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AN ACT relating to coverage of mental health wellness examinations. 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) "Health plan": 6
1. Means any health insurance policy, certificate, contract, or plan that 7
offers or provides coverage in this state for both medical and surgical 8
benefits and mental health or substance use disorder benefits, whether 9
such coverage is by direct payment, reimbursement, or otherwise; and 10
2. Includes but is not limited to: 11
a. Health benefit plans; and 12
b. Student health insurance offered by a Kentucky-licensed insurer 13
under written contract with a university or college whose 14
students it proposes to insure; 15
(b) "Mental health professional" means any of the following persons engaged 16
in providing mental health services: 17
1. A physician or psychiatrist licensed to practice medicine or osteopathy 18
under KRS Chapter 311; 19
2. A medical officer of the government of the United States; 20
3. A licensed psychologist, licensed psychological practitioner, certified 21
psychologist, or licensed psychological associate, licensed under KRS 22
Chapter 319; 23
4. A certified nurse practitioner or clinical nurse specialist with a 24
psychiatric or mental health population focus licensed to engage in 25
advanced practice nursing under KRS 314.042; 26
5. A licensed clinical social worker licensed under KRS 335.100 or a 27 UNOFFICIAL COPY 23 RS BR 916
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certified social worker licensed under KRS 335.080; 1
6. A licensed marriage and family therapist licensed under KRS 335.330 2
or a marriage and family therapist associate holding a permit under 3
KRS 335.332; 4
7. A licensed professional clinical counselor or licensed professional 5
counselor associate, licensed under KRS 335.500 to 335.599; 6
8. A licensed professional art therapist licensed under KRS 309.133 or a 7
licensed professional art therapist associate licensed under KRS 8
309.134; 9
9. A Kentucky licensed pastoral counselor licensed under KRS 335.600 10
to 335.699; 11
10. A licensed clinical alcohol and drug counselor, licensed clinical 12
alcohol and drug counselor associate, or certified alcohol and drug 13
counselor, licensed or certified under KRS 309.080 to 309.089; or 14
11. A physician assistant licensed under KRS 311.840 to 311.862 who 15
meets the criteria for being a qualified mental health professional 16
under KRS 202A.011(12)(h); and 17
(c) "Mental health wellness examination" includes but is not limited to: 18
1. A behavioral health screening; 19
2. Education and consultation on healthy lifestyle changes; 20
3. Referrals to ongoing treatment, mental health services, and other 21
supports; and 22
4. Discussion of potential options for medication. 23
(2) To the extent permitted by federal law, all health plans shall provide coverage for 24
an annual mental health wellness examination of at least forty-five (45) minutes 25
that is performed by a mental health professional. 26
(3) The coverage required by this section shall: 27 UNOFFICIAL COPY 23 RS BR 916
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(a) Be no less extensive than the coverage provided for medical and surgical 1
benefits; 2
(b) Comply with the Mental Health Parity and Addiction Equity Act of 2008, 42 3
U.S.C. sec. 300gg-26, as amended; and 4
(c) Not be subject to copayments, coinsurance, deductibles, or any other cost-5
sharing requirements. 6
Section 2. KRS 164.2871 is amended to read as follows: 7
(1) The governing board of each state postsecondary educational institution is 8
authorized to purchase liability insurance for the protection of the individual 9
members of the governing board, faculty, and staff of such institutions from liability 10
for acts and omissions committed in the course and scope of the individual's 11
employment or service. Each institution may purchase the type and amount of 12
liability coverage deemed to best serve the interest of such institution. 13
(2) All retirement annuity allowances accrued or accruing to any employee of a state 14
postsecondary educational institution through a retirement program sponsored by 15
the state postsecondary educational institution are hereby exempt from any state, 16
county, or municipal tax, and shall not be subject to execution, attachment, 17
garnishment, or any other process whatsoever, nor shall any assignment thereof be 18
enforceable in any court. Except retirement benefits accrued or accruing to any 19
employee of a state postsecondary educational institution through a retirement 20
program sponsored by the state postsecondary educational institution on or after 21
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 22
provided in KRS 141.010 and 141.0215. 23
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 24
members of governing boards, faculty and staff of institutions of higher education 25
in this state shall not be construed to be a waiver of sovereign immunity or any 26
other immunity or privilege. 27 UNOFFICIAL COPY 23 RS BR 916
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(4) The governing board of each state postsecondary education institution is authorized 1
to provide a self-insured employer group health plan to its employees, which plan 2
shall: 3
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 4
(b) Except as provided in subsection (5) of this section, be exempt from 5
