Monday, March 31, 2014

Senate approves ‘prompt pay’ bill, with Medicaid provision

House to decide if KanCare managed care
contractors are required to make prompt payments
The Kansas Senate on Tuesday approved a bill designed to increase requirements that the state’s KanCare managed care contractors make prompt payments to Medicaid service providers.

According to a KHI News Service article, the bill had wide support from doctors and service providers. Supporters said payment delays could create critical cash flow problems, especially from small provider organizations.  Since Brownback’s KanCare initiative was launched earlier this year, provider groups have reported problems getting timely payments for services from the managed care companies.

Before approving the bill, the Senate added a provision to it stating that the state’s Medicaid program can’t be expanded in keeping with the Affordable Care Act without express approval of the Legislature. The federal health reform law encourages states to expand Medicaid eligibility to include people earning up to 138 percent of federal poverty guidelines. Kansas currently has among the nation’s most restrictive eligibility standards and essentially limits Medicaid to poor children and those who are disabled or elderly. Childless adults don’t qualify regardless of how poor they are.

The underlying legislation of the bill would allow Medicaid providers who don't get paid in timely fashion a cause of action to pursue their claims in court and allow the assessing of 12 percent extra for each month a managed care company did not fully pay or if the KanCare contractor failed to deny a claim within a certain period.

It is now up to the House to decide if it will accept the bill with the Senate's changes.

No comments:

Post a Comment