AN ACT relating to service improvements in the Medicaid program. Create a new section of KRS Chapter 205 to limit the number of MCO contracts to operate the Medicaid program to 2 and to establish a process for selecting the two winning MCOs; create a new section of KRS Chapter 205 to require that services provided in rural counties be reimbursed at least at the median amount paid to an urban health care provider within the nearest metropolitan statistical area; establish a penalty that goes to the underpaid provider.