Kentucky House Bill 69 (Prior Session Legislation)

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Completed Legislative Action
Spectrum: Partisan Bill (Republican 2-0)
Status: Passed on April 4 2018 - 100% progression
Action: 2018-04-04 - became law without Governor's Signature (Acts, ch. 106)
Text: Latest bill text (Draft #3) [PDF]

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.

AN ACT relating to service delivery improvements in managed care networks.

Rep. Ken Fleming [R]

Rep. Melinda Prunty [R]

2018-03-21 - House - House: Third Reading RCS# 382 (Y: 91 N: 1 NV: 0 Abs: 8) [PASS]
2018-03-19 - Senate - Senate: Third Reading W/SCS 1, SFA 1 RSN# 560 (Y: 37 N: 0 NV: 0 Abs: 1) [PASS]
2018-02-22 - House - House: Third Reading RCS# 164 (Y: 94 N: 0 NV: 0 Abs: 4) [PASS]

Date	Chamber	Action
2018-04-04	House	became law without Governor's Signature (Acts, ch. 106)
2018-04-02	House	filed without Governor's signature with the Secretary of State
2018-03-22	House	delivered to Governor
2018-03-22	House	enrolled, signed by President of the Senate
2018-03-22	House	enrolled, signed by Speaker of the House
2018-03-21	House	passed 91-1
2018-03-21	House	House concurred in Senate Committee Substitute and floor amendment (1)
2018-03-21	House	posted for passage for concurrence in Senate Committee Substitute and floor amendment (1)
2018-03-21	House	taken from Rules
2018-03-20	House	to Rules (H)
2018-03-20	House	received in House
2018-03-19	Senate	3rd reading, passed 37-0 with Committee Substitute (1) floor amendment (1)
2018-03-16	Senate	floor amendment (1) filed to Committee Substitute
2018-03-16	Senate	passed over and retained in the Orders of the Day
2018-03-16	Senate	taken from the Consent Orders of the Day, placed in the Regular Orders of the Day
2018-03-15	Senate	posted for passage in the Consent Orders of the Day for Friday, March 16, 2018
2018-03-15	Senate	2nd reading, to Rules
2018-03-14	Senate	reported favorably, 1st reading, to Consent Calendar with Committee Substitute (1)
2018-02-26	Senate	to Health & Welfare (S)
2018-02-23	Senate	received in Senate
2018-02-22	House	3rd reading, passed 94-0 with Committee Substitute, floor amendment (1)
2018-02-21	House	floor amendment (1) filed to Committee Substitute
2018-02-20	House	posted for passage in the Regular Orders of the Day for Wednesday, February 21, 2018
2018-02-16	House	2nd reading, to Rules
2018-02-15	House	reported favorably, 1st reading, to Calendar with Committee Substitute
2018-01-31	House	posted in committee
2018-01-02	House	to Banking & Insurance (H)
2018-01-02	House	introduced in House
2017-11-29	House	Prefiled by the sponsor(s).

Type	Source
Summary	http://www.lrc.ky.gov/record/18RS/HB69.htm
Text	http://www.lrc.ky.gov/recorddocuments/bill/18RS/HB69/bill.pdf
Amendment	http://www.lrc.ky.gov/recorddocuments/bill/18RS/HB69/HCS1.pdf
Amendment	http://www.lrc.ky.gov/recorddocuments/bill/18RS/HB69/HFA1.pdf
Amendment	http://www.lrc.ky.gov/recorddocuments/bill/18RS/HB69/SCS1.pdf
Amendment	http://www.lrc.ky.gov/recorddocuments/bill/18RS/HB69/SFA1.pdf
Roll Call	http://www.lrc.ky.gov/record/18RS/HB69/vote_history.pdf