HB787: AN ACT relating to Medicaid managed care organizations.

Legislative Summary

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 appeal to be paid within 30 days; require payments made following an appeal to include 12% interest and reasonable attorney's fees; establish standards and requirements for provider audits; require the inclusion of additional information in the monthly report filed by managed care organizations; require the Department for Medicaid Services to submit an annual report to the Legislative Research Commission related to Medicaid claims, appeals, and grievances; authorize the Department for Medicaid Services to promulgate administrative regulations.