Introduced

Passed House

Passed Senate

Became law

Adjourned sine die. The bill was pending when the session ended, so it did not pass.

Last action · February 9, 2026

To Health Services (H)

Introduced February 2, 2026

House

Adjourned Sine Die

2026 Regular Session

HB538

AN ACT relating to Medicaid managed care organizations.

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 or 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…

Health and Medical Services Health Care Professionals Medicaid Reports Mandated State Agencies Administrative Regulations and Proceedings

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This bill would add new rules for Medicaid managed care organizations in Kentucky, focused on how they handle disputes with healthcare providers. It would give providers more time to appeal denied or reduced payments, set deadlines for resolving those disputes, and require overdue payments to include interest and attorney's fees. It also sets standards for audits of providers and requires more detailed public reporting on Medicaid claims and appeals. Who it may affect: healthcare providers who accept Medicaid patients, and state agencies overseeing Medicaid programs.

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