Direct the Cabinet for Health and Family Services to withdraw the 1115(a) demonstration waiver application that was submitted on June 25, 2025, to the federal Centers for Medicare and Medicaid Services to implement a mandatory community engagement program; EMERGENCY
Amend KRS 218A.025 to remove 1 physician and 1 nurse from the Controlled Substances Prescribing Council and to add 1 livestock veterinarian and 1 equine veterinarian.
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.
Create new sections of KRS 304.17A-600 to 304.17A-633 to define terms; prohibit insurers of health benefit plans from requiring prior authorization for a health care service for which the provider has an exemption; require insurers of health benefit plans to establish a program under which participating providers may qualify for exemptions from prior authorization; establish mandatory and permitted provisions of an insurer's prior authorization exemption program; establish requirements for sending forms and notices; require the commissioner of the Department of Insurance to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 304.17A-605 to conform; amend KRS 304.17A-611 to prohibit conducting a retrospective review that is based solely on a participating provider having a prior authorization exemption; provide that certain utilization review time frames do not apply to retrospective reviews conducted for the purposes of determining eligibility for a prior authorization exemption; create a new section of KRS Chapter 205 to require the commissioner of the Department for Medicaid Services to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 205.536 to conform; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028; EFFECTIVE, in part, January 1, 2027, and January 1, 2028.
Create a new section of KRS 304.17A-660 to 304.17A-669 to define "psychiatric collaborative care model"; require the commissioner of insurance to promulgate and maintain an administrative regulation to list alterations and additions to relevant billing codes; require health benefit plans that provide coverage for treatment of a mental health condition to provide reimbursement for those benefits that are delivered through the psychiatric collaborative care model; authorize insurers to deny any benefit billed under a covered billing code on grounds of medical necessity if certain conditions are met; apply requirement to health benefit plans issued, delivered, or renewed on or after January 1, 2027; require the Department of Insurance to seek a federal waiver if cost defrayal is determined.
Direct the Legislative Research Commission to procure a vendor to conduct a feasibility study for an Accountable Communities for Health Medicaid delivery model pilot project; require the results of the study to be submitted to the Legislative Research Commission by November 1, 2026; strongly encourage the Legislative Research Commission to begin the procurement process immediately upon the adoption of this Resolution; establish that a pilot project resulting from the feasibility study shall be known as the 20 by 30 Accountable Care Pilot Project.
HB 369 adds post-traumatic stress disorder (PTSD) as a qualifying condition for veterans to access hyperbaric oxygen therapy (HBOT) in Kentucky. It amends state law to allow veterans diagnosed with PTSD - confirmed by a treating health care provider - to receive HBOT, expanding eligibility beyond traumatic brain injury. The bill requires written informed consent from veterans or their legal guardians, detailing treatment options, potential outcomes, and financial responsibility for the therapy. This policy change directly affects Kentucky veterans with PTSD seeking this specific medical treatment option.
SJR 23 declares Kentucky a "Food is Medicine" state to address chronic health conditions through nutrition. It directs state agencies to integrate nutrition into healthcare by supporting medically tailored meals, produce prescriptions for high-risk groups, and partnerships with farms and hospitals. The resolution specifically requires agencies to coordinate with the Kentucky Hospital Association and Department of Agriculture to expand local food-based health interventions. This policy change aims to reduce healthcare costs linked to diet-related chronic conditions, which affect 40.4% of Kentucky adults and cost over $29 billion annually.
Create new sections of Subtitle 17A of KRS Chapter 304 to define terms; require health plans to provide coverage for the diagnosis and treatment of feeding or eating disorders; prohibit insurers from using certain standards, including body mass index, to deny, limit, or restrict coverage; authorize insurers to consider certain factors when determining medical necessity or the appropriate level of care for an individual diagnosed with a feeding or eating disorder; amend KRS 304.17C-125, 304.38A-115, 205.522, 205.6485, 164.2871, and 18A.225 to require limited health services benefit plans, limited health service organizations, Medicaid, KCHIP, self-insured employer group plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the coverage requirements for feeding or eating disorders; provide that various sections apply to health plans issued or renewed on or after January 1, 2027; require the Cabinet for Health and Family Services or the Department for Medicaid Services to seek federal approval if it is determined that such approval is necessary; provide authorization from the General Assembly to make changes in the Medicaid program as required under KRS 205.5372(1); EFFECTIVE, in part, January 1, 2027.
Amend KRS 205.522 and 205.6485 to require Medicaid and KCHIP to comply with pharmacy reimbursement requirements established in KRS 304.12-237; require the Cabinet for Health and Family Services or the Department for Medicaid to seek federal approval if it is determined that such approval is necessary; provide authorization from the General Assembly to make changes to the Medicaid program as required under KRS 205.5372(1).
