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.
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).
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
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.
Create a new section of KRS 304.17A-660 to 304.17A-669 to define "psychiatric collaborative care model"; require the commissioner of insurance to promulgate and maintain an administrative regulation to list alterations and additions to relevant billing codes; require health benefit plans that provide coverage for treatment of a mental health condition to provide reimbursement for those benefits that are delivered through the psychiatric collaborative care model; authorize insurers to deny any benefit billed under a covered billing code on grounds of medical necessity if certain conditions are met; apply requirement to health benefit plans issued, delivered, or renewed on or after January 1, 2027; require the Department of Insurance to seek a federal waiver if cost defrayal is determined.
HB 369 adds post-traumatic stress disorder (PTSD) as a qualifying condition for veterans to access hyperbaric oxygen therapy (HBOT) in Kentucky. It amends state law to allow veterans diagnosed with PTSD - confirmed by a treating health care provider - to receive HBOT, expanding eligibility beyond traumatic brain injury. The bill requires written informed consent from veterans or their legal guardians, detailing treatment options, potential outcomes, and financial responsibility for the therapy. This policy change directly affects Kentucky veterans with PTSD seeking this specific medical treatment option.
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.
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 311.840 to define terms; amend KRS 311.842, 311.848, 311.850, 202A.011, 202C.010, 216B.175, and 600.020 to change references to "supervising physician" to "collaborating physician" to conform; amend KRS 311.844 to include Schedule II controlled substances in the list of controlled substances authorized license holders may prescribe; amend KRS 311.858 to list the services a physician assistant may provide; require a physician assistant to consult and collaborate with or refer a patient to an appropriate licensed physician as indicated by the patient's condition and the standard of care; create a new section of KRS 311.840 to 311.862 to establish requirements for a collaboration agreement between a collaborating physician and a physician assistant; amend KRS 186.577 to allow physician assistants to administer driver vision tests; amend KRS 218A.202 to conform; repeal KRS 311.854, 311.856, and 311.860, relating to supervising physicians.
Create a new section of Subtitle 17A of KRS Chapter 304 to require health benefit plans to provide coverage for prostheses and orthoses; establish minimum requirements for the required coverage; require utilizations review decisions to be made in a nondiscriminatory manner; require an insurer or its private review agent to provide notice of certain rights of the insured; establish notice requirements for denials; establish network adequacy requirements for the provision of a prosthesis or orthosis that is required to be covered; establish reporting requirements for insurers and the commissioner of the Department of Insurance relating to the required coverage; amend KRS 164.2871 and 18A.225 to require self-insured group health plans offering by the governing board of state postsecondary education institutions and the state employee health plan to comply with the requirements relating to coverage for prostheses and orthoses; provide that the Act applies to health benefit plans issued or renewed on or after January 1, 2027; EFFECTIVE January 1, 2027.
