HB787
Log in to followAN 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 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…
Introduced: February 19, 2025
Last action: February 27, 2025
Plain-language summary
This bill would set new rules for how Medicaid managed care organizations in Kentucky handle disputes with healthcare providers over denied or reduced claims. It would give providers more time to appeal claim decisions, require faster payments after successful appeals, and add interest and attorney's fees if payments are delayed. It also establishes oversight through new reporting requirements to state government. Who it may affect: healthcare providers who bill Medicaid, such as doctors, hospitals, and clinics, as well as Medicaid patients whose care those providers deliver.
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Legislative History
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