations and Proceedings - Medicaid Services, Medicaid pharmacy benefits, independent monitoring |
| Jump to Proposed Amendments | House Committee Substitute 1 |
| Votes | Vote History |
| 01/07/21 |
|
|---|---|
| 02/02/21 |
|
| 02/09/21 |
|
| 02/11/21 |
|
| 02/22/21 |
|
| 02/24/21 |
|
| 02/25/21 |
|
| 03/01/21 |
|
| Amendment | House Committee Substitute 1 |
|---|---|
| Summary | Retain original provisions; limit original contract period to two years; permit the Department for Medicaid Services to renew the contract for up to two years; prohibit the contracted entity from performing drug utilization reviews; require the Department for Medicaid Services to verify underpayments identified by the contracted entity; establish appeals process; require the contracted entity to submit a quarterly report to the Medicaid Oversight and Advisory Committee; limit compensation to no more than 30% of the total savings generated by the contracted entity; establish that the provisions of this section expire on January 1, 2024 unless reauthorized by the General Assembly. |
| Index Headings |
Reports Mandated - Medicaid pharmacy benefits, independent monitoring Sunset Legislation - Medicaid pharmacy benefits, independent monitoring, January 1, 2024 |
Last updated: 11/9/2023 2:52 PM (EST)