AN ACT relating to prepayment review of Medicaid claims.

Create a new section of KRS Chapter 205 to define terms and to establish standards for the utilization of prepayment claims review in the Medicaid program; require the Cabinet for Health and Family Services or the Department for Medicaid Services to seek federal approval if they determine that such approval is necessary and comply with KRS 205.525.

Introduced: February 13, 2025

Last action: March 14, 2025

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This bill sets rules for how Kentucky's Medicaid program reviews certain claims for payment before those payments are made. It establishes definitions and standards for this review process and requires the state health agency to seek federal approval if needed before putting the process in place. Who it may affect: Kentuckians enrolled in Medicaid and healthcare providers who bill the Medicaid program.

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