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AN ACT relating to behavioral health services. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 210 IS CREATED TO 3
READ AS FOLLOWS: 4
(1) As used in Sections 1 to 3 of this Act: 5
(a) "Behavioral health emergency services" means a continuum of services to 6
address crisis intervention, crisis stabilization, and crisis residential 7
treatment needs of those experiencing a mental health or substance use 8
disorder emergency or those experiencing a suicidal crisis, including but 9
not limited to crisis intervention, mobile crisis response teams, and crisis 10
receiving and stabilization services; 11
(b) "Crisis receiving and stabilization services" means short-term services, 12
provided in a person's home or in a home-like facility, with capacity for 13
diagnosis, initial management, observation, treatment interventions, and 14
follow-up referral services; 15
(c) "Mental health professional": 16
1. Has the same meaning as in KRS 645.020; and 17
2. Includes any additional licensed or certified professionals as 18
determined by the cabinet by an administrative regulation 19
promulgated in accordance with KRS Chapter 13A; 20
(d) "Mobile crisis response team" means a multidisciplinary behavioral health 21
team established under this section; 22
(e) "Program" means the Kentucky Youth Mobile Crisis Response Program 23
established by this section; 24
(f) "SAMHSA" means the Substance Abuse and Mental Health Services 25
Administration; and 26
(g) "Youth" means any person twenty-two (22) years old or younger. 27 UNOFFICIAL COPY 24 RS BR 2129
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(2) The Kentucky Youth Mobile Crisis Response Program is hereby established to be 1
administered by the cabinet. As part of the program, the cabinet shall collaborate 2
with regional community services programs to create mobile crisis response 3
teams that shall be dispatched through the 9-8-8 national suicide and crisis 4
hotline to provide behavioral health emergency services for youth experiencing 5
substance use, mental health, or suicidal crisis. 6
(3) Mobile crisis response teams shall: 7
(a) Include a mental health professional and a qualified crisis responder, as 8
defined by the cabinet; and 9
(b) Provide services regardless of a youth's age, ability to pay, location, or level 10
of clinical services needed. 11
(4) The cabinet shall: 12
(a) Develop protocols for mobile crisis response teams that follow national 13
guidelines established by SAMHSA, including but not limited to: 14
1. Avoiding out-of-home placements when possible; 15
2. Providing developmentally appropriate services that are tailored to the 16
needs of youth; 17
3. Providing culturally and linguistically appropriate, equity-driven 18
services; and 19
4. Minimizing or eliminating involvement of the juvenile justice system 20
or law enforcement; and 21
(b) Create a credentialing process and criteria for qualified crisis responders 22
who are not otherwise licensed or credentialed as mental health 23
professionals. 24
(5) The cabinet shall submit an annual report on the program to the Legislative 25
Research Commission for referral to the Interim Joint Committees on Health 26
Services and Families and Children by December 1, 2025, and each December 1 27 UNOFFICIAL COPY 24 RS BR 2129
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thereafter, including: 1
(a) A geographical breakdown of dispatches; 2
(b) Demographics of youth served; and 3
(c) Recommendations for improving the program. 4
(6) The cabinet shall promulgate administrative regulations in accordance with KRS 5
Chapter 13A to implement Sections 1 to 3 of this Act. 6
SECTION 2. A NEW SECTION OF KRS CHAPTER 210 IS CREATED TO 7
READ AS FOLLOWS: 8
(1) There is hereby created the Youth Behavioral Health Crisis Advisory Board 9
consisting of fourteen (14) members as follows: 10
(a) The secretary of the cabinet or designee; 11
(b) The commissioner of the Department for Behavioral Health, Developmental 12
and Intellectual Disabilities or designee; 13
(c) The commissioner of the Department of Juvenile Justice or designee; 14
(d) The commissioner of the Department of Education or designee; 15
(e) The state suicide prevention coordinator of the Department for Behavioral 16
Health, Developmental and Intellectual Disabilities; 17
(f) The president of the Kentucky Children's Hospital or designee; 18
(g) One (1) elected city official of a city government appointed by the Kentucky 19
League of Cities; 20
(h) One (1) elected county official of a county government appointed by the 21
Kentucky Association of Counties; 22
(i) Three (3) parents of children with behavioral health challenges, including 23
individuals who represent historically marginalized communities, appointed 24
by the Governor from a list of: 25
1. Three (3) names provided by the Department for Behavioral Health, 26
Developmental and Intellectual Disabilities; and 27 UNOFFICIAL COPY 24 RS BR 2129
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2. Three (3) names provided by the Department of Juvenile Justice; and 1
(j) Three (3) individuals, aged eighteen (18) to twenty-six (26) years old, who 2