conformity with Subtitle 17A of KRS Chapter 304. 6
(5) A self-insured employer group health plan provided by the governing board of a 7
state postsecondary education institution to its employees shall comply with: 8
(a) KRS 304.17A-163 and 304.17A-1631; and 9
(b) Section 1 of this Act. 10
SECTION 3. A NEW SECTION OF SUBTITLE 17C OF KRS CHAPTER 304 11
IS CREATED TO READ AS FOLLOWS: 12
Section 1 of this Act shall apply to limited health service benefit plans, including any 13
limited health service contract as defined in KRS 304.38A-010. 14
SECTION 4. A NEW SECTION OF SUBTITLE 38A OF KRS CHAPTER 304 15
IS CREATED TO READ AS FOLLOWS: 16
Limited health service organizations shall comply with Section 1 of this Act. 17
Section 5. KRS 205.522 is amended to read as follows: 18
(1) The Department for Medicaid Services and any managed care organization 19
contracted to provide Medicaid benefits pursuant to this chapter shall comply with 20
the provisions of Section 1 of this Act and KRS 304.17A-163, 304.17A-1631, 21
304.17A-167, 304.17A-235, 304.17A-257, 304.17A-259, 304.17A-515, 304.17A-22
580, 304.17A-600, 304.17A-603, 304.17A-607, and 304.17A-740 to 304.17A-743, 23
as applicable. 24
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 25
this chapter shall comply with the reporting requirements of KRS 304.17A-732. 26
Section 6. KRS 205.6485 is amended to read as follows: 27 UNOFFICIAL COPY 23 RS BR 916
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(1) The Cabinet for Health and Family Services shall prepare a state child health plan 1
meeting the requirements of Title XXI of the Federal Social Security Act, for 2
submission to the Secretary of the United States Department of Health and Human 3
Services within such time as will permit the state to receive the maximum amounts 4
of federal matching funds available under Title XXI. The cabinet shall, by 5
administrative regulation promulgated in accordance with KRS Chapter 13A, 6
establish the following: 7
(a) The eligibility criteria for children covered by the Kentucky Children's Health 8
Insurance Program. However, no person eligible for services under Title XIX 9
of the Social Security Act, 42 U.S.C. secs. 1396 to 1396v, as amended, shall 10
be eligible for services under the Kentucky Children's Health Insurance 11
Program except to the extent that Title XIX coverage is expanded by KRS 12
205.6481 to 205.6495 and KRS 304.17A-340; 13
(b) The schedule of benefits to be covered by the Kentucky Children's Health 14
Insurance Program, which shall include preventive services, vision services 15
including glasses, and dental services including at least sealants, extractions, 16
and fillings, and which shall be at least equivalent to one (1) of the following: 17
1. The standard Blue Cross/Blue Shield preferred provider option under 18
the Federal Employees Health Benefit Plan established by 5 U.S.C. sec. 19
8903(1); 20
2. A mid-range health benefit coverage plan that is offered and generally 21
available to state employees; or 22
3. Health insurance coverage offered by a health maintenance organization 23
that has the largest insured commercial, non-Medicaid enrollment of 24
covered lives in the state; 25
(c) The premium contribution per family of health insurance coverage available 26
under the Kentucky Children's Health Insurance Program with provisions for 27 UNOFFICIAL COPY 23 RS BR 916
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the payment of premium contributions by families of children eligible for 1
coverage by the program based upon a sliding scale relating to family income. 2
Premium contributions shall be based on a six (6) month period not to exceed: 3
1. Ten dollars ($10), to be paid by a family with income between one 4
hundred percent (100%) to one hundred thirty-three percent (133%) of 5
the federal poverty level; 6
2. Twenty dollars ($20), to be paid by a family with income between one 7
hundred thirty-four percent (134%) to one hundred forty-nine percent 8
(149%) of the federal poverty level; and 9
3. One hundred twenty dollars ($120), to be paid by a family with income 10
between one hundred fifty percent (150%) to two hundred percent 11
(200%) of the federal poverty level, and which may be made on a partial 12
payment plan of twenty dollars ($20) per month or sixty dollars ($60) 13
per quarter; 14
(d) There shall be no copayments for services provided under the Kentucky 15
Children's Health Insurance Program; and 16
(e) The criteria for health services providers and insurers wishing to contract with 17
the Commonwealth to provide the children's health insurance coverage. 18
However, the cabinet shall provide, in any contracting process for the 19
preventive health insurance program, the opportunity for a public health 20
department to bid on preventive health services to eligible children within the 21
public health department's service area. A public health department shall not 22
be disqualified from bidding because the department does not currently offer 23
all the services required by paragraph (b) of this subsection. The criteria shall 24
be set forth in administrative regulations under KRS Chapter 13A and shall 25
maximize competition among the providers and insurers. The Cabinet for 26
Finance and Administration shall provide oversight over contracting policies 27 UNOFFICIAL COPY 23 RS BR 916
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and procedures to assure that the number of applicants for contracts is 1
