HB538

Kentucky HB538 amends Medicaid managed care organization regulations to enhance provider and member protections.

Kentucky HB538 modifies Medicaid managed care organization regulations to improve provider and member protections. Managed care organizations must maintain an interactive website for electronic grievances, appeals, and documentation. They must also provide a toll-free telephone line for claims resolution and written replies for adverse payment or coverage determinations. The bill mandates timely consideration and resolution of grievances and appeals, with fines for non-compliance.