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HB538Introduced in the House

AN ACT relating to Medicaid managed care organizations.

IntroducedHouse Health Services

Introduced by Kimberly Moser, District 64

What does this bill do?

Plain-English breakdown

Writing a plain-English summary of this bill… this can take a few seconds the first time.

Official description

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 or 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 interest in accordance with KRS 304.17A-730 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 for the previous state fiscal year; authorize the Department for Medicaid Services to promulgate administrative regulations; require Cabinet for Health and Family Services or the Department for Medicaid Services to seek federal approval if they determine that such approval is necessary.

Where it stands

to Health Services (H)

February 9, 2026

How did lawmakers vote?

No recorded vote is available for this bill yet.

What do people think?

Citizen Voice

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Bill history

  1. introduced in House

  2. to Committee on Committees (H)

  3. to Health Services (H)

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