maximized. 2
(2) Within twelve (12) months of federal approval of the state's Title XXI child health 3
plan, the Cabinet for Health and Family Services shall assure that a KCHIP 4
program is available to all eligible children in all regions of the state. If necessary, 5
in order to meet this assurance, the cabinet shall institute its own program. 6
(3) KCHIP recipients shall have direct access without a referral from any gatekeeper 7
primary care provider to dentists for covered primary dental services and to 8
optometrists and ophthalmologists for covered primary eye and vision services. 9
(4) The Kentucky Children's Health Insurance Program[Plan] shall comply with: 10
(a) KRS 304.17A-163 and 304.17A-1631; and 11
(b) Section 1 of this Act. 12
Section 7. KRS 18A.225 is amended to read as follows: 13
(1) (a) The term "employee" for purposes of this section means: 14
1. Any person, including an elected public official, who is regularly 15
employed by any department, office, board, agency, or branch of state 16
government; or by a public postsecondary educational institution; or by 17
any city, urban-county, charter county, county, or consolidated local 18
government, whose legislative body has opted to participate in the state-19
sponsored health insurance program pursuant to KRS 79.080; and who 20
is either a contributing member to any one (1) of the retirement systems 21
administered by the state, including but not limited to the Kentucky 22
Retirement Systems, County Employees Retirement System, Kentucky 23
Teachers' Retirement System, the Legislators' Retirement Plan, or the 24
Judicial Retirement Plan; or is receiving a contractual contribution from 25
the state toward a retirement plan; or, in the case of a public 26
postsecondary education institution, is an individual participating in an 27 UNOFFICIAL COPY 23 RS BR 916
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optional retirement plan authorized by KRS 161.567; or is eligible to 1
participate in a retirement plan established by an employer who ceases 2
participating in the Kentucky Employees Retirement System pursuant to 3
KRS 61.522 whose employees participated in the health insurance plans 4
administered by the Personnel Cabinet prior to the employer's effective 5
cessation date in the Kentucky Employees Retirement System; 6
2. Any certified or classified employee of a local board of education or a 7
public charter school as defined in KRS 160.1590; 8
3. Any elected member of a local board of education; 9
4. Any person who is a present or future recipient of a retirement 10
allowance from the Kentucky Retirement Systems, County Employees 11
Retirement System, Kentucky Teachers' Retirement System, the 12
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 13
Kentucky Community and Technical College System's optional 14
retirement plan authorized by KRS 161.567, except that a person who is 15
receiving a retirement allowance and who is age sixty-five (65) or older 16
shall not be included, with the exception of persons covered under KRS 17
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 18
employed pursuant to subparagraph 1. of this paragraph; and 19
5. Any eligible dependents and beneficiaries of participating employees 20
and retirees who are entitled to participate in the state-sponsored health 21
insurance program; 22
(b) The term "health benefit plan" for the purposes of this section means a health 23
benefit plan as defined in KRS 304.17A-005; 24
(c) The term "insurer" for the purposes of this section means an insurer as defined 25
in KRS 304.17A-005; and 26
(d) The term "managed care plan" for the purposes of this section means a 27 UNOFFICIAL COPY 23 RS BR 916
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managed care plan as defined in KRS 304.17A-500. 1
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 2
recommendation of the secretary of the Personnel Cabinet, shall procure, in 3
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 4
from one (1) or more insurers authorized to do business in this state, a group 5
health benefit plan that may include but not be limited to health maintenance 6
organization (HMO), preferred provider organization (PPO), point of service 7
(POS), and exclusive provider organization (EPO) benefit plans 8
encompassing all or any class or classes of employees. With the exception of 9
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 10
all employers of any class of employees or former employees shall enter into 11
a contract with the Personnel Cabinet prior to including that group in the state 12
health insurance group. The contracts shall include but not be limited to 13
designating the entity responsible for filing any federal forms, adoption of 14
policies required for proper plan administration, acceptance of the contractual 15
provisions with health insurance carriers or third-party administrators, and 16
adoption of the payment and reimbursement methods necessary for efficient 17
administration of the health insurance program. Health insurance coverage 18
provided to state employees under this section shall, at a minimum, contain 19
the same benefits as provided under Kentucky Kare Standard as of January 1, 20
1994, and shall include a mail-order drug option as provided in subsection 21
(13) of this section. All employees and other persons for whom the health care 22
