Direct the Legislative Research Commission and state agencies to collaborate to create a state fiscal map of substance use disorder programs and funding sources; require the Legislative Research Commission to post the state fiscal map on its website and submit a report to the General Assembly by October 30, 2026.
Direct the University of Kentucky, the University of Louisville, and Eastern Kentucky University to coordinate a search for actionable solutions to physician shortages and to explore and expand health care opportunities in medically underserved areas in collaboration with community, state agency, professional associations, and other stakeholders; require a report to the General Assembly by January 1, 2027; APPROPRIATION; EMERGENCY, EFFECTIVE July 1, 2026.
Create a new section of KRS Chapter 205 to prohibit the Department for Medicaid Services, any Medicaid managed care organization contracted by the department, and the Medicaid state pharmacy benefit manager from denying coverage for a nonopioid analgesic in favor of opioid analgesic or establishing more restrictive or more extensive utilization controls for nonopioid analgesics than the least restrictive or extensive utilization controls for any opioid or narcotic analgesic; 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 304.39-020, relating to personal injury protection benefits, to modify requirements for certain medical expenses paid by a reparation obligor; amend KRS 304.39-130 to increase the allowable weekly reimbursement for work loss and other loss; amend KRS 304.39-210 to establish requirements for a reparation obligor paying medical expenses and a person submitting and collecting medical expenses; create a new section of KRS Chapter 15 to provide the Attorney General with concurrent jurisdiction in the investigation and prosecution of offenses under KRS 304.47-020; amend KRS 304.47-020 to conform; create a new section of Subtitle 47 of KRS Chapter 304 to require the insurance commissioner to publish an annual insurance fraud report; direct that certain provisions apply to basic and added reparation benefits issued or renewed on or after the effective date of the Act.
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.
Create new sections of KRS Chapter 218A to define terms; establish the ibogaine research and intellectual property fund to be administered by the Department of Agriculture for the purpose of allowing the department to enter a public-private partnership with a drug developer to conduct a clinical drug development trial or trials related to the use of ibogaine for the treatment of opioid use disorder, co-occurring substance use disorder, or any other neurological or mental health condition for which ibogaine demonstrates efficacy; establish requirements for the department related to how it contracts with a drug developer related to ibogaine research and intellectual property; appropriate $21 million from the opioid abatement trust fund to the ibogaine research and intellectual property development fund in fiscal year 2026-2027 and in fiscal year 2027-2028; APPROPRIATION; EMERGENCY.
Amend KRS 205.5371 to require the Cabinet for Health and Family Services to condition eligibility for enrollment or continued enrollment in the Medicaid program on demonstrated community engagement as required under federal law; require the cabinet to continue to condition eligibility on demonstrated community engagement if federal requirements are abolished, repealed, or otherwise diminished; amend KRS 205.6312 to require the cabinet and any contracted Medicaid managed care organization to impose cost-sharing requirements for Medicaid enrollees as required under federal law no later than January 1, 2027; establish minimum cost-sharing amounts; amend KRS 205.556 and 205.618 to conform; create new sections of KRS Chapter 205 to require the cabinet to, no later than July 1, 2026, begin conducting Medicaid eligibility redeterminations once every 6 months as required under federal law; require the cabinet to access and review certain data when conducting eligibility redeterminations; establish a process for identifying and, when appropriate, disenrolling individuals who are concurrently enrolled in the Kentucky Medicaid program and a Medicaid program administered by another state or states; amend KRS 205.178 to require the cabinet to receive and review information from the Kentucky Lottery Corporation, Department of Corrections, and the Kentucky Horse Racing and Gaming Corporation on at least a monthly basis, the Kentucky Department of Revenue on at least an annual basis, and the Kentucky Transportation Cabinet on a quarterly basis; require the Department for Medicaid Services to enter into a data sharing agreement with the Social Security Administration to receive the full file of death information on at least a quarterly basis; prohibit the cabinet from seeking or requesting an exemption or waiver from federal community engagement requirements related to county unemployment rates unless specifically authorized by the General Assembly to do so; amend KRS 205.5375 to require hospitals to assist presumptively eligible individuals in submitting a full Medicaid application; amend KRS 205.200 to prohibit the cabinet from accepting self-attestation of income, residency, or age for the purpose of determining eligibility for Medicaid or compliance with community engagement requirements; create new sections of KRS Chapter 205 to establish Medicaid managed care organization contracting requirements and penalties; establish the Medicaid managed care organization compliance fund within the State Treasury; establish