Healthcare (Medicaid)

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.

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.

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.

Amend KRS 205.520 to establish that it is the policy of the Commonwealth to provide Medicaid eligibility for all residents of the Commonwealth who may be eligible under federal law; amend KRS 205.6312 to require the establishment of cost-sharing requirements in the Medicaid program to the extent required under federal law; require the Governor to commission an independent third-party analysis of the current Medicaid expansion; 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 the Medicaid program as required under KRS 205.5372(1).

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).

Amend KRS 95A.292 to allow rescue squad members to participate in the Alan "Chip" Terry Professional Development and Wellness Program; create a new section of KRS Chapter 39F to direct the Division of Emergency Management and the Kentucky Fire Commission to enter into an agreement to ensure that rescue squad members have access to the program; provide that the Act may be cited as Gavin's Rights.