coverage is provided or made available shall annually be given an option to 23
elect health care coverage through a self-funded plan offered by the 24
Commonwealth or, if a self-funded plan is not available, from a list of 25
coverage options determined by the competitive bid process under the 26
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 27 UNOFFICIAL COPY 23 RS BR 916
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during annual open enrollment. 1
(b) The policy or policies shall be approved by the commissioner of insurance 2
and may contain the provisions the commissioner of insurance approves, 3
whether or not otherwise permitted by the insurance laws. 4
(c) Any carrier bidding to offer health care coverage to employees shall agree to 5
provide coverage to all members of the state group, including active 6
employees and retirees and their eligible covered dependents and 7
beneficiaries, within the county or counties specified in its bid. Except as 8
provided in subsection (20) of this section, any carrier bidding to offer health 9
care coverage to employees shall also agree to rate all employees as a single 10
entity, except for those retirees whose former employers insure their active 11
employees outside the state-sponsored health insurance program and as 12
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 13
(d) Any carrier bidding to offer health care coverage to employees shall agree to 14
provide enrollment, claims, and utilization data to the Commonwealth in a 15
format specified by the Personnel Cabinet with the understanding that the data 16
shall be owned by the Commonwealth; to provide data in an electronic form 17
and within a time frame specified by the Personnel Cabinet; and to be subject 18
to penalties for noncompliance with data reporting requirements as specified 19
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 20
to protect the confidentiality of each individual employee; however, 21
confidentiality assertions shall not relieve a carrier from the requirement of 22
providing stipulated data to the Commonwealth. 23
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 24
for timely analysis of data received from carriers and, to the extent possible, 25
provide in the request-for-proposal specifics relating to data requirements, 26
electronic reporting, and penalties for noncompliance. The Commonwealth 27 UNOFFICIAL COPY 23 RS BR 916
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shall own the enrollment, claims, and utilization data provided by each carrier 1
and shall develop methods to protect the confidentiality of the individual. The 2
Personnel Cabinet shall include in the October annual report submitted 3
pursuant to the provisions of KRS 18A.226 to the Governor, the General 4
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 5
financial stability of the program, which shall include but not be limited to 6
loss ratios, methods of risk adjustment, measurements of carrier quality of 7
service, prescription coverage and cost management, and statutorily required 8
mandates. If state self-insurance was available as a carrier option, the report 9
also shall provide a detailed financial analysis of the self-insurance fund 10
including but not limited to loss ratios, reserves, and reinsurance agreements. 11
(f) If any agency participating in the state-sponsored employee health insurance 12
program for its active employees terminates participation and there is a state 13
appropriation for the employer's contribution for active employees' health 14
insurance coverage, then neither the agency nor the employees shall receive 15
the state-funded contribution after termination from the state-sponsored 16
employee health insurance program. 17
(g) Any funds in flexible spending accounts that remain after all reimbursements 18
have been processed shall be transferred to the credit of the state-sponsored 19
health insurance plan's appropriation account. 20
(h) Each entity participating in the state-sponsored health insurance program shall 21
provide an amount at least equal to the state contribution rate for the employer 22
portion of the health insurance premium. For any participating entity that used 23
the state payroll system, the employer contribution amount shall be equal to 24
but not greater than the state contribution rate. 25
(3) The premiums may be paid by the policyholder: 26
(a) Wholly from funds contributed by the employee, by payroll deduction or 27 UNOFFICIAL COPY 23 RS BR 916
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otherwise; 1
(b) Wholly from funds contributed by any department, board, agency, public 2
postsecondary education institution, or branch of state, city, urban-county, 3
charter county, county, or consolidated local government; or 4
(c) Partly from each, except that any premium due for health care coverage or 5
dental coverage, if any, in excess of the premium amount contributed by any 6
department, board, agency, postsecondary education institution, or branch of 7
state, city, urban-county, charter county, county, or consolidated local 8
government for any other health care coverage shall be paid by the employee. 9
(4) If an employee moves his or her place of residence or employment out of the 10
service area of an insurer offering a managed health care plan, under which he or 11
she has elected coverage, into either the service area of another managed health care 12
plan or into an area of the Commonwealth not within a managed health care plan 13