have experienced behavioral health challenges, appointed by the Governor 3
from a list of three (3) names provided by the Department for Behavioral 4
Health, Developmental and Intellectual Disabilities and three (3) names 5
provided by the Department of Juvenile Justice. 6
(2) The board shall review data, assess community needs and experience of care, and 7
make recommendations to the General Assembly and to the cabinet regarding 8
gaps, needs, strengths of the program, ensuring equity and inclusion, and areas 9
for potential improvement. 10
(3) (a) Members appointed under subsection (1)(g) to (j) of this section shall serve 11
for a term of four (4) years and until their successors are appointed and 12
qualified. 13
(b) Members appointed under subsection (1)(g) or (h) of this section are only 14
eligible to serve as long as the appointee holds the applicable local office or 15
position he or she held at the time of his or her appointment. 16
(c) Any vacancy on the board shall be filled in the same manner as the original 17
appointment and shall be for the remainder of the unexpired term. 18
(4) A member of the board shall not be considered to be a public officer by reason of 19
membership on the board. 20
(5) (a) The secretary of the cabinet or designee shall serve as chair and preside 21
over meetings of the board, which shall be conducted at least four (4) times 22
each year. In the absence of the chair, the board may be chaired by any 23
other member of the board selected by the remaining members. 24
(b) The board shall: 25
1. Be subject to the Kentucky Open Meetings Act, KRS 61.805 to 61.850; 26
2. Establish a regular meeting schedule for each calendar year; 27 UNOFFICIAL COPY 24 RS BR 2129
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3. Hold at least two (2) meetings per calendar year in Kentucky 1
congressional districts other than the one in which Frankfort is 2
located; and 3
4. Rotate its traveling meeting locations among the congressional 4
districts before holding another traveling meeting in the same 5
congressional district. 6
(c) A majority of the members appointed to the board shall constitute a 7
quorum. 8
(6) The cabinet shall provide staff services, office space, and other resources 9
necessary to conduct the affairs of the board. The board shall be attached to the 10
cabinet for administrative purposes but shall operate as an independent entity 11
within state government. 12
(7) The board members shall serve without compensation but shall be reimbursed for 13
actual and necessary expenses incurred in connection with their official duties as 14
members of the board. 15
SECTION 3. A NEW SECTION OF KRS CHAPTER 210 IS CREATED TO 16
READ AS FOLLOWS: 17
Behavioral health emergency services provided by a mobile crisis response team to a 18
youth shall be paid for by the cabinet if: 19
(1) The youth receiving the services is uninsured; or 20
(2) The services are not covered by the youth's health plan. 21
SECTION 4. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 22
IS CREATED TO READ AS FOLLOWS: 23
(1) As used in this section: 24
(a) "Behavioral health emergency services"; 25
(b) "Mobile crisis response team"; and 26
(c) "Youth"; 27 UNOFFICIAL COPY 24 RS BR 2129
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have the same meaning as in Section 1 of this Act. 1
(2) (a) All health benefit plans that provide coverage for mental health or 2
substance abuse shall provide coverage for behavioral health emergency 3
services provided by a mobile crisis response team to a youth, both in-4
network and out-of-network, without prior authorization. 5
(b) For coverage required under this section, the insured's cost sharing for out-6
of-network services shall not exceed the amount of cost sharing that would 7
be imposed for in-network services. 8
Section 5. KRS 205.522 is amended to read as follows: 9
(1) With respect to the administration and provision of Medicaid benefits pursuant to 10
this chapter, the Department for Medicaid Services and any managed care 11
organization contracted to provide Medicaid benefits pursuant to this chapter, and 12
the state's medical assistance program shall be subject to, and comply with, the 13
following, as applicable:[provisions of ] 14
(a) KRS 304.17A-163;[,] 15
(b) KRS 304.17A-1631;[,] 16
(c) KRS 304.17A-167;[,] 17
(d) KRS 304.17A-235;[,] 18
(e) KRS 304.17A-257;[,] 19
(f) KRS 304.17A-259;[,] 20
(g) KRS 304.17A-263;[,] 21
(h) KRS 304.17A-515;[,] 22
(i) KRS 304.17A-580;[,] 23
(j) KRS 304.17A-600, 304.17A-603, and 304.17A-607;[, and] 24
(k) KRS 304.17A-740 to 304.17A-743; and[, as applicable] 25
(l) Section 4 of this Act. 26
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 27 UNOFFICIAL COPY 24 RS BR 2129
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this chapter shall comply with the reporting requirements of KRS 304.17A-732. 1
Section 6. KRS 205.6485 is amended to read as follows: 2
(1) As used in this section, "KCHIP" means the Kentucky Children's Health 3
Insurance Program. 4
(2) The Cabinet for Health and Family Services shall 5
(a) Prepare a state child health plan, to be known as KCHIP, meeting the 6
