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AN ACT relating to coverage for the treatment of postpartum mood disorders. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 3
IS CREATED TO READ AS FOLLOWS: 4
(1) As used in this section: 5
(a) "FDA" means the United States Food and Drug Administration; and 6
(b) "Health benefit plan" has the same meaning as in KRS 304.17A-005, 7
except that for purposes of this section, the term shall include student 8
health insurance offered by a Kentucky-licensed insurer under written 9
contract with a university or college whose students it proposes to insure. 10
(2) Subject to subsection (3) of this section, a health benefit plan issued or renewed 11
on or after the effective date of this Act shall provide coverage for all FDA-12
approved prescription drugs for the treatment of postpartum mood disorders. 13
(3) (a) For the coverage required under this section, a health benefit plan shall 14
cover either: 15
1. The original FDA-approved prescription drug; or 16
2. At least one (1) therapeutic equivalent of the original FDA-approved 17
prescription drug if the FDA has designated a therapeutic equivalent 18
of the original FDA-approved prescription drug. 19
(b) The coverage required under this section shall include but not be limited to 20
any cost associated with the administration of the prescription drug, 21
including a stay in a health facility. 22
Section 2. KRS 164.2871 is amended to read as follows: 23
(1) The governing board of each state postsecondary educational institution is 24
authorized to purchase liability insurance for the protection of the individual 25
members of the governing board, faculty, and staff of such institutions from liability 26
for acts and omissions committed in the course and scope of the individual's 27 UNOFFICIAL COPY 22 RS BR 146
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employment or service. Each institution may purchase the type and amount of 1
liability coverage deemed to best serve the interest of such institution. 2
(2) All retirement annuity allowances accrued or accruing to any employee of a state 3
postsecondary educational institution through a retirement program sponsored by 4
the state postsecondary educational institution are hereby exempt from any state, 5
county, or municipal tax, and shall not be subject to execution, attachment, 6
garnishment, or any other process whatsoever, nor shall any assignment thereof be 7
enforceable in any court. Except retirement benefits accrued or accruing to any 8
employee of a state postsecondary educational institution through a retirement 9
program sponsored by the state postsecondary educational institution on or after 10
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 11
provided in KRS 141.010 and 141.0215. 12
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 13
members of governing boards, faculty and staff of institutions of higher education in 14
this state shall not be construed to be a waiver of sovereign immunity or any other 15
immunity or privilege. 16
(4) The governing board of each state postsecondary education institution is authorized 17
to provide a self-insured employer group health plan to its employees, which plan 18
shall: 19
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 20
(b) Except as provided in subsection (5) of this section,[ shall] be exempt from 21
conformity with Subtitle 17A of KRS Chapter 304. 22
(5) A self-insured employer group health plan provided by the governing board of a 23
state postsecondary education institution to its employees shall comply with 24
Section 1 of this Act. 25
Section 3. KRS 205.522 is amended to read as follows: 26
(1) The Department for Medicaid Services and any managed care organization 27 UNOFFICIAL COPY 22 RS BR 146
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contracted to provide Medicaid benefits pursuant to this chapter shall comply with 1
the provisions of Section 1 of this Act and KRS 304.17A-167, 304.17A-235, 2
304.17A-257, 304.17A-259, 304.17A-515, 304.17A-580, 304.17A-600, 304.17A-3
603, 304.17A-607, and 304.17A-740 to 304.17A-743, as applicable. 4
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 5
this chapter shall comply with the reporting requirements of KRS 304.17A-732. 6
Section 4. KRS 205.6485 is amended to read as follows: 7
(1) The Cabinet for Health and Family Services shall prepare a state child health plan 8
meeting the requirements of Title XXI of the Federal Social Security Act, for 9
submission to the Secretary of the United States Department of Health and Human 10
Services within such time as will permit the state to receive the maximum amounts 11
of federal matching funds available under Title XXI. The cabinet shall, by 12
administrative regulation promulgated in accordance with KRS Chapter 13A, 13
establish the following: 14
(a) The eligibility criteria for children covered by the Kentucky Children's Health 15
