HB 1008 Summary

• Extends the repeal date of Section 43-13-117 from July 1, 2021 to July 1, 2022, maintaining current Medicaid services and managed care provisions.

• Removes the repeal date from Section 43-13-145, making permanent the Medicaid assessment provisions for nursing facilities, intermediate care facilities, psychiatric residential treatment facilities, and hospitals.

• Implements uniform credentialing and enrollment process for providers in managed care delivery systems by December 1, 2021, or the division will establish a consolidated process by July 1, 2022.

• Establishes reporting requirements for managed care contractors regarding administrative expenses, staffing levels, claim denials, prior authorization processes, and pharmacy/dental benefits administration.

• Requires contractors receiving capitated payments to issue detailed denial letters within 60 days and allows providers to appeal contested denials through state fair hearing processes.