service area, the employee shall be given an option, at the time of the move or 14
transfer, to change his or her coverage to another health benefit plan. 15
(5) No payment of premium by any department, board, agency, public postsecondary 16
educational institution, or branch of state, city, urban-county, charter county, 17
county, or consolidated local government shall constitute compensation to an 18
insured employee for the purposes of any statute fixing or limiting the 19
compensation of such an employee. Any premium or other expense incurred by any 20
department, board, agency, public postsecondary educational institution, or branch 21
of state, city, urban-county, charter county, county, or consolidated local 22
government shall be considered a proper cost of administration. 23
(6) The policy or policies may contain the provisions with respect to the class or classes 24
of employees covered, amounts of insurance or coverage for designated classes or 25
groups of employees, policy options, terms of eligibility, and continuation of 26
insurance or coverage after retirement. 27 UNOFFICIAL COPY 23 RS BR 916
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(7) Group rates under this section shall be made available to the disabled child of an 1
employee regardless of the child's age if the entire premium for the disabled child's 2
coverage is paid by the state employee. A child shall be considered disabled if he or 3
she has been determined to be eligible for federal Social Security disability benefits. 4
(8) The health care contract or contracts for employees shall be entered into for a 5
period of not less than one (1) year. 6
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 7
State Health Insurance Subscribers to advise the secretary or the secretary's 8
designee regarding the state-sponsored health insurance program for employees. 9
The secretary shall appoint, from a list of names submitted by appointing 10
authorities, members representing school districts from each of the seven (7) 11
Supreme Court districts, members representing state government from each of the 12
seven (7) Supreme Court districts, two (2) members representing retirees under age 13
sixty-five (65), one (1) member representing local health departments, two (2) 14
members representing the Kentucky Teachers' Retirement System, and three (3) 15
members at large. The secretary shall also appoint two (2) members from a list of 16
five (5) names submitted by the Kentucky Education Association, two (2) members 17
from a list of five (5) names submitted by the largest state employee organization of 18
nonschool state employees, two (2) members from a list of five (5) names submitted 19
by the Kentucky Association of Counties, two (2) members from a list of five (5) 20
names submitted by the Kentucky League of Cities, and two (2) members from a 21
list of names consisting of five (5) names submitted by each state employee 22
organization that has two thousand (2,000) or more members on state payroll 23
deduction. The advisory committee shall be appointed in January of each year and 24
shall meet quarterly. 25
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 26
provided to employees pursuant to this section shall not provide coverage for 27 UNOFFICIAL COPY 23 RS BR 916
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obtaining or performing an abortion, nor shall any state funds be used for the 1
purpose of obtaining or performing an abortion on behalf of employees or their 2
dependents. 3
(11) Interruption of an established treatment regime with maintenance drugs shall be 4
grounds for an insured to appeal a formulary change through the established appeal 5
procedures approved by the Department of Insurance, if the physician supervising 6
the treatment certifies that the change is not in the best interests of the patient. 7
(12) Any employee who is eligible for and elects to participate in the state health 8
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 9
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 10
state health insurance contribution toward health care coverage as a result of any 11
other employment for which there is a public employer contribution. This does not 12
preclude a retiree and an active employee spouse from using both contributions to 13
the extent needed for purchase of one (1) state sponsored health insurance policy 14
for that plan year. 15
(13) (a) The policies of health insurance coverage procured under subsection (2) of 16
this section shall include a mail-order drug option for maintenance drugs for 17
state employees. Maintenance drugs may be dispensed by mail order in 18
accordance with Kentucky law. 19
(b) A health insurer shall not discriminate against any retail pharmacy located 20
within the geographic coverage area of the health benefit plan and that meets 21
the terms and conditions for participation established by the insurer, including 22
price, dispensing fee, and copay requirements of a mail-order option. The 23
retail pharmacy shall not be required to dispense by mail. 24
(c) The mail-order option shall not permit the dispensing of a controlled 25
substance classified in Schedule II. 26
(14) The policy or policies provided to state employees or their dependents pursuant to 27 UNOFFICIAL COPY 23 RS BR 916
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this section shall provide coverage for obtaining a hearing aid and acquiring hearing 1