Insurance Program. However, no person eligible for services under Title XIX 16
of the Social Security Act 42 U.S.C. 1396 to 1396v, as amended, shall be 17
eligible for services under the Kentucky Children's Health Insurance Program 18
except to the extent that Title XIX coverage is expanded by KRS 205.6481 to 19
205.6495 and KRS 304.17A-340; 20
(b) The schedule of benefits to be covered by the Kentucky Children's Health 21
Insurance Program, which shall include preventive services, vision services 22
including glasses, and dental services including at least sealants, extractions, 23
and fillings, and which shall be at least equivalent to one (1) of the following: 24
1. The standard Blue Cross/Blue Shield preferred provider option under the 25
Federal Employees Health Benefit Plan established by U.S.C. sec. 26
8903(1); 27 UNOFFICIAL COPY 22 RS BR 146
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2. A mid-range health benefit coverage plan that is offered and generally 1
available to state employees; or 2
3. Health insurance coverage offered by a health maintenance organization 3
that has the largest insured commercial, non-Medicaid enrollment of 4
covered lives in the state; 5
(c) The premium contribution per family of health insurance coverage available 6
under the Kentucky Children's Health Insurance Program with provisions for 7
the payment of premium contributions by families of children eligible for 8
coverage by the program based upon a sliding scale relating to family income. 9
Premium contributions shall be based on a six (6) month period not to exceed: 10
1. Ten dollars ($10), to be paid by a family with income between one 11
hundred percent (100%) to one hundred thirty-three percent (133%) of 12
the federal poverty level; 13
2. Twenty dollars ($20), to be paid by a family with income between one 14
hundred thirty-four percent (134%) to one hundred forty-nine percent 15
(149%) of the federal poverty level; and 16
3. One hundred twenty dollars ($120), to be paid by a family with income 17
between one hundred fifty percent (150%) to two hundred percent 18
(200%) of the federal poverty level, and which may be made on a partial 19
payment plan of twenty dollars ($20) per month or sixty dollars ($60) 20
per quarter; 21
(d) There shall be no copayments for services provided under the Kentucky 22
Children's Health Insurance Program; and 23
(e) The criteria for health services providers and insurers wishing to contract with 24
the Commonwealth to provide the children's health insurance coverage. 25
However, the cabinet shall provide, in any contracting process for the 26
preventive health insurance program, the opportunity for a public health 27 UNOFFICIAL COPY 22 RS BR 146
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department to bid on preventive health services to eligible children within the 1
public health department's service area. A public health department shall not 2
be disqualified from bidding because the department does not currently offer 3
all the services required by paragraph (b) of this subsection. The criteria shall 4
be set forth in administrative regulations under KRS Chapter 13A and shall 5
maximize competition among the providers and insurers. The Cabinet for 6
Finance and Administration shall provide oversight over contracting policies 7
and procedures to assure that the number of applicants for contracts is 8
maximized. 9
(2) Within twelve (12) months of federal approval of the state's Title XXI child health 10
plan, the Cabinet for Health and Family Services shall assure that a KCHIP program 11
is available to all eligible children in all regions of the state. If necessary, in order to 12
meet this assurance, the cabinet shall institute its own program. 13
(3) KCHIP recipients shall have direct access without a referral from any gatekeeper 14
primary care provider to dentists for covered primary dental services and to 15
optometrists and ophthalmologists for covered primary eye and vision services. 16
(4) The Kentucky Children's Health Insurance Program shall comply with Section 1 17
of this Act. 18
Section 5. KRS 18A.225 (Effective January 1, 2022) is amended to read as 19
follows: 20
(1) (a) The term "employee" for purposes of this section means: 21
1. Any person, including an elected public official, who is regularly 22
employed by any department, office, board, agency, or branch of state 23
government; or by a public postsecondary educational institution; or by 24
any city, urban-county, charter county, county, or consolidated local 25
government, whose legislative body has opted to participate in the state-26
sponsored health insurance program pursuant to KRS 79.080; and who 27 UNOFFICIAL COPY 22 RS BR 146
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is either a contributing member to any one (1) of the retirement systems 1
administered by the state, including but not limited to the Kentucky 2
