Video & Transcript Research : 'chapter 14'

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KY
Transcript Highlights:
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Summary: The House Standing Committee on Health Services met with a quorum and took up House Bill 785, as amended by a committee substitute that combined language from HB 785 and HB 787. The bill was described as addressing Medicaid managed care organization (MCO) audits, provider contract notice and amendment procedures, mental health parity compliance, and related transparency requirements. Supporters said the measure would tighten notice to providers, limit repeated contract amendments and rate reductions, require more standardized audit procedures, and add reporting on Medicaid claims, appeals, and grievances. It also includes a provision requiring coverage of at least two evaluation-and-management billable services per physician per recipient per date of service, and a section addressing narcotic/opioid treatment program licensing and reimbursement language. Testimony in support came from Representative Kim Moore, John Inman of BrightView Health, Michelle Sandborne of the Children’s Alliance, and Kelly Cormic of RYSE. They argued that MCOs often use audits and recoupments in ways that are burdensome, opaque, and financially damaging to providers, especially smaller and rural ones. They cited examples of multiple audit requests in short timeframes, large record requests with short deadlines, delayed or absent feedback, and recoupments taken before appeals are resolved. They also said parity laws are not being consistently enforced and that the bill would give the Department of Insurance authority to suspend or revoke an MCO certificate of authority for willful or repeated parity violations. Committee members generally expressed support for provider protections and transparency, while asking for clarification on the narcotic treatment and E/M billing provisions. Tom Stevens of the Kentucky Association of Health Plans testified in opposition, saying the bill is complex to implement and should be handled through the broader Medicaid oversight work of House Bill 9, the MOAB. He said the issues raised were better suited for that bipartisan stakeholder process and noted the committee substitute had not yet been fully reviewed by his group. After discussion, the committee adopted the committee substitute and then moved to a vote on the bill; the roll call began, with several members recorded as voting yes, but the transcript cuts off before the final vote result is shown.