House passes bills on Medicaid and prescription drugs

Frankfort – The Kentucky House of Representatives voted unanimously today for two bills House Speaker Greg Stumbo sponsored to address concerns with Medicaid managed care and to update last year’s law targeting prescription drug abuse.

“Taken together, these bills will improve our healthcare system by making some common-sense changes and clarifications,” said Speaker Stumbo, D-Prestonsburg.  “House Bill 5 will do that by making it easier for medical providers to resolve payment disputes much more quickly with the state’s Medicaid managed care organizations (MCOs).  House Bill 217, meanwhile, will make some minor changes to last year’s ‘pill mill’ legislation and ensure that both the law and the regulations being finalized by the medical licensure boards mesh well.”

In remarks to his fellow House members on House Bill 5, Speaker Stumbo said his plan would be to treat the MCOs more like private insurers when disputes with healthcare providers arise.  The bill would give the state’s Dept. of Insurance more authority to levy and enforce penalties, and it encourages more transparency so that providers and patients alike know why claims may be denied.

Speaker Stumbo said the Auditor’s office has indicated that the MCOs have received a half-billion Medicaid dollars from the state that have yet to be paid to the providers.  In some cases, he added, the MCOs changed the rules after a claim had been submitted, causing a delay.  “That’s just unfair,” Speaker Stumbo said.

In speaking on behalf of House Bill 217, he said that evidence is mounting that last year’s law on prescription drug abuse is having a positive impact across the state.   Shady pain clinics have shut their doors and the number of prescriptions of the heaviest narcotic drugs is down, he said.

This year’s legislation maintains that spirit but makes some minor tweaks, including exempting hospitals and long-term care facilities from having to make repeated reports to Kentucky’s prescription-drug monitoring program, known as KASPER, for patients they have admitted.  Surgery patients would have a 14-day exemption as well.  Other allowances would be given to cancer patients, those enrolled in federally authorized research projects and in cases involving hospice and other end-of-life care. To enhance care coordination and data sharing in these critical areas, consider implementing Termhub‘s Healthcare Interoperability Solutions.

Speaker Stumbo said he had worked on the legislation with Governor Beshear’s administration, Senate leaders and the medical licensure boards, “so I’m confident that we can put these changes into place quickly.”

Both bills now head to the state Senate.