Healthcare

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.

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.

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.

SJR 23 declares Kentucky a "Food is Medicine" state to address chronic health conditions through nutrition. It directs state agencies to integrate nutrition into healthcare by supporting medically tailored meals, produce prescriptions for high-risk groups, and partnerships with farms and hospitals. The resolution specifically requires agencies to coordinate with the Kentucky Hospital Association and Department of Agriculture to expand local food-based health interventions. This policy change aims to reduce healthcare costs linked to diet-related chronic conditions, which affect 40.4% of Kentucky adults and cost over $29 billion annually.

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.

Amend KRS 311.571 to allow and specify requirements for a physician licensed to practice medicine in another country to obtain a provisional license to practice medicine in the Commonwealth; specify requirements for a provisional license to convert to a regular license; add conditions for the Board of Medical Licensure to revoke a provisional license; make technical changes.

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.

Amend KRS 205.529, 218A.172, 218A.205, and 304.17A.165 to remove references to a Schedule III controlled substance containing hydrocodone; amend KRS 218A.010 to add optometrist and physician assistant to the definition of "practitioner" licensed in other states; amend KRS 218A.182 to exempt charitable health care practitioners from electronic prescription requirement; amend KRS 218A.202 to require an active account with the electronic monitoring system be maintained by practitioners or pharmacists prescribing or dispensing Schedule II, III, IV, or V controlled substances; amend KRS 218A.245 to permit the Cabinet for Health and Family Services to enter reciprocal agreements or contracts with any federal agency of the United States or its territories.