Spring 2016
... to Lead, Educate, Mentor and Respond ...
What’s Inside
Kentucky Conclave
Focus On: Kentucky Conclave
Six Sessions, Ten Presenters ... Will you plug in?
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Join your colleagues for a weekend of education, networking, exhibits food and fun at the Kentucky Conclave!
19 Documentation Series 20
Pain Symposium 21 Wellness & Neurological Disorders 22 Total Joint Reconstruction Program 24 Education & Exercise for Fibromyalgia 25
Senate Bills 18 & 20 Pass Thanks to KPTA Lobbying
KPTA Efforts Help Pass Legislation Benefitting Patients and Physical Therapy Thanks to the lobbying efforts of the KPTA, two influential bills were passed during the Kentucky General Assembly’s 2016 Legislative Session. Senate Bill 18 (SB18) addresses material changes to contracts and Senate Bill 20 (SB20) develops an appeal process for Medicaid. The KPTA is currently asking the Kentucky Department of Insurance for guidance on the impacts of SB18. For now, we can identify a few things in the bill that are clear. SB18 creates clear guidelines for insurers to follow when changing existing agreements with health care providers. These include a 90-day notice of “material changes” to an existing agreement, the color and size of the envelope used to make such notices to providers, and the process and timelines for replies from providers to insurers.
Sen. Ralph Alvarado, the bill spon sor from district 28, originally limited the bill to physicians, but because of the KPTA’s efforts in collaboration with other allied health professionals, the bill was amended to include all health care providers. SB20, also sponsored by Sen. Alvarado, is long-sought legislation to establish an appeals process for Medicaid providers once the “internal appeals process” of a Medicaid Managed Care Organization has been exhausted. Under the new law, providers may appeal to the Cabinet for Health and Family Services for a decision. One additional change to the bill was that the ‘loser’ of an appeal may be required to pay up to $1,000 for the cost of the administrative hearing used to determine the outcome of the appeal. SB20 went into effect April 8, 2016. SB18 will go into effect January 1, 2017. We encourage our members to read this legislation and understand your rights and the rights of your patients. Contact Leigh Ann Thacker, KPTA lobbyist, with questions.