HB687
Log in to followAN ACT relating to third-party payors.
Create a new section of KRS Chapter 205 to define terms; establish payment and response requirements for third-party payors; amend KRS 205.623 to require third-party payors to respond within 60 days of certain health care claim inquiries from the Department for Medicaid Services; create a new section of KRS Chapter 18A, and amend KRS 205.532 and 304.12-255, to require the state employee health plan, affiliated and associated entities of Medicaid managed care organizations, and health insurers to comply with third-party payor requirements.
Introduced: February 18, 2025
Last action: February 26, 2025
Plain-language summary
This bill sets rules for how third-party payors, such as insurance companies and the state employee health plan, must handle health care payment claims. It requires these payors to meet specific payment and response deadlines, including responding within 60 days when the state Medicaid program asks about a claim. The goal is to improve coordination between insurers and Medicaid so that claims are resolved more efficiently. Who it may affect: Kentuckians enrolled in Medicaid, state employees with government health coverage, and health insurers operating in Kentucky.
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Legislative History
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