KY HB317 | 2024 | Regular Session
Status
Spectrum: Bipartisan Bill
Status: Introduced on January 19 2024 - 25% progression
Action: 2024-03-12 - returned to Banking & Insurance (H)
Pending: House Banking and Insurance Committee
Text: Latest bill text (Introduced) [PDF]
Status: Introduced on January 19 2024 - 25% progression
Action: 2024-03-12 - returned to Banking & Insurance (H)
Pending: House Banking and Insurance Committee
Text: Latest bill text (Introduced) [PDF]
Summary
Amend KRS 304.17A-600 to define "health care provider"; make conforming amendments; create new sections of KRS 304.17A-600 to 304.17A-633 to establish eligibility criteria and requirements for prior authorization exemptions; establish requirements for rescinding prior authorization exemptions; set forth requirements for external reviews of prior authorization exemption denials and rescissions; establish requirements for sending forms and notices to health care providers; provide that nothing shall be construed to authorize a health care provider to act outside the provider's scope of practice or require an insurer or private review agent to pay for a health care service performed in violation of law; require the commissioner of the Department of Insurance to establish forms; amend KRS 304.17A-605 to establish applicability of provisions relating to prior authorization exemptions to certain insurers and private review agents; amend KRS 304.17A-607 to establish requirements for prior authorizations; amend KRS 304.17A-611 to prohibit the retrospective denial, reduction in payment, and review of health care services for which a health care provider has a prior authorization exemption and establish exceptions; amend KRS 304.17A-621 to conform; amend KRS 304.17A-627 to prohibit conflicts of interest with independent review entities and reviewers of prior authorization exemption denials and rescissions; require independent review entities and reviewers of prior authorization exemption denials and rescissions to submit an annual report to the Department of Insurance; amend KRS 304.17A-633 to require the commissioner of the Department of Insurance to report on external reviews of prior authorization exemptions denials and rescissions; amend KRS 304.17A-706 to conform; amend KRS 205.536 to require managed care organizations contracted to provide Medicaid benefits to comply with the sections on prior authorization exemptions; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after the effective date of the Act; require the Cabinet for Health and Family Services to seek approval if it is determined that such approval is necessary; EFFECTIVE, in part, January 1, 2025.
Title
AN ACT relating to prior authorization.
Sponsors
History
| Date | Chamber | Action |
|---|---|---|
| 2024-03-12 | House | returned to Banking & Insurance (H) |
| 2024-03-12 | House | 2nd reading |
| 2024-03-12 | House | taken from Banking & Insurance (H) |
| 2024-03-11 | House | returned to Banking & Insurance (H) |
| 2024-03-11 | House | 1st reading |
| 2024-03-11 | House | taken from Banking & Insurance (H) |
| 2024-02-08 | House | to Banking & Insurance (H) |
| 2024-01-19 | House | to Committee on Committees (H) |
| 2024-01-19 | House | introduced in House |
Subjects
Actuarial Analysis
Conflict of Interest
Effective Dates, Delayed
Health and Medical Services
Health Benefit Mandate
Insurance, Health
Local Mandate
Medicaid
Physicians and Practitioners
Reports Mandated
State Agencies
Conflict of Interest
Effective Dates, Delayed
Health and Medical Services
Health Benefit Mandate
Insurance, Health
Local Mandate
Medicaid
Physicians and Practitioners
Reports Mandated
State Agencies
