Summary of Original Version

Amend KRS 205.6412 to require the Department for Medicaid Services to seek authorization from the United States Centers for Medicare and Medicaid Services to implement a state-directed payment for physician and nonphysician professional services provided to a Medicaid beneficiary by a qualifying hospital's affiliated physician groups or physicians and other professionals employed or contracted by the qualified hospital; require the Department of Medicaid Services to direct Medicaid managed care organizations to issue payments back to January 1, 2026, upon federal approval; RETROACTIVE.

Summary of Amendment: House Floor Amendment 1 -- J. Petrie

Summary Establish that the nonfederal share, or state match, required for the state-directed payment shall not be from state funds including the general fund or state restricted funds; require the Department for Medicaid Services to terminate a state-directed payment program for which an appropriate source of funding for the nonfederal share is unavailable; establish that the state shall not be liable for providing reimbursement to the federal government if the Centers for Medicare and Medicaid Services seeks to recoup funds associated with a state-directed payment program; establish that the qualifying hospitals that receive state-directed payments shall be jointly and severally liable for reimbursement.

Summary of Amendment: Senate Committee Substitute 1

Summary Retain original provisions, except delete prohibition on use of state funds other than the general fund; revise provisions related to the possible recoupment of funds by a federal agency; make technical corrections.

Statutes affected:
Introduced: 205.6412
Senate Committee Substitute 1: 205.6412
Current: 205.6412