requirements of Title XXI of the Federal Social Security Act, for submission 7
to the Secretary of the United States Department of Health and Human 8
Services within such time as will permit the state to receive the maximum 9
amounts of federal matching funds available under Title XXI; and[. The 10
cabinet shall,] 11
(b) By administrative regulation promulgated in accordance with KRS Chapter 12
13A, establish the following: 13
1.[(a)] The eligibility criteria for children covered by KCHIP, which 14
shall include a provision that[the Kentucky Children's Health Insurance 15
Program. However,] no person eligible for services under Title XIX of 16
the Social Security Act, 42 U.S.C. secs. 1396 to 1396v, as amended, 17
shall be eligible for services under KCHIP[the Kentucky Children's 18
Health Insurance Program] except to the extent that Title XIX coverage 19
is expanded by KRS 205.6481 to 205.6495 and KRS 304.17A-340; 20
2.[(b)] The schedule of benefits to be covered by KCHIP[the Kentucky 21
Children's Health Insurance Program,] which shall:[ include preventive 22
services, vision services including glasses, and dental services including 23
at least sealants, extractions, and fillings, and which shall ] 24
a. Be at least equivalent to one (1) of the following: 25
i.[1.] The standard Blue Cross/Blue Shield preferred provider 26
option under the Federal Employees Health Benefit Plan 27 UNOFFICIAL COPY 24 RS BR 2129
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established by U.S.C. sec. 8903(1); 1
ii.[2.] A mid-range health benefit coverage plan that is offered and 2
generally available to state employees; or 3
iii.[3.] Health insurance coverage offered by a health 4
maintenance organization that has the largest insured 5
commercial, non-Medicaid enrollment of covered lives in the 6
state; and 7
b. Comply with subsection (6) of this section; 8
3.[(c)] The premium contribution per family of health insurance coverage 9
available under KCHIP, which[the Kentucky Children's Health 10
Insurance Program with provisions for the payment of premium 11
contributions by families of children eligible for coverage by the 12
program based upon a sliding scale relating to family income. Premium 13
contributions] shall be based: 14
a. On a six (6) month period; and 15
b. Upon a sliding scare relating to family income not to exceed: 16
i.[1.] Ten dollars ($10), to be paid by a family with income 17
between one hundred percent (100%) to one hundred thirty-18
three percent (133%) of the federal poverty level; 19
ii.[2.] Twenty dollars ($20), to be paid by a family with income 20
between one hundred thirty-four percent (134%) to one 21
hundred forty-nine percent (149%) of the federal poverty 22
level; and 23
iii.[3.] One hundred twenty dollars ($120), to be paid by a 24
family with income between one hundred fifty percent 25
(150%) to two hundred percent (200%) of the federal 26
poverty level, and which may be made on a partial payment 27 UNOFFICIAL COPY 24 RS BR 2129
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plan of twenty dollars ($20) per month or sixty dollars ($60) 1
per quarter; 2
4.[(d)] There shall be no copayments for services provided under 3
KCHIP[the Kentucky Children's Health Insurance Program]; and 4
5.[(e)] a. The criteria for health services providers and insurers 5
wishing to contract with the Commonwealth to provide[ the 6
children's health insurance] coverage under KCHIP. 7
b. [However, ]The cabinet shall provide, in any contracting process 8
for coverage of[the] preventive services[health insurance 9
program], the opportunity for a public health department to bid on 10
preventive health services to eligible children within the public 11
health department's service area. A public health department shall 12
not be disqualified from bidding because the department does not 13
currently offer all the services required by this 14
subsection[paragraph (b) of this subsection]. The criteria shall be 15
set forth in administrative regulations pursuant to[under] KRS 16
Chapter 13A and shall maximize competition among the providers 17
and insurers. The [Cabinet for ]Finance and Administration 18
Cabinet shall provide oversight over contracting policies and 19
procedures to assure that the number of applicants for contracts is 20
maximized. 21
(3)[(2)] Within twelve (12) months of federal approval of the state's Title XXI child 22
health plan, the Cabinet for Health and Family Services shall assure that a KCHIP 23
program is available to all eligible children in all regions of the state. If necessary, 24
in order to meet this assurance, the cabinet shall institute its own program. 25
(4)[(3)] KCHIP recipients shall have direct access without a referral from any 26
gatekeeper primary care provider to dentists for covered primary dental services 27 UNOFFICIAL COPY 24 RS BR 2129
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and to optometrists and ophthalmologists for covered primary eye and vision 1
services. 2
(5)[(4)] KCHIP[The Kentucky Children's Health Insurance Plan] shall comply with 3
KRS 304.17A-163 and 304.17A-1631. 4
(6) The schedule of benefits required under subsection (2)(b)2. of this section shall 5
include: 6
(a) Preventive services; 7
