HB 317 KY

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Introduced

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.

• K. Moser Republican · primary
• R. Duvall Republican · primary
• C. Aull Democratic · primary
• K. Banta Republican · primary
• D. Bentley · primary
• T. Bojanowski Democratic · primary
• S. Bratcher Republican · primary
• A. Camuel Democratic · primary
• A. Gentry Democratic · primary
• D. Grossberg Democratic · primary
• M. Hart Republican · primary
• R. Palumbo · primary
• J. Raymond · primary
• R. Roberts · primary
• T. Smith Republican · primary
• S. Stalker Democratic · primary
• K. Timoney · primary
• R. White Republican · primary
• W. Williams Republican · primary

1. Jan 19, 2024 introduced in House · lower
2. Jan 19, 2024 to Committee on Committees (H) · lower
3. Feb 8, 2024 to Banking & Insurance (H) · lower
4. Mar 11, 2024 taken from Banking & Insurance (H) · lower
5. Mar 11, 2024 1st reading · lower
6. Mar 11, 2024 returned to Banking & Insurance (H) · lower
7. Mar 12, 2024 taken from Banking & Insurance (H) · lower
8. Mar 12, 2024 2nd reading · lower
9. Mar 12, 2024 returned to Banking & Insurance (H) · lower

The published texts of this bill as it moves through the legislature. Each links to the official document on the state legislature site. Data from OpenStates.

• Introduced · PDF