HB 538 Kentucky House · 2026 Regular Session

AN ACT relating to Medicaid managed care organizations.

Summary
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.
Bill status in committee 1 of 4 stages cleared
Introduction
Feb 2026
Committee Review
Floor Vote
Governor
Introduced Feb 2, 2026 Last action Feb 9, 2026
Floor votes

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Full legislative history

Actions timeline

Total actions
3
Key actions
0
Committee
2
Feb 9, 2026
Committee
to Health Services (H)
lower
Feb 2, 2026
Committee
to Committee on Committees (H)
lower
Feb 2, 2026
Introduced
introduced in House
lower
0 primary · 0 co-sponsors

Sponsors

No sponsor information available.