(b) Vision services, including glasses; 8
(c) Dental services, including sealants, extractions, and fillings; and 9
(d) Coverage required under Section 4 of this Act. 10
Section 7. KRS 164.2871 (Effective January 1, 2025) is amended to read as 11
follows: 12
(1) The governing board of each state postsecondary educational institution is 13
authorized to purchase liability insurance for the protection of the individual 14
members of the governing board, faculty, and staff of such institutions from liability 15
for acts and omissions committed in the course and scope of the individual's 16
employment or service. Each institution may purchase the type and amount of 17
liability coverage deemed to best serve the interest of such institution. 18
(2) All retirement annuity allowances accrued or accruing to any employee of a state 19
postsecondary educational institution through a retirement program sponsored by 20
the state postsecondary educational institution are hereby exempt from any state, 21
county, or municipal tax, and shall not be subject to execution, attachment, 22
garnishment, or any other process whatsoever, nor shall any assignment thereof be 23
enforceable in any court. Except retirement benefits accrued or accruing to any 24
employee of a state postsecondary educational institution through a retirement 25
program sponsored by the state postsecondary educational institution on or after 26
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 27 UNOFFICIAL COPY 24 RS BR 2129
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provided in KRS 141.010 and 141.0215. 1
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 2
members of governing boards, faculty and staff of institutions of higher education 3
in this state shall not be construed to be a waiver of sovereign immunity or any 4
other immunity or privilege. 5
(4) The governing board of each state postsecondary education institution is authorized 6
to provide a self-insured employer group health plan to its employees, which plan 7
shall: 8
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 9
(b) Except as provided in subsection (5) of this section, be exempt from 10
conformity with Subtitle 17A of KRS Chapter 304. 11
(5) A self-insured employer group health plan provided by the governing board of a 12
state postsecondary education institution to its employees shall comply with: 13
(a) KRS 304.17A-163 and 304.17A-1631; 14
(b) KRS 304.17A-265; 15
(c) KRS 304.17A-261;[ and] 16
(d) KRS 304.17A-262; and 17
(e) Section 4 of this Act. 18
Section 8. KRS 18A.225 (Effective January 1, 2025) 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 24 RS BR 2129
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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 or a 14
public charter school as defined in KRS 160.1590; 15
3. Any elected member of a local board of education; 16
4. Any person who is a present or future recipient of a retirement 17
allowance from the Kentucky Retirement Systems, County Employees 18
Retirement System, Kentucky Teachers' Retirement System, the 19
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 20
Kentucky Community and Technical College System's optional 21
retirement plan authorized by KRS 161.567, except that a person who is 22
receiving a retirement allowance and who is age sixty-five (65) or older 23
shall not be included, with the exception of persons covered under KRS 24
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 25
employed pursuant to subparagraph 1. of this paragraph; and 26
5. Any eligible dependents and beneficiaries of participating employees 27 UNOFFICIAL COPY 24 RS BR 2129
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and retirees who are entitled to participate in the state-sponsored health 1
insurance program; 2
(b) The term "health benefit plan" for the purposes of this section means a health 3
benefit plan as defined in KRS 304.17A-005; 4
(c) The term "insurer" for the purposes of this section means an insurer as defined 5
in KRS 304.17A-005; and 6
(d) The term "managed care plan" for the purposes of this section means a 7
managed care plan as defined in KRS 304.17A-500. 8
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 9
recommendation of the secretary of the Personnel Cabinet, shall procure, in 10
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 11
from one (1) or more insurers authorized to do business in this state, a group 12
health benefit plan that may include but not be limited to health maintenance 13
organization (HMO), preferred provider organization (PPO), point of service 14
(POS), and exclusive provider organization (EPO) benefit plans 15
encompassing all or any class or classes of employees. With the exception of 16
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 17
all employers of any class of employees or former employees shall enter into 18
a contract with the Personnel Cabinet prior to including that group in the state 19
health insurance group. The contracts shall include but not be limited to 20
designating the entity responsible for filing any federal forms, adoption of 21
policies required for proper plan administration, acceptance of the contractual 22