Retirement Systems, County Employees Retirement System, Kentucky 3
Teachers' Retirement System, the Legislators' Retirement Plan, or the 4
Judicial Retirement Plan; or is receiving a contractual contribution from 5
the state toward a retirement plan; or, in the case of a public 6
postsecondary education institution, is an individual participating in an 7
optional retirement plan authorized by KRS 161.567; or is eligible to 8
participate in a retirement plan established by an employer who ceases 9
participating in the Kentucky Employees Retirement System pursuant to 10
KRS 61.522 whose employees participated in the health insurance plans 11
administered by the Personnel Cabinet prior to the employer's effective 12
cessation date in the Kentucky Employees Retirement System; 13
2. Any certified or classified employee of a local board of education; 14
3. Any elected member of a local board of education; 15
4. Any person who is a present or future recipient of a retirement 16
allowance from the Kentucky Retirement Systems, County Employees 17
Retirement System, Kentucky Teachers' Retirement System, the 18
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 19
Kentucky Community and Technical College System's optional 20
retirement plan authorized by KRS 161.567, except that a person who is 21
receiving a retirement allowance and who is age sixty-five (65) or older 22
shall not be included, with the exception of persons covered under KRS 23
61.702(4)(c), unless he or she is actively employed pursuant to 24
subparagraph 1. of this paragraph; and 25
5. Any eligible dependents and beneficiaries of participating employees 26
and retirees who are entitled to participate in the state-sponsored health 27 UNOFFICIAL COPY 22 RS BR 146
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insurance program; 1
(b) The term "health benefit plan" for the purposes of this section means a health 2
benefit plan as defined in KRS 304.17A-005; 3
(c) The term "insurer" for the purposes of this section means an insurer as defined 4
in KRS 304.17A-005; and 5
(d) The term "managed care plan" for the purposes of this section means a 6
managed care plan as defined in KRS 304.17A-500. 7
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 8
recommendation of the secretary of the Personnel Cabinet, shall procure, in 9
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 10
from one (1) or more insurers authorized to do business in this state, a group 11
health benefit plan that may include but not be limited to health maintenance 12
organization (HMO), preferred provider organization (PPO), point of service 13
(POS), and exclusive provider organization (EPO) benefit plans encompassing 14
all or any class or classes of employees. With the exception of employers 15
governed by the provisions of KRS Chapters 16, 18A, and 151B, all 16
employers of any class of employees or former employees shall enter into a 17
contract with the Personnel Cabinet prior to including that group in the state 18
health insurance group. The contracts shall include but not be limited to 19
designating the entity responsible for filing any federal forms, adoption of 20
policies required for proper plan administration, acceptance of the contractual 21
provisions with health insurance carriers or third-party administrators, and 22
adoption of the payment and reimbursement methods necessary for efficient 23
administration of the health insurance program. Health insurance coverage 24
provided to state employees under this section shall, at a minimum, contain 25
the same benefits as provided under Kentucky Kare Standard as of January 1, 26
1994, and shall include a mail-order drug option as provided in subsection 27 UNOFFICIAL COPY 22 RS BR 146
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(13) of this section. All employees and other persons for whom the health care 1
coverage is provided or made available shall annually be given an option to 2
elect health care coverage through a self-funded plan offered by the 3
Commonwealth or, if a self-funded plan is not available, from a list of 4
coverage options determined by the competitive bid process under the 5
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 6
during annual open enrollment. 7
(b) The policy or policies shall be approved by the commissioner of insurance and 8
may contain the provisions the commissioner of insurance approves, whether 9
or not otherwise permitted by the insurance laws. 10
(c) Any carrier bidding to offer health care coverage to employees shall agree to 11
provide coverage to all members of the state group, including active 12
employees and retirees and their eligible covered dependents and 13
beneficiaries, within the county or counties specified in its bid. Except as 14
provided in subsection (20) of this section, any carrier bidding to offer health 15
