Rep. Kim Moser

Create new sections of KRS Chapter 205 to define terms; establish limitations on material changes to contracts between Medicaid managed care organizations and Medicaid-participating providers; require contracts between the Department for Medicaid Services and a managed care organization to comply with federal laws related to mental health parity; require behavioral health programs to be accredited and narcotic treatment programs to be licensed in order to be eligible for Medicaid reimbursement; amend KRS 205.522 to require the Department for Medicaid Services and managed care organizations to comply with KRS 304.17A-661 related to treatment of mental health conditions and 304.17A-700 to 304.171A-730 related to payment of claims; require managed care organizations to provide a description of reasons for denial when payment of a claim is denied; amend KRS 304.38-130 to authorize the commissioner of the Department of Insurance to suspend or revoke a Medicaid managed care organization's certificate of authority for willful or frequent and repeated failure to comply with Section 1 of this Act, 42 U.S.C. sec. 1396u-2, or 42 C.F.R. pt. 438 Subpart K.

Create a new section of KRS Chapter 311 to require that a dosage regimen for Buprenorphine-Mono-Product or Buprenorphine-Combined-with-Naloxone prescribed by a licensed physician to meet the treatment needs of a patient; require the Kentucky Board of Medical Licensure to promulgate administrative regulations to implement the requirement; create a new section of KRS Chapter 314 to require that a dosage regimen for Buprenorphine-Mono-Product or Buprenorphine-Combined-with-Naloxone prescribed by a licensed advanced practice registered nurse meet the treatment needs of a patient; require the Kentucky Board of Nursing to promulgate administrative regulations to implement the requirement.

Create new sections of KRS Chapter 533 to define terms; require the court, upon conviction of the defendant, to consider the defendant's status as a primary caretaker of a dependent child unless the defendant is a violent offender, the victim is a child, or a statute prohibits an alternative sentence; require the court, upon a finding that the defendant is a primary caretaker of a dependent child, to consider an alternative sentence; provide that the defendant shall have the right to present an alternative sentencing plan and a family impact statement to the court; provide that in issuing an alternative sentence, the court may require the defendant to participate in programs and services that support the parent-child relationship; provide that the court may modify or revoke the alternative sentence and commit the defendant to an institution if the defendant fails to adhere to or complete the conditions of an alternative sentence; require the Administrative Office of the Court to report annually, beginning in 2026, to the Kentucky State Corrections Commission and to the Legislative Research Commission on the number, percentage, and demographics of parents and children impacted under this Act; provide that the Act may be cited as the Primary Caretaker Consideration Act.

Create new section of KRS 6.601 to 6.849 to prohibit sexual harassment by any legislator or legislative agent to a legislator, legislative, or legislative branch employee; define "sexual harassment."

Amend KRS 205.540 to comply with 42 C.F.R. sec. 431.12; change the name of the Advisory Council for Medical Assistance to the Medicaid Advisory Committee; revise membership of the committee; amend KRS 205.552 to conform; amend KRS 205.590 to establish the length of terms for members of the Medicaid technical advisory committees; create a new section of KRS Chapter 205 to establish the Beneficiary Advisory Council; establish council membership; establish that the council shall be exempt from KRS 61.800 to 61.884 in accordance with 42 C.F.R. 431.12.

Amend KRS 403.720, relating to orders of protection, to define "coercive control" and "stalking"; amend the definition of "domestic violence and abuse" to include coercive control of a family member or member of an unmarried couple; amend KRS 456.010 to define "coercive control"; amend the definition of "dating violence and abuse" to include coercive control of a person with whom the perpetrator is or has been in a dating relationship; amend KRS 209A.122 to require the Administrative Office of the Courts to provide information on petitions for orders of protection where the basis of the petition is coercive control and whether parties to a petition for an order of protection were represented by a legal representative.

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 of 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 12% interest 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; authorize the Department for Medicaid Services to promulgate administrative regulations.

Create a new section of KRS Chapter 205 to define terms; establish payment and response requirements for third-party payors; amend KRS 205.623 to require third-party payors to respond within 60 days of certain health care claim inquiries from the Department for Medicaid Services; create a new section of KRS Chapter 18A, and amend KRS 205.532 and 304.12-255, to require the state employee health plan, affiliated and associated entities of Medicaid managed care organizations, and health insurers to comply with third-party payor requirements.

Create a new section of KRS Chapter 311.530 to 311.620 to permit an international medical graduate to apply for a provisional license that may lead to a full and unrestricted license to practice medicine in Kentucky notwithstanding KRS 311.571; require the Board of Medical Licensure to promulgate administrative regulations to establish provisional licensure pathway requirements, applicant requirements, eligibility for obtaining a full and unrestricted license after completing the provisional period, establish a data collection process to evaluate the provisional license option, and require an annual report to the Legislative Research Commission.

Create a new section of KRS Chapter 216 to define terms; require nonprofit hospitals to submit a 340B Drug Pricing Program report to the Cabinet for Health and Family Services by July 1, 2026, and annually thereafter; direct the Personnel Cabinet to submit a report to the Legislative Research Commission on the impact of the 340B Drug Pricing Program on the Kentucky Employee Health Plan no later than December 1, 2025; require the Cabinet for Health and Family Services to submit a report to the Legislative Research Commission on the impact of the 340B Drug Pricing Program on Medicaid no later than December 1, 2025.