provisions with health insurance carriers or third-party administrators, and 23
adoption of the payment and reimbursement methods necessary for efficient 24
administration of the health insurance program. Health insurance coverage 25
provided to state employees under this section shall, at a minimum, contain 26
the same benefits as provided under Kentucky Kare Standard as of January 1, 27 UNOFFICIAL COPY 24 RS BR 2129
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1994, and shall include a mail-order drug option as provided in subsection 1
(13) of this section. All employees and other persons for whom the health care 2
coverage is provided or made available shall annually be given an option to 3
elect health care coverage through a self-funded plan offered by the 4
Commonwealth or, if a self-funded plan is not available, from a list of 5
coverage options determined by the competitive bid process under the 6
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 7
during annual open enrollment. 8
(b) The policy or policies shall be approved by the commissioner of insurance 9
and may contain the provisions the commissioner of insurance approves, 10
whether or not otherwise permitted by the insurance laws. 11
(c) Any carrier bidding to offer health care coverage to employees shall agree to 12
provide coverage to all members of the state group, including active 13
employees and retirees and their eligible covered dependents and 14
beneficiaries, within the county or counties specified in its bid. Except as 15
provided in subsection (20) of this section, any carrier bidding to offer health 16
care coverage to employees shall also agree to rate all employees as a single 17
entity, except for those retirees whose former employers insure their active 18
employees outside the state-sponsored health insurance program and as 19
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 20
(d) Any carrier bidding to offer health care coverage to employees shall agree to 21
provide enrollment, claims, and utilization data to the Commonwealth in a 22
format specified by the Personnel Cabinet with the understanding that the data 23
shall be owned by the Commonwealth; to provide data in an electronic form 24
and within a time frame specified by the Personnel Cabinet; and to be subject 25
to penalties for noncompliance with data reporting requirements as specified 26
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 27 UNOFFICIAL COPY 24 RS BR 2129
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to protect the confidentiality of each individual employee; however, 1
confidentiality assertions shall not relieve a carrier from the requirement of 2
providing stipulated data to the Commonwealth. 3
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 4
for timely analysis of data received from carriers and, to the extent possible, 5
provide in the request-for-proposal specifics relating to data requirements, 6
electronic reporting, and penalties for noncompliance. The Commonwealth 7
shall own the enrollment, claims, and utilization data provided by each carrier 8
and shall develop methods to protect the confidentiality of the individual. The 9
Personnel Cabinet shall include in the October annual report submitted 10
pursuant to the provisions of KRS 18A.226 to the Governor, the General 11
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 12
financial stability of the program, which shall include but not be limited to 13
loss ratios, methods of risk adjustment, measurements of carrier quality of 14
service, prescription coverage and cost management, and statutorily required 15
mandates. If state self-insurance was available as a carrier option, the report 16
also shall provide a detailed financial analysis of the self-insurance fund 17
including but not limited to loss ratios, reserves, and reinsurance agreements. 18
(f) If any agency participating in the state-sponsored employee health insurance 19
program for its active employees terminates participation and there is a state 20
appropriation for the employer's contribution for active employees' health 21
insurance coverage, then neither the agency nor the employees shall receive 22
the state-funded contribution after termination from the state-sponsored 23
employee health insurance program. 24
(g) Any funds in flexible spending accounts that remain after all reimbursements 25
have been processed shall be transferred to the credit of the state-sponsored 26
health insurance plan's appropriation account. 27 UNOFFICIAL COPY 24 RS BR 2129
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(h) Each entity participating in the state-sponsored health insurance program shall 1
provide an amount at least equal to the state contribution rate for the employer 2
portion of the health insurance premium. For any participating entity that used 3
the state payroll system, the employer contribution amount shall be equal to 4
but not greater than the state contribution rate. 5
(3) The premiums may be paid by the policyholder: 6
(a) Wholly from funds contributed by the employee, by payroll deduction or 7
otherwise; 8
(b) Wholly from funds contributed by any department, board, agency, public 9
