Kentucky House Bill 134 (Prior Session Legislation)

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Spectrum: Slight Partisan Bill (Democrat 5-2)
Status: Introduced on January 6 2023 - 25% progression, died in committee
Action: 2023-02-24 - recommitted to Banking & Insurance (H)
Pending: House Banking and Insurance Committee
Text: Latest bill text (Introduced) [PDF]

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; 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; 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; amend KRS 304.17A-600 to conform; 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; provide that a lack of prior authorization shall not alone be a basis for a retrospective review; 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 prohibit contesting a clean claim by conducting a retrospective review based on a lack of prior authorization; amend KRS 205.536 to require the Department for Medicaid Services, or 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, 2024.

AN ACT relating to prior authorization.

Rep. Kimberly Moser [R]	Rep. Chad Aull [D]	Rep. Nima Kulkarni [D]	Rep. Josie Raymond [D]
Rep. Sarah Stalker [D]	Rep. Cherlynn Stevenson [D]	Rep. Wade Williams [R]

Date	Chamber	Action
2023-02-24	House	recommitted to Banking & Insurance (H)
2023-02-24	House	2nd reading, to Rules
2023-02-23	House	reported favorably, 1st reading, to Calendar with Committee Substitute (1)
2023-02-17	House	to Health Services (H)
2023-01-06	House	to Committee on Committees (H)
2023-01-06	House	introduced in House

Type	Source
Summary	https://apps.legislature.ky.gov/record/23RS/hb134.html
Text	https://apps.legislature.ky.gov/recorddocuments/bill/23RS/hb134/orig_bill.pdf
Amendment	https://apps.legislature.ky.gov/recorddocuments/bill/23RS/HB134/HCS1.pdf
Amendment	https://apps.legislature.ky.gov/recorddocuments/note/23RS/hb134/HCS1HM.pdf