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MCO bill becomes law in Kentucky

April 5, 2019HME News Staff

FRANKFORT, Ky. - Kentucky Gov. Matt Bevin has signed into law a bill that streamlines DME regulations and reimbursement policy for the managed care organizations managing the state's Medicaid program.The bill ensures that MCOs:Reimburse DME suppliers by at least 90% of the rate set by the Kentucky Medicaid program;Requires that specialty items not listed on the current fee schedule be reimbursed at the manufacturer's suggested retail price minus 18% or at invoice cost plus 20% when there is no MSRP,...

Kentucky, legislation, Managed Care, protections


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MCO bill clears Kentucky House

February 22, 2019HME News Staff

FRANKFORT, Ky. - A bill that would hold managed care organizations more accountable passed the Kentucky House of Representatives on Thursday 100-0, VGM reports. The bill, H.B. 224, would ensure that DME providers are paid at the rate set by the Kentucky Medicaid program and would ensure that when they receive prior authorizations their claims can't be denied for “lack of medical necessity.” Stakeholders, including members of KMESA, had been lobbying hard to move the bill in the past couple...

Kentucky, legislation, Managed Care


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