that amounts in the fund not appropriated at the close of a fiscal year shall not lapse and shall be carried forward; prohibit the expenditure of funds in the account unless expressly appropriated by the General Assembly; require the Department for Medicaid Services to submit recommendations for use of monies in the fund to the Legislative Research Commission by November 1, 2027, and November 1, of each following odd-numbered year; 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 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 new sections of KRS Chapter 205 to establish requirements for administration of the Medicaid-covered nonemergency medical transportation services; establish requirements for the administration of 1915(c) Medicaid waiver programs; require the Department for Medicaid Services to develop and implement a tiered priority system for assigning 1915(c) Medicaid waiver program slots by January 1, 2027; require administration of Medicaid-covered dental services by an administrative service organization; establish that the administrative service organization shall not assume any financial or insurance risk; limit compensation paid to the administrative service organization to no more than 2% of the actual Medicaid-covered dental service claims paid on an annual basis; require the Department for Medicaid Services to establish a Dental Program Advisory Panel; require the Department for Medicaid Services to employ a dental director; require the Department for Medicaid Services to submit an annual report on the Medicaid dental program to the Legislative Research Commission; create new sections of KRS 7A.270 to 7A.290 to establish legislative findings; require the cabinet to provide the Legislative Research Commission with access to all databases, datasets, electronic records, and files pertaining to any aspect of the Medicaid program determined by the director of the Legislative Research Commission to be necessary for the meaningful and effective discharge of the General Assembly's legislative duties; require the Legislative Research Commission, the University of Kentucky, and the University of Louisville to enter into a partnership to design and develop a web-based healthcare transparency dashboard; require the dashboard be overseen by a subcommittee of the Medicaid Oversight and Advisory Board; require the dashboard be maintained and operated by the Legislative Research Commission; amend KRS 7A.283 to allow the appointment of individuals who are not members of the board to advisory committees or subcommittees upon approval of the Legislative Research Commission; create a new section of KRS Chapter 43 to require the Auditor of Public Accounts to conduct an examination of the state's Medicaid program and Kentucky Children's Health Insurance Program; establish audit reporting requirements; require the Auditor to conduct a review of the Medicaid program and Kentucky Children's Health Insurance Program to assess progress in addressing issues identified in previous examinations; establish that the Office of Program Performance in the Commonwealth Office of the Ombudsman shall conduct all quality control reviews of the Department for Community Based Services for the Medicaid program, Supplemental Nutrition Assistance Program, and Temporary Assistance for Needy Families to comply with federal law and regulations; establish that no other state agency shall conduct these quality control reviews unless otherwise authorized by the General Assembly; amend KRS 7A.286 to establish that examinations conducted by the Auditor may constitute fulfillment of certain duties assigned to the Medicaid Oversight and Advisory Board at the discretion of the Legislative Review Commission; repeal KRS 205.515 related to administration of the Medicaid program; repeal KRS 311A.172 related to nonemergency medical transportation services; appropriate $500,000 in General Fund moneys in fiscal year 2025-2026 for staffing and technology needs in the Office of the Auditor of Public Accounts; create a new section of KRS Chapter 6 to establish a Medicaid impact statement; require any legislation that makes or directs a change to the Medicaid program to be accompanied by a Medicaid impact statement; require certain factors to be analyzed and included in a Medicaid impact statement; require Medicaid impact statements to be completed by an economic consulting firm retained by the Legislative Research Commission; create a new section of KRS Chapter 13A to require the cabinet to provide a draft copy of certain administrative regulations related to the Medicaid program to the Medicaid Oversight and Advisory Board for comment at least 30 days before filing the administrative regulation with the regulations compiler; direct the Medicaid Oversight and Advisory Board to establish a Dental Services Transition Subcommittee; establish membership and duties of the Dental Services Subcommittee; require any contract between the Department for Medicaid Services and a Medicaid managed care organization entered into, renewed, or extended after the effective date of this Act to include notice to the managed care organization of the department's intent to transition to an administrative service organization delivery model for Medicaid-covered dental services; 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); direct the Medicaid Oversight and Advisory Board to evaluate the nonemergency medical transportation program and submit findings and recommendations to the Legislative Research Commission by December 31, 2026; APPROPRIATION; EMERGENCY.
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.
