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SB20/FN (BR131) - R. Alvarado, J. Bowen, D. Carroll, J. Higdon, S. Humphries, D. Thayer, R. Webb, S. West, W. Westerfield, M. Wilson, M. Wise

     AN ACT relating to Medicaid provider appeals and declaring an emergency.
    Create new sections of KRS Chapter 205 to define terms, and permit a provider that has exhausted an internal appeals process of a Medicaid managed care organization (MCO) to be entitled to an administrative appeals hearing; require an MCO to send a final determination letter; establish proceedings for an administrative appeals hearing; establish a mechanism for attorneys' fees; establish a fee for the party that does not prevail to cover costs of the proceeding; clarify that this bill applies to all MCO contracts enacted on or after July 1, 2016; amend KRS 13B.020 to include the provider appeals process as a type of administrative hearings to be conducted by the CHFS.


SB20 - AMENDMENTS

     SCS1 - Retain original provisions of the bill except to require the Cabinet for Health and Family Services to conduct hearings instead of the Office of the Attorney General; change the time to make a decision from 30 to 60 days; require the hearing officer to determine administrative costs to be reimbursed; increase the fee for the party not prevailing from $100 to $250; declare an EMERGENCY.
     SCS2 - Retain original provisions of the bill except to require the cabinet to promulgate administrative regulations to implement the external independent third party review; permit reasonable fees up to $1,000; declare an EMERGENCY.

     Jan 06, 2016 - introduced in Senate
     Jan 07, 2016 - to Health & Welfare (S)
     Jan 13, 2016 - reported favorably, 1st reading, to Calendar
     Jan 14, 2016 - 2nd reading, to Rules; taken from Rules; recommitted to Appropriations & Revenue (S)
     Jan 26, 2016 - reported favorably, to Rules with Committee Substitute (1)
     Feb 10, 2016 - taken from Rules; recommitted to Health & Welfare (S); reported favorably, to Rules with Committee Substitute (2); posted for passage in the Regular Orders of the Day for Wednesday, February 10, 2016; 3rd reading; Committee Substitute (1) withdrawn; passed 37-0 with Committee Substitute (2)
     Feb 11, 2016 - received in House
     Feb 16, 2016 - to Health & Welfare (H)
     Mar 17, 2016 - posted in committee
     Mar 22, 2016 - reported favorably, 1st reading, to Consent Calendar
     Mar 23, 2016 - 2nd reading, to Rules
     Mar 24, 2016 - posted for passage in the Consent Orders of the Day for Friday, March 25, 2016
     Mar 25, 2016 - taken from the Consent Orders of the Day, placed in the Regular Orders of the Day
     Mar 28, 2016 - 3rd reading, passed 99-0; received in Senate; enrolled, signed by President of the Senate
     Mar 29, 2016 - enrolled, signed by Speaker of the House; delivered to Governor
     Apr 08, 2016 - signed by Governor (Acts, ch. 55)