care coverage to employees shall also agree to rate all employees as a single 16
entity, except for those retirees whose former employers insure their active 17
employees outside the state-sponsored health insurance program. 18
(d) Any carrier bidding to offer health care coverage to employees shall agree to 19
provide enrollment, claims, and utilization data to the Commonwealth in a 20
format specified by the Personnel Cabinet with the understanding that the data 21
shall be owned by the Commonwealth; to provide data in an electronic form 22
and within a time frame specified by the Personnel Cabinet; and to be subject 23
to penalties for noncompliance with data reporting requirements as specified 24
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 25
to protect the confidentiality of each individual employee; however, 26
confidentiality assertions shall not relieve a carrier from the requirement of 27 UNOFFICIAL COPY 22 RS BR 146
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providing stipulated data to the Commonwealth. 1
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 2
for timely analysis of data received from carriers and, to the extent possible, 3
provide in the request-for-proposal specifics relating to data requirements, 4
electronic reporting, and penalties for noncompliance. The Commonwealth 5
shall own the enrollment, claims, and utilization data provided by each carrier 6
and shall develop methods to protect the confidentiality of the individual. The 7
Personnel Cabinet shall include in the October annual report submitted 8
pursuant to the provisions of KRS 18A.226 to the Governor, the General 9
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 10
financial stability of the program, which shall include but not be limited to 11
loss ratios, methods of risk adjustment, measurements of carrier quality of 12
service, prescription coverage and cost management, and statutorily required 13
mandates. If state self-insurance was available as a carrier option, the report 14
also shall provide a detailed financial analysis of the self-insurance fund 15
including but not limited to loss ratios, reserves, and reinsurance agreements. 16
(f) If any agency participating in the state-sponsored employee health insurance 17
program for its active employees terminates participation and there is a state 18
appropriation for the employer's contribution for active employees' health 19
insurance coverage, then neither the agency nor the employees shall receive 20
the state-funded contribution after termination from the state-sponsored 21
employee health insurance program. 22
(g) Any funds in flexible spending accounts that remain after all reimbursements 23
have been processed shall be transferred to the credit of the state-sponsored 24
health insurance plan's appropriation account. 25
(h) Each entity participating in the state-sponsored health insurance program shall 26
provide an amount at least equal to the state contribution rate for the employer 27 UNOFFICIAL COPY 22 RS BR 146
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portion of the health insurance premium. For any participating entity that used 1
the state payroll system, the employer contribution amount shall be equal to 2
but not greater than the state contribution rate. 3
(3) The premiums may be paid by the policyholder: 4
(a) Wholly from funds contributed by the employee, by payroll deduction or 5
otherwise; 6
(b) Wholly from funds contributed by any department, board, agency, public 7
postsecondary education institution, or branch of state, city, urban-county, 8
charter county, county, or consolidated local government; or 9
(c) Partly from each, except that any premium due for health care coverage or 10
dental coverage, if any, in excess of the premium amount contributed by any 11
department, board, agency, postsecondary education institution, or branch of 12
state, city, urban-county, charter county, county, or consolidated local 13
government for any other health care coverage shall be paid by the employee. 14
(4) If an employee moves his or her place of residence or employment out of the service 15
area of an insurer offering a managed health care plan, under which he or she has 16
elected coverage, into either the service area of another managed health care plan or 17
into an area of the Commonwealth not within a managed health care plan service 18
area, the employee shall be given an option, at the time of the move or transfer, to 19
change his or her coverage to another health benefit plan. 20
(5) No payment of premium by any department, board, agency, public postsecondary 21
educational institution, or branch of state, city, urban-county, charter county, 22
county, or consolidated local government shall constitute compensation to an 23
insured employee for the purposes of any statute fixing or limiting the 24
compensation of such an employee. Any premium or other expense incurred by any 25