postsecondary education institution, or branch of state, city, urban-county, 10
charter county, county, or consolidated local government; or 11
(c) Partly from each, except that any premium due for health care coverage or 12
dental coverage, if any, in excess of the premium amount contributed by any 13
department, board, agency, postsecondary education institution, or branch of 14
state, city, urban-county, charter county, county, or consolidated local 15
government for any other health care coverage shall be paid by the employee. 16
(4) If an employee moves his or her place of residence or employment out of the 17
service area of an insurer offering a managed health care plan, under which he or 18
she has elected coverage, into either the service area of another managed health care 19
plan or into an area of the Commonwealth not within a managed health care plan 20
service area, the employee shall be given an option, at the time of the move or 21
transfer, to change his or her coverage to another health benefit plan. 22
(5) No payment of premium by any department, board, agency, public postsecondary 23
educational institution, or branch of state, city, urban-county, charter county, 24
county, or consolidated local government shall constitute compensation to an 25
insured employee for the purposes of any statute fixing or limiting the 26
compensation of such an employee. Any premium or other expense incurred by any 27 UNOFFICIAL COPY 24 RS BR 2129
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department, board, agency, public postsecondary educational institution, or branch 1
of state, city, urban-county, charter county, county, or consolidated local 2
government shall be considered a proper cost of administration. 3
(6) The policy or policies may contain the provisions with respect to the class or classes 4
of employees covered, amounts of insurance or coverage for designated classes or 5
groups of employees, policy options, terms of eligibility, and continuation of 6
insurance or coverage after retirement. 7
(7) Group rates under this section shall be made available to the disabled child of an 8
employee regardless of the child's age if the entire premium for the disabled child's 9
coverage is paid by the state employee. A child shall be considered disabled if he or 10
she has been determined to be eligible for federal Social Security disability benefits. 11
(8) The health care contract or contracts for employees shall be entered into for a 12
period of not less than one (1) year. 13
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 14
State Health Insurance Subscribers to advise the secretary or the secretary's 15
designee regarding the state-sponsored health insurance program for employees. 16
The secretary shall appoint, from a list of names submitted by appointing 17
authorities, members representing school districts from each of the seven (7) 18
Supreme Court districts, members representing state government from each of the 19
seven (7) Supreme Court districts, two (2) members representing retirees under age 20
sixty-five (65), one (1) member representing local health departments, two (2) 21
members representing the Kentucky Teachers' Retirement System, and three (3) 22
members at large. The secretary shall also appoint two (2) members from a list of 23
five (5) names submitted by the Kentucky Education Association, two (2) members 24
from a list of five (5) names submitted by the largest state employee organization of 25
nonschool state employees, two (2) members from a list of five (5) names submitted 26
by the Kentucky Association of Counties, two (2) members from a list of five (5) 27 UNOFFICIAL COPY 24 RS BR 2129
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names submitted by the Kentucky League of Cities, and two (2) members from a 1
list of names consisting of five (5) names submitted by each state employee 2
organization that has two thousand (2,000) or more members on state payroll 3
deduction. The advisory committee shall be appointed in January of each year and 4
shall meet quarterly. 5
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 6
provided to employees pursuant to this section shall not provide coverage for 7
obtaining or performing an abortion, nor shall any state funds be used for the 8
purpose of obtaining or performing an abortion on behalf of employees or their 9
dependents. 10
(11) Interruption of an established treatment regime with maintenance drugs shall be 11
grounds for an insured to appeal a formulary change through the established appeal 12
procedures approved by the Department of Insurance, if the physician supervising 13
the treatment certifies that the change is not in the best interests of the patient. 14
(12) Any employee who is eligible for and elects to participate in the state health 15
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 16
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 17
state health insurance contribution toward health care coverage as a result of any 18
other employment for which there is a public employer contribution. This does not 19
preclude a retiree and an active employee spouse from using both contributions to 20
