AN ACT relating to pharmacy benefit managers. Create a new section of Subtitle 12 of KRS Chapter 304 to prohibit certain practices of pharmacy benefit managers; allow audits of contracts entered with pharmacy benefit managers; require certain disclosures relating to contracts with pharmacy benefit managers; require pharmacy benefit managers to file an annual report with the commissioner of insurance; provide that confidential or proprietary information disclosed to the Department of Insurance shall not be subject to disclosure under the Open Records Act; prohibit pharmacy benefit managers from sharing certain pharmacy records with pharmacy affiliates; [...]
AN ACT relating to the payment of insurance premiums and cost sharing on behalf of an insured. Create a new section of Subtitle 17A, KRS Chapter 304 to require health benefit plans to accept, and count towards the insured's contributions, premium and cost-sharing payments made on behalf of an insured from state or federal government programs, Indian or tribal organizations, and certain tax-exempt organizations; permit insurers to accept, and count towards the insured's contributions, premium and cost-sharing payments made on behalf of an insured from other persons; provide exception for Health Savings Account-qualified High [...]
AN ACT relating to addiction treatment. Amend KRS 304.17A-611 to prohibit insurers from requiring or using certain utilization reviews for certain prescription drugs used to treat alcohol or opioid use disorder; amend KRS 205.536 to prohibit the Department for Medicaid Services or a Medicaid managed care organization from requiring or using certain utilization reviews for certain prescription drugs used to treat alcohol or opioid use disorder; create a new section of Subtitle 17A of KRS Chapter 304 to require insurers to report the number and type of providers prescribing medication for addiction treatment; require [...]
AN ACT relating to Medicaid ordering, referring, and prescribing providers. Create new sections of KRS 205.510 to 205.560 to define terms; establish that the Department for Medicaid Services and any Medicaid managed care organization shall not prohibit a Medicaid beneficiary from entering into a direct primary care membership agreement or penalize a Medicaid beneficiary for receiving primary care services under a direct primary care membership agreement; establish that the department and any Medicaid managed care organization shall require a primary care provider who enters into a direct primary care membership agreement with a Medicaid [...]
AN ACT relating to pharmacy benefits in the Medicaid program and declaring an emergency. Amend KRS 205.5514 to require the Department for Medicaid Services to establish and implement a preferred drug list, reimbursement methodologies, and dispensing fees for Medicaid managed care organizations and the state pharmacy benefit manager within 30 days after the effective date of this Act; amend KRS 205.5518 to require Medicaid managed care organizations and pharmacy benefit managers to use reimbursement methodologies and dispensing fees established by the department for all Medicaid pharmacy benefit claims submitted on or after January 1, [...]
AN ACT relating to reimbursement for pharmacist services. Create a new section of Subtitle 12 of KRS Chapter 304 to establish certain insurance practices relating to the reimbursement of pharmacists; amend KRS 304.14-135 to establish a clean claim form for the reimbursement of certain pharmacist services or procedures; amend KRS 304.17A-844 and 304.17B-011 to conform; amend KRS 18A.225 to require the state employee health plan to comply with pharmacist reimbursement requirements; amend KRS 342.020 to require workers' compensation employers, insurers, and payment obligors to comply with pharmacist reimbursement requirements.
AN ACT relating to maternal health. Create a new section of KRS 211 to require Medicaid reimbursement for qualified doula services; require a report on the effect of these provisions to be submitted annually to the Legislative Research Commission by the Cabinet for Health and Family Services and by any entity under contract with the cabinet to administer the Medicaid program.
AN ACT relating to Medicare supplement insurance. Amend KRS 304.14-520 to prohibit an insurer from denying, or conditioning the effectiveness of, a Medicare supplement policy, or discriminating in price, based on the age, gender, health status, claims experience, receipt of health care, or medical condition of an applicant or a person covered under the policy; prohibit the policy from containing a waiting period or pre-existing condition limitation or exclusion; require applications to be accepted, and policies issued, at all times throughout the year.
AN ACT relating to postpartum Medicaid coverage. Amend KRS 205.592 to extend Medicaid eligibility for certain new mothers for up to 12 months postpartum; require the Cabinet for Health and Family Services or the Department for Medicaid Services to seek a federal waiver or other approval if they determine that such waiver or approval is necessary.
AN ACT relating to the codification of existing Medicaid cancer coverage. Amend KRS 205.522 to require the Department for Medicaid Services and any managed care organization contracted to provide Medicaid benefits in the Commonwealth to comply with KRS 304.17A-257, relating to coverage for colorectal cancer examinations and laboratory tests, and KRS 304.17A-259, relating to coverage for genetic test for cancer risk.