Kentucky 2018 Regular Session Status: Enacted 1 R cosponsors

HB 69 — AN ACT relating to service delivery improvements in managed care networks. Create new sections of KRS Chapter 205 to define terms; establish and require that the Department for Medicaid Services designate a single credentialing verification organization to verify credentials for DMS and all contracted Medicaid Managed Care Organizations; submit the credentialing organization to Government Contract Review Committee for comment; require providers to submit a single application to the credentialing organization; require notification within 5 days to the provider if application is complete; require verified packets be sent to the DMS and MCOs within 30 days; require DMS to enroll providers within 15 days and for the MCOs to determine if they will contract with the provider within 15 days; specify that for reimbursement of claims purposes the date of the submission of the credentialing application shall be the date of original enrollment and credentialing; address the written internal appeals process of MCOs; require 24/7 utilization reviews and daily staffing for claims resolution; establish grievance and appeal timeline and written appeal requirements; require reprocessing of incorrectly paid or erroneously denied claims; allow for in-person meetings for unpaid claims beyond 45 days and that individually or in the aggregate exceed $2,500; require consistency and timeliness between physical, behavioral, or other medically necessary services; establish timelines for preauthorization requests; require that substance use disorder be treated as an urgent preauthorization request; require a single nationally recognized clinical review criteria for both physical health and behavioral health services; establish monthly reporting requirements for MCOs relating to claims; require reporting between the DMS and the Department of Insurance; establish penalties for MCOs that fail to comply; prohibit automatic assignment of Medicaid enrollees to an MCO unless there is a participating acute care hospital within the distance requirements; allow for enrollees to change MCOs outside of the open enrollment if their hospital or PCP terminates participation with an MCO; amend KRS 304.17A-515 to require each managed care plan to demonstrate that it offers physically available acute care hospital services; amend KRS 304.17A-576 to require a response about credentialing within 45 instead of 90 days; amend KRS 304.17A-700 to reference Section 1 of the bill.

Last action — Became law without Governor's Signature (Acts, ch. 106)

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed House
  4. ✓
    Passed Senate
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced November 29, 2017. Enacted.

Prognosis

Advancing 54% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 2 sponsors

    2 primary, 0 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (1 R).

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

Action History

  1. Became law without Governor's Signature (Acts, ch. 106)

  2. Filed without Governor's signature with the Secretary of State

  3. Delivered to Governor

  4. Enrolled, signed by President of the Senate

  5. Enrolled, signed by Speaker of the House

  6. Passed 91-1

  7. House concurred in Senate Committee Substitute and floor amendment (1)

  8. Posted for passage for concurrence in Senate Committee Substitute and floor amendment (1)

  9. Taken from Rules

  10. To Rules (H)

  11. Received in House

  12. 3rd reading, passed 37-0 with Committee Substitute (1) floor amendment (1)

  13. Floor amendment (1) filed to Committee Substitute

  14. Passed over and retained in the Orders of the Day

  15. Taken from the Consent Orders of the Day, placed in the Regular Orders of the Day

  16. Posted for passage in the Consent Orders of the Day for Friday, March 16, 2018

  17. 2nd reading, to Rules

  18. Reported favorably, 1st reading, to Consent Calendar with Committee Substitute (1)

  19. To Health & Welfare (S)

  20. Received in Senate

  21. 3rd reading, passed 94-0 with Committee Substitute, floor amendment (1)

  22. Floor amendment (1) filed to Committee Substitute

  23. Posted for passage in the Regular Orders of the Day for Wednesday, February 21, 2018

  24. 2nd reading, to Rules

  25. Reported favorably, 1st reading, to Calendar with Committee Substitute

  26. Posted in committee

  27. To Banking & Insurance (H)

  28. Introduced in House

  29. Prefiled by the sponsor(s).

Sponsors

Sponsorship breakdown

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2 sponsors · 0 co-sponsors · 136 not signed on

Sponsors (2)

Co-sponsors (0)

None.

Not signed on (136)

136 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors HB 69?
HB 69 is sponsored by M. Prunty and Ken Fleming (Republican).
What is the current status of HB 69?
This bill has been enacted into law. Introduced November 29, 2017. Enacted.
Where can I track HB 69?
Track HB 69 free on One Click Politics — get push/email alerts when it moves.

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Last checked for changes 3 months ago · updated continuously

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