department, board, agency, public postsecondary educational institution, or branch 26
of state, city, urban-county, charter county, county, or consolidated local 27 UNOFFICIAL COPY 22 RS BR 146
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government shall be considered a proper cost of administration. 1
(6) The policy or policies may contain the provisions with respect to the class or classes 2
of employees covered, amounts of insurance or coverage for designated classes or 3
groups of employees, policy options, terms of eligibility, and continuation of 4
insurance or coverage after retirement. 5
(7) Group rates under this section shall be made available to the disabled child of an 6
employee regardless of the child's age if the entire premium for the disabled child's 7
coverage is paid by the state employee. A child shall be considered disabled if he or 8
she has been determined to be eligible for federal Social Security disability benefits. 9
(8) The health care contract or contracts for employees shall be entered into for a period 10
of not less than one (1) year. 11
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 12
State Health Insurance Subscribers to advise the secretary or the secretary's designee 13
regarding the state-sponsored health insurance program for employees. The 14
secretary shall appoint, from a list of names submitted by appointing authorities, 15
members representing school districts from each of the seven (7) Supreme Court 16
districts, members representing state government from each of the seven (7) 17
Supreme Court districts, two (2) members representing retirees under age sixty-five 18
(65), one (1) member representing local health departments, two (2) members 19
representing the Kentucky Teachers' Retirement System, and three (3) members at 20
large. The secretary shall also appoint two (2) members from a list of five (5) names 21
submitted by the Kentucky Education Association, two (2) members from a list of 22
five (5) names submitted by the largest state employee organization of nonschool 23
state employees, two (2) members from a list of five (5) names submitted by the 24
Kentucky Association of Counties, two (2) members from a list of five (5) names 25
submitted by the Kentucky League of Cities, and two (2) members from a list of 26
names consisting of five (5) names submitted by each state employee organization 27 UNOFFICIAL COPY 22 RS BR 146
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that has two thousand (2,000) or more members on state payroll deduction. The 1
advisory committee shall be appointed in January of each year and shall meet 2
quarterly. 3
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 4
provided to employees pursuant to this section shall not provide coverage for 5
obtaining or performing an abortion, nor shall any state funds be used for the 6
purpose of obtaining or performing an abortion on behalf of employees or their 7
dependents. 8
(11) Interruption of an established treatment regime with maintenance drugs shall be 9
grounds for an insured to appeal a formulary change through the established appeal 10
procedures approved by the Department of Insurance, if the physician supervising 11
the treatment certifies that the change is not in the best interests of the patient. 12
(12) Any employee who is eligible for and elects to participate in the state health 13
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 14
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 15
state health insurance contribution toward health care coverage as a result of any 16
other employment for which there is a public employer contribution. This does not 17
preclude a retiree and an active employee spouse from using both contributions to 18
the extent needed for purchase of one (1) state sponsored health insurance policy for 19
that plan year. 20
(13) (a) The policies of health insurance coverage procured under subsection (2) of 21
this section shall include a mail-order drug option for maintenance drugs for 22
state employees. Maintenance drugs may be dispensed by mail order in 23
accordance with Kentucky law. 24
(b) A health insurer shall not discriminate against any retail pharmacy located 25
within the geographic coverage area of the health benefit plan and that meets 26
the terms and conditions for participation established by the insurer, including 27 UNOFFICIAL COPY 22 RS BR 146
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price, dispensing fee, and copay requirements of a mail-order option. The 1
retail pharmacy shall not be required to dispense by mail. 2
(c) The mail-order option shall not permit the dispensing of a controlled 3
substance classified in Schedule II. 4
(14) The policy or policies provided to state employees or their dependents pursuant to 5
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 6
aid-related services for insured individuals under eighteen (18) years of age, subject 7
