HB 689 Kentucky House · 2026 Regular Session

AN ACT relating to the establishment of a Medicaid state-directed payment program.

Summary

Amend KRS 205.6412 to require the Department for Medicaid Services to seek authorization from the United States Centers for Medicare and Medicaid Services to implement a state-directed payment for physician and nonphysician professional services provided to a Medicaid beneficiary by a qualifying hospital's affiliated physician groups or physicians and other professionals employed or contracted by the qualified hospital; require the Department of Medicaid Services to direct Medicaid managed care organizations to issue payments back to January 1, 2026, upon federal approval; RETROACTIVE.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Feb 2026

Committee Review

Mar 2026

House Passage

Apr 2026

Senate Passage

Apr 2026

Signed into Law

Apr 2026

Introduced Feb 20, 2026 Signed Apr 13, 2026

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What changed between versions

Introduced → Current/Final · 6 edits

MODERATE

The bill was renumbered and reorganized to clarify eligibility for enhanced Medicaid payments. It now distinguishes between two specific programs: one for general qualifying hospitals (requiring trauma center status or high Medicaid enrollment) and a new, separate program specifically for pediatric teaching hospitals serving patients aged 18 or younger. The bill also mandates a new funding source separate from existing assessments and adds strict reporting requirements tied to federal approval.

Scope change

The bill's scope was expanded to include a distinct payment program for pediatric teaching hospitals, while the criteria for general hospital payments were restructured to include trauma center status and Medicaid enrollment thresholds.

ELIGIBILITY

Eligibility criteria were restructured to separate general qualifying hospitals from pediatric teaching hospitals, with the latter now requiring a specific age limit for patients.

New eligibility requirements were added for general hospitals, including being a Level II, III, or IV trauma center or located in a county with above-median Medicaid enrollment.

FISCAL

A requirement was added to identify a separate funding source for the nonfederal share, distinct from the existing KRS 205.6406 assessment.

REQUIREMENT

New reporting requirements were added, mandating that hospitals report quality measures similar to those used in existing university teaching hospital payment plans.

TIMELINE

The timeline for federal preprint submission was clarified to require a January 1, 2026, effective date within 60 days of the act's passage.

TECHNICAL

The bill text was renumbered and reorganized to align with the new structure of subsections.

Floor votes · House Mar 18, 2026

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Apr 13, 2026

Signed into law

signed by Governor (Acts Ch. 117)

lower

Apr 1, 2026

Upper · Passed

enrolled, signed by President of the Senate

upper

Apr 1, 2026

Lower · Passed

enrolled, signed by Speaker of the House

lower

Mar 31, 2026

Lower · Passed

passed 90-1

lower

Mar 31, 2026

Lower · Passed

House concurred in Committee Substitute (1)

lower

Mar 31, 2026

Lower · Passed

posted for passage for concurrence in Senate Committee Substitute (1)

lower

Mar 31, 2026

Committee

to Rules (H)

lower

Mar 31, 2026

Lower · Passed

3rd reading, passed 38-0 with Committee Substitute (1)

lower

Mar 25, 2026

Lower · Passed

reported favorably, 1st reading, to Consent Calendar with Committee Substitute (1)

lower

Mar 24, 2026

Committee

to Health Services (S)

upper

Mar 19, 2026

Committee

to Committee on Committees (S)

upper

Mar 18, 2026

Lower · Passed

3rd reading, passed 94-0 with Floor Amendment (1)

lower

Mar 16, 2026

Introduced

floor amendment (1) filed

lower

Mar 5, 2026

Lower · Passed

reported favorably, 1st reading, to Calendar

lower

Feb 27, 2026

Committee

to Health Services (H)

lower

Feb 20, 2026

Committee

to Committee on Committees (H)

lower

Feb 20, 2026

Introduced

introduced in House

lower

0 primary · 0 co-sponsors

What changed between versions

How they voted

Actions timeline

Sponsors