Bill > HB2753

This bill, known as the Kansas Managed Care Bid Fidelity and Accountability Act, aims to ensure that managed care organizations (MCOs) providing state Medicaid services adhere to the promises made in their proposals when bidding for contracts. "Bid fidelity" means an MCO must continuously and significantly follow through on the provider network, clinical expertise, and management methods they outlined in their "RFP response" (their bid to the state). The bill prohibits MCOs from terminating "clinical service contracts" (agreements with healthcare providers for services to Medicaid recipients) within the first 24 months of a contract, unless it's for specific reasons like fraud, documented safety risks, or the provider voluntarily leaving. A "material deviation" is defined as a significant change by the MCO within those first 24 months, such as terminating contracts with more than 3% of their listed providers, reducing the availability of specific services by over 5%, or making prior authorization rules stricter than what was proposed, unless required by law. The state will conduct regular audits to check for these deviations, and if found, MCOs can face substantial financial penalties, including civil fines or liquidated damages, and even suspension of new member assignments. Providers whose contracts are wrongly terminated can sue the MCO for damages and to get their contract reinstated. The bill also mandates that the state report audit findings and any penalties to the legislature and make MCO bid proposals public.

Health and Social Services

Health and Human Services (House)

https://kslegislature.gov/li/b2025_26/measures/hb2753/