Healthcare (Medicaid)

Amend KRS 214.450 to define "autologous donation," "directed donation," and "informed consent"; create a new section of KRS 214.450 to 214.466 to establish an individual's right to select a willing blood donor; establish related prohibitions for blood establishments, health facilities, health services, and health care providers; establish related requirements for blood establishments and health care facilities; prohibit misrepresentation of the availability, safety, or legality of directed or autologous donations; establish protections for physicians who facilitate directed or autologous donations; establish penalty for violations; require the Cabinet for Health and Family Services to establish a reporting mechanism to report obstructions to directed or autologous donations, complete investigations within 60 days, and promulgate administrative regulations to implement and enforce reporting; permit emergency transfusions with consent and provide exemption from liability; permit an individual to bring a civil action for violations of individual rights to directed or autologous donations; amend KRS 214.452, 214.456, and 214.990 to conform and make technical corrections; create a new section of Subchapter 17A of KRS Chapter 304 to require all health benefit plans to cover any autologous or directed transfusion of blood; amend KRS 205.522 and 205.6485 to require Medicaid coverage of any autologous or a directed transfusion of blood; amend KRS 18A.225 to require state health benefit plans coverage of any autologous or directed transfusion of blood; apply coverage mandates to health benefit plans issued or renewed on or after January 1, 2027; provide that sections of the Act may be cited as the Medical Autonomy and Directed Donation Act; require the Cabinet for Health and Family Services to seek federal approval if they determine that such approval is necessary; provide authorization from the General Assembly to make changes as required under KRS 205.5372(1); include provisions for cost defrayal requirements; EFFECTIVE, in part, January 1, 2027.

Amend KRS 205.592 to extend Medicaid eligibility for new parents from 12 months to 24 months postpartum; require the Cabinet for Health and Familly 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 to the Medicaid program as required under KRS 205.5372(1).

Create a new section of Subtitle 17A of KRS Chapter 304 to establish that any health benefit plan that provides coverage for hospital, medical, or surgical expenses shall include coverage for chronic pain treatments provided by a licensed professional; amend KRS 205.522 to require Medicaid and Medicaid managed care organizations to include coverage for chronic pain treatments provided by a licensed professional; amend KRS 218A.172 to require that a health care practitioner discuss and refer or prescribe alternative chronic pain treatments before initially prescribing or dispensing a controlled substance; provide that certain provisions apply to health benefit 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 they determine 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); EFFECTIVE January 1, 2027.

Create a new section of KRS Chapter 205 to require the Department for Medicaid Services and Medicaid managed care organizations to cover evaluation and management services; prohibit the department or managed care organizations from limiting coverage for evaluation and management services to fewer than 2 units per provider, per recipient, per date of service; 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).

Create a new section of KRS Chapter 205 to require Medicaid coverage for palliative care services; establish eligibility criteria and service requirements; require the Department for Medicaid Services to promulgate administrative regulations; 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 to the Medicaid program as required under KRS 205.5372(1).

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.

Create a new section of KRS Chapter 205 to require the Department for Medicaid Services and any managed care organization with whom the department contracts for the delivery of Medicaid services to provide coverage for doula services; create a new section of KRS Chapter 194A to establish the Doula Advisory Council, council membership, and council duties; require the Cabinet for Health and Family Services or the Department for Medicaid Services to seek federal approval if they determine 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).

Amend KRS 304.17A-258 to require health benefit plans to provide coverage for certain formulas; suspend the coverage requirement's application to qualified health plans if the state would be required to make cost defrayal payments; amend KRS 304.17A-145 to require coverage for breastfeeding and lactation services in conjunction with the birth and without a prescription; amend KRS 304.17A-099 to conform; amend KRS 205.522 to require Medicaid to comply with the coverage requirements for formulas; amend KRS 205.560 to conform; amend KRS 205.6485, 164.2871, and 18A.225 to require KCHIP, self-insured employer group health 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 formulas; provide that certain provisions apply to health benefit 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 necessary, and to comply with notice requirements; 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.

Propose to create a new section of the Constitution of Kentucky to enshrine Medicaid expansion coverage; direct the Secretary of State to advertise the proposed constitutional amendment prior to a general election vote; provide ballot language; submit to voters for ratification or rejection.

Create new sections of KRS Chapter 216B to define terms; require hospitals to disclose prices for certain items and services provided by hospitals; require hospitals to make public a digital list of all standard charges and a consumer-friendly list of charges for a set of shoppable services; require hospitals to provide descriptions of different services and standard charges of those services; require the Cabinet for Health and Family Services to promulgate administrative regulations to establish a template for each hospital; require the cabinet to monitor each facility's compliance; provide for administrative penalties; require health care providers to provide patients with written pricing sheets for health care services provided except in an emergency; require the cabinet to promulgate administrative regulations to establish a template for the written pricing sheets; require the cabinet or the Department for Medicaid Services to seek federal approval if they determine that such approval is necessary to comply with KRS 205.5372(1).