aid-related services for insured individuals under eighteen (18) years of age, subject 2
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 3
pursuant to KRS 304.17A-132. 4
(15) Any policy provided to state employees or their dependents pursuant to this section 5
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 6
consistent with KRS 304.17A-142. 7
(16) Any policy provided to state employees or their dependents pursuant to this section 8
shall provide coverage for obtaining amino acid-based elemental formula pursuant 9
to KRS 304.17A-258. 10
(17) If a state employee's residence and place of employment are in the same county, 11
and if the hospital located within that county does not offer surgical services, 12
intensive care services, obstetrical services, level II neonatal services, diagnostic 13
cardiac catheterization services, and magnetic resonance imaging services, the 14
employee may select a plan available in a contiguous county that does provide 15
those services, and the state contribution for the plan shall be the amount available 16
in the county where the plan selected is located. 17
(18) If a state employee's residence and place of employment are each located in 18
counties in which the hospitals do not offer surgical services, intensive care 19
services, obstetrical services, level II neonatal services, diagnostic cardiac 20
catheterization services, and magnetic resonance imaging services, the employee 21
may select a plan available in a county contiguous to the county of residence that 22
does provide those services, and the state contribution for the plan shall be the 23
amount available in the county where the plan selected is located. 24
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 25
in the best interests of the state group to allow any carrier bidding to offer health 26
care coverage under this section to submit bids that may vary county by county or 27 UNOFFICIAL COPY 23 RS BR 916
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by larger geographic areas. 1
(20) Notwithstanding any other provision of this section, the bid for proposals for health 2
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 3
the statewide rating structure provided in calendar year 2003 and a bid scenario that 4
allows for a regional rating structure that allows carriers to submit bids that may 5
vary by region for a given product offering as described in this subsection: 6
(a) The regional rating bid scenario shall not include a request for bid on a 7
statewide option; 8
(b) The Personnel Cabinet shall divide the state into geographical regions which 9
shall be the same as the partnership regions designated by the Department for 10
Medicaid Services for purposes of the Kentucky Health Care Partnership 11
Program established pursuant to 907 KAR 1:705; 12
(c) The request for proposal shall require a carrier's bid to include every county 13
within the region or regions for which the bid is submitted and include but not 14
be restricted to a preferred provider organization (PPO) option; 15
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 16
carrier all of the counties included in its bid within the region. If the Personnel 17
Cabinet deems the bids submitted in accordance with this subsection to be in 18
the best interests of state employees in a region, the cabinet may award the 19
contract for that region to no more than two (2) carriers; and 20
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 21
other requirements or criteria in the request for proposal. 22
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 23
after July 12, 2006, to public employees pursuant to this section which provides 24
coverage for services rendered by a physician or osteopath duly licensed under KRS 25
Chapter 311 that are within the scope of practice of an optometrist duly licensed 26
under the provisions of KRS Chapter 320 shall provide the same payment of 27 UNOFFICIAL COPY 23 RS BR 916
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coverage to optometrists as allowed for those services rendered by physicians or 1
osteopaths. 2
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 3
public employees pursuant to this section shall comply with: 4
(a) KRS 304.12-237; 5
(b) KRS 304.17A-270 and 304.17A-525; 6
(c) KRS 304.17A-600 to 304.17A-633; 7
(d) KRS 205.593; 8
(e) KRS 304.17A-700 to 304.17A-730; 9
(f) KRS 304.14-135; 10
(g) KRS 304.17A-580 and 304.17A-641; 11
(h) KRS 304.99-123; 12
(i) KRS 304.17A-138; 13
(j) KRS 304.17A-148; 14
(k) KRS 304.17A-163 and 304.17A-1631;[ and] 15
(l) Section 1 of this Act; and 16
(m) Administrative regulations promulgated pursuant to statutes listed in this 17
subsection. 18
Section 8. This Act applies to health plans issued or renewed on or after the 19
effective date of this section. 20
Section 9. If the Cabinet for Health and Family Services determines that a 21
waiver or any other authorization from a federal agency is necessary to implement 22
Section 5 or 6 of this Act for any reason, including the loss of federal funds, the cabinet 23
shall, within 90 days after the effective date of this section, request the waiver or 24
authorization, and may only delay implementation of those provisions for which a waiver 25
or authorization was deemed necessary until the waiver or authorization is granted. 26
Section 10. Sections 1 to 8 of this Act take effect January 1, 2024. 27