| Last Action | 02/27/25: to Health Services (H) |
|---|---|
| Title | AN ACT relating to Medicaid managed care organizations. |
| Bill Documents | Introduced |
| Bill Request Number | 1947 |
| Sponsor | K. Moser |
| Summary of Original Version | Amend KRS 205.533 to require Medicaid managed care organizations to include certain information for providers on their websites; amend KRS 205.534 to require managed care organizations to allow providers 120 days to file an appeal or grievance related to a reduction of denial of a claim; establish penalties for a managed care organization's failure to ensure the timely disposition of any appeal or grievance; require payment of any amount owed to a provider following an appeal to be paid within 30 days; require payments made following an appeal to include 12% interest and reasonable attorney's fees; establish standards and requirements for provider audits; require the inclusion of additional information in the monthly report filed by managed care organizations; require the Department for Medicaid Services to submit an annual report to the Legislative Research Commission related to Medicaid claims, appeals, and grievances; authorize the Department for Medicaid Services to promulgate administrative regulations. |
| Index Headings of Original Version |
Health and Medical Services - Medicaid, managed care organization provider audits, requirements Physicians and Practitioners - Medicaid, managed care organization provider audits, requirements Public Medical Assistance - Managed care organization provider audits, requirements State Agencies - Department for Medicaid Services, annual report, requirement State Agencies - Department for Medicaid Services, promulgation of administrative regulations, authorization Medicaid - Managed care organization provider audits, requirements Administrative Regulations and Proceedings - Department for Medicaid Services, provider audits, authorizaton Reports Mandated - Department for Medicaid Services, annual report, Medicaid claims, requirement |
| 02/19/25 |
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| 02/27/25 |
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Last updated: 7/24/2025 3:26 PM (EDT)