SB 242: Payment for Medicaid physician services.

Official summary

Abstract published by the legislature (via Open States). Text as published by the legislature; reproduced verbatim.

Requires the office of Medicaid policy and planning (office) or a managed care organization to promptly cover physician services rendered in a hospital emergency department by a physician who has entered into a provider agreement with the office or managed care organization, without limiting what constitutes an emergency medical condition. Specifies considerations that must be made in determining whether the prudent layperson standard has been met. Prohibits any delay in or denial of compensation to the physician unless the cause of the delay or denial is specifically provided for in: (1) the Medicaid managed care law; (2) an administrative rule adopted under the Medicaid managed care law; (3) the federal administrative rules on Medicaid managed care; or (4) the provider agreement. Prohibits a managed care organization from denying an emergency services claim solely because the claim code is not listed on the autopay list.

Sponsors

Sponsors by party (alphabetical): Republican 2

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. February 6, 2025Committee report: amend do pass adopted; reassigned to Committee on Appropriations
2. February 6, 2025Senator Busch added as second author
3. January 13, 2025First reading: referred to Committee on Health and Provider Services
4. January 13, 2025Authored by Senator Johnson T