Healthcare (Medicaid)

Create a new section of KRS Chapter 205 to define "community intervener"; require the Michelle P. waiver program to cover community intervener services if approved by the federal Centers for Medicare and Medicaid Services; require the Department for Medicaid Services to promulgate administrative regulations; require the cabinet 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).

Amend KRS 304.17A-257 to require health benefit plans to provide coverage for colorectal cancer examinations and laboratory tests specified in the most recent version of a Centers for Medicare and Medicaid Services national coverage determination or nationally recognized clinical practice guidelines or recommendations; direct that coverage requirements for colorectal cancer examinations and laboratory tests applies to health benefit plans issued or renewed on or after the effective date of the Act; require the Cabinet for Health and Family Services or the Department for Medicaid Services to obtain federal approval, if necessary; provide authorization from the General Assembly to make changes in the Medicaid program as required under KRS 205.5372(1); EMERGENCY.

Create new sections of KRS Chapter 194A to establish the Kentucky all-payer claims database; establish purposes, definitions, and a restricted fund for the database; require the executive director of the Office of Data Analytics to develop, implement, operate, and maintain the database and promulgate administrative regulations to carry out those duties; establish an advisory council to make recommendations to the executive director; establish requirements for database administration and operations; require state-regulated health payers to report to the database; amend KRS 194A.030, 194A.101, and 304.2-100 to conform; create a new section of Subtitle 99 of KRS Chapter 304 to require the commissioner of insurance to enforce reporting requirements; establish time for making initial appointments and provide for staggered appointments to the advisory council; 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).

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.

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.

Amend KRS 205.533 to require Medicaid managed care organizations to include certain information for providers on their websites; amend KRS 205.534 to require managed care organizations to allow providers 120 days to file an appeal or grievance related to a reduction or denial of a claim; establish penalties for a managed care organization's failure to ensure the timely disposition of any appeal or grievance; require payment of any amount owed to a provider following an appeal to be paid within 30 days; require payments made following an appeal to include interest in accordance with KRS 304.17A-730 and reasonable attorney's fees; establish standards and requirements for provider audits; require the inclusion of additional information in the monthly report filed by managed care organizations; require the Department for Medicaid Services to submit an annual report to the Legislative Research Commission related to Medicaid claims, appeals, and grievances for the previous state fiscal year; authorize the Department for Medicaid Services to promulgate administrative regulations; require Cabinet for Health and Family Services or the Department for Medicaid Services to seek federal approval if they determine that such approval is necessary.

Amend KRS 164.936 to establish maximum loan repayment awards under the Healthcare Worker Loan Relief Program for dentists and dentists in counties that do not have an actively practicing dentist; provide rural dental practice grant awards and criteria; establish distribution requirements for funds appropriated to the Center of Excellence in Rural Health for loan repayment awards for dentists and rural dental practice grants; amend KRS 164.937 to require information on the Healthcare Worker Loan Relief Program to be reported to the Council on Postsecondary Education and the Legislative Research Commission; amend KRS 313.035 to require the Kentucky Board of Dentistry to create a Rural Dental Fellows Network; require the Kentucky Department for Medicaid Services to increase Medicaid reimbursement rates by 25% for dental services in federally designated health professional shortage areas; appropriate $4,400,000 in each fiscal year of the 2026-2028 fiscal biennium to the Center of Excellence in Rural Health budget unit; appropriate $600,000 in each fiscal year of the 2026-2028 fiscal biennium to the Kentucky Board of Dentistry; appropriate $1,000,000 in each fiscal year of the 2026-2028 fiscal biennium to the Department for Medicaid Services; provide that the Act may be cited as the Rural Dental Incentive and Access Program Act; specify that the expanded award eligibility, required reporting on the Healthcare Worker Loan Relief Program, and the Rural Dental Fellows Network shall expire on July 1, 2036; APPROPRIATION; EMERGENCY.

Amend KRS 304.17A-163 to modify the definition of "health plan"; require insurers, health plans, private review agents, and pharmacy benefit managers to disclose certain information about step therapy protocols on their website and ensure that the electronic process for requesting and transmitting prior authorization for a drug includes the ability for prescribing providers to electronically transmit a complete request for a step therapy exception; require coverage for a prescription drug on the date the provider submits a step therapy exception request; provide that requirements apply to Medicaid and KCHIP benefits to the extent authorized by federal law; 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); provide that the Act applies to policies, certificates, contracts, and plans issued or renewed on or after the effective date of the Act.

Create a new section of KRS Chapter 205 to require the Department for Medicaid Services to include coverage for adult day health care and in-home attendant services in all 1915(c) waiver programs that enroll adults; require coverage of at least 40 hours per week separately for adult day health care and in-home attendant services; prohibit aggregating coverage limits for adult day health care and in-home attendant services; require the department to promulgate administrative regulations; require the Cabinet for Health and Family Services or the department 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).

SB 301 (as detailed in its bill text) corrects a discrepancy in its abstract: it does not add gender-neutral language but instead amends Kentucky law to establish a statewide prescreening system for long-term care admissions. The bill requires the Health and Family Services cabinet to implement a preadmission review system, including a resource means test (ensuring applicants have funds for 365 days of care), before authorizing placement in skilled-nursing or intermediate-care facilities. It mandates that facilities cannot admit patients without this screening, and non-compliant admissions would be a Class B violation. The law directly affects long-term care facilities, hospitals offering skilled-nursing beds, and Kentuckians seeking Medicaid-covered care in these settings. The bill was introduced in the Senate on February 27, 2026, and referred to committee.