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 8
pursuant to KRS 304.17A-132. 9
(15) Any policy provided to state employees or their dependents pursuant to this section 10
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 11
consistent with KRS 304.17A-142. 12
(16) Any policy provided to state employees or their dependents pursuant to this section 13
shall provide coverage for obtaining amino acid-based elemental formula pursuant 14
to KRS 304.17A-258. 15
(17) If a state employee's residence and place of employment are in the same county, and 16
if the hospital located within that county does not offer surgical services, intensive 17
care services, obstetrical services, level II neonatal services, diagnostic cardiac 18
catheterization services, and magnetic resonance imaging services, the employee 19
may select a plan available in a contiguous county that does provide those services, 20
and the state contribution for the plan shall be the amount available in the county 21
where the plan selected is located. 22
(18) If a state employee's residence and place of employment are each located in counties 23
in which the hospitals do not offer surgical services, intensive care services, 24
obstetrical services, level II neonatal services, diagnostic cardiac catheterization 25
services, and magnetic resonance imaging services, the employee may select a plan 26
available in a county contiguous to the county of residence that does provide those 27 UNOFFICIAL COPY 22 RS BR 146
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services, and the state contribution for the plan shall be the amount available in the 1
county where the plan selected is located. 2
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 3
in the best interests of the state group to allow any carrier bidding to offer health 4
care coverage under this section to submit bids that may vary county by county or 5
by larger geographic areas. 6
(20) Notwithstanding any other provision of this section, the bid for proposals for health 7
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 8
the statewide rating structure provided in calendar year 2003 and a bid scenario that 9
allows for a regional rating structure that allows carriers to submit bids that may 10
vary by region for a given product offering as described in this subsection: 11
(a) The regional rating bid scenario shall not include a request for bid on a 12
statewide option; 13
(b) The Personnel Cabinet shall divide the state into geographical regions which 14
shall be the same as the partnership regions designated by the Department for 15
Medicaid Services for purposes of the Kentucky Health Care Partnership 16
Program established pursuant to 907 KAR 1:705; 17
(c) The request for proposal shall require a carrier's bid to include every county 18
within the region or regions for which the bid is submitted and include but not 19
be restricted to a preferred provider organization (PPO) option; 20
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 21
carrier all of the counties included in its bid within the region. If the Personnel 22
Cabinet deems the bids submitted in accordance with this subsection to be in 23
the best interests of state employees in a region, the cabinet may award the 24
contract for that region to no more than two (2) carriers; and 25
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 26
other requirements or criteria in the request for proposal. 27 UNOFFICIAL COPY 22 RS BR 146
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(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 1
after July 12, 2006, to public employees pursuant to this section which provides 2
coverage for services rendered by a physician or osteopath duly licensed under KRS 3
Chapter 311 that are within the scope of practice of an optometrist duly licensed 4
under the provisions of KRS Chapter 320 shall provide the same payment of 5
coverage to optometrists as allowed for those services rendered by physicians or 6
osteopaths. 7
(22) Any fully insured health benefit plan or self-insured plan issued or renewed[ on or 8
after June 29, 2021,] to public employees pursuant to this section shall comply with: 9
(a) KRS 304.12-237; 10
(b) KRS 304.17A-270 and 304.17A-525; 11
(c) KRS 304.17A-600 to 304.17A-633; 12
(d) KRS 205.593; 13
(e) KRS 304.17A-700 to 304.17A-730; 14
(f) KRS 304.14-135; 15
(g) KRS 304.17A-580 and 304.17A-641; 16
(h) KRS 304.99-123; 17
(i) KRS 304.17A-138;[ and] 18
(j) KRS 304.17A-148; 19
(h) Section 1 of this Act; and 20
(i) Administrative regulations promulgated pursuant to statutes listed in this 21
subsection. 22
[(23) Any fully insured health benefit plan or self-insured plan issued or renewed on or 23
after January 1, 2022, to public employees pursuant to this section shall comply 24
with KRS 304.17A-148.] 25
Section 6. This Act takes effect January 1, 2023. 26