Summary of Original Version

Create new sections of KRS 205 to define terms; established limitations on material changes to contracts between Medicaid managed care organizations and Medicaid-participating providers; require contracts between the Department for Medicaid Services and a managed care organization to comply with federal laws related to mental health parity; require behavioral health programs to be accredited and narcotic treatment programs to be licensed in order to be eligible for Medicaid reimbursement; amend KRS 205.522 to require the Department for Medicaid Services and managed care organizations to comply with KRS 304.17A-661 related to treatment of mental health conditions and 304.17A-700 to 304.171A-730 related to payment of claims; require managed care organizations to provide a description of reasons for denial when payment of a claim is denied; amend KRS 304.38.130 to authorize the commissioner of the Department of Insurance to suspend or revoke a Medicaid managed care organization's certificate of authority for willful or frequent and repeated failure to comply with Section 1 of this Act, 42 U.S.C. sec. 1396u-2, or 42 C.F.R. pt. 438 Subpart K.

Statutes affected:
Introduced: 205.522