the extent needed for purchase of one (1) state sponsored health insurance policy 21
for that plan year. 22
(13) (a) The policies of health insurance coverage procured under subsection (2) of 23
this section shall include a mail-order drug option for maintenance drugs for 24
state employees. Maintenance drugs may be dispensed by mail order in 25
accordance with Kentucky law. 26
(b) A health insurer shall not discriminate against any retail pharmacy located 27 UNOFFICIAL COPY 24 RS BR 2129
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within the geographic coverage area of the health benefit plan and that meets 1
the terms and conditions for participation established by the insurer, including 2
price, dispensing fee, and copay requirements of a mail-order option. The 3
retail pharmacy shall not be required to dispense by mail. 4
(c) The mail-order option shall not permit the dispensing of a controlled 5
substance classified in Schedule II. 6
(14) The policy or policies provided to state employees or their dependents pursuant to 7
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 8
aid-related services for insured individuals under eighteen (18) years of age, subject 9
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 10
pursuant to KRS 304.17A-132. 11
(15) Any policy provided to state employees or their dependents pursuant to this section 12
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 13
consistent with KRS 304.17A-142. 14
(16) Any policy provided to state employees or their dependents pursuant to this section 15
shall provide coverage for obtaining amino acid-based elemental formula pursuant 16
to KRS 304.17A-258. 17
(17) If a state employee's residence and place of employment are in the same county, 18
and if the hospital located within that county does not offer surgical services, 19
intensive care services, obstetrical services, level II neonatal services, diagnostic 20
cardiac catheterization services, and magnetic resonance imaging services, the 21
employee may select a plan available in a contiguous county that does provide 22
those services, and the state contribution for the plan shall be the amount available 23
in the county where the plan selected is located. 24
(18) If a state employee's residence and place of employment are each located in 25
counties in which the hospitals do not offer surgical services, intensive care 26
services, obstetrical services, level II neonatal services, diagnostic cardiac 27 UNOFFICIAL COPY 24 RS BR 2129
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catheterization services, and magnetic resonance imaging services, the employee 1
may select a plan available in a county contiguous to the county of residence that 2
does provide those services, and the state contribution for the plan shall be the 3
amount available in the county where the plan selected is located. 4
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 5
in the best interests of the state group to allow any carrier bidding to offer health 6
care coverage under this section to submit bids that may vary county by county or 7
by larger geographic areas. 8
(20) Notwithstanding any other provision of this section, the bid for proposals for health 9
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 10
the statewide rating structure provided in calendar year 2003 and a bid scenario that 11
allows for a regional rating structure that allows carriers to submit bids that may 12
vary by region for a given product offering as described in this subsection: 13
(a) The regional rating bid scenario shall not include a request for bid on a 14
statewide option; 15
(b) The Personnel Cabinet shall divide the state into geographical regions which 16
shall be the same as the partnership regions designated by the Department for 17
Medicaid Services for purposes of the Kentucky Health Care Partnership 18
Program established pursuant to 907 KAR 1:705; 19
(c) The request for proposal shall require a carrier's bid to include every county 20
within the region or regions for which the bid is submitted and include but not 21
be restricted to a preferred provider organization (PPO) option; 22
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 23
carrier all of the counties included in its bid within the region. If the Personnel 24
Cabinet deems the bids submitted in accordance with this subsection to be in 25
the best interests of state employees in a region, the cabinet may award the 26
contract for that region to no more than two (2) carriers; and 27 UNOFFICIAL COPY 24 RS BR 2129
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(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 1
other requirements or criteria in the request for proposal. 2
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 3
after July 12, 2006, to public employees pursuant to this section which provides 4
coverage for services rendered by a physician or osteopath duly licensed under KRS 5
Chapter 311 that are within the scope of practice of an optometrist duly licensed 6
under the provisions of KRS Chapter 320 shall provide the same payment of 7
coverage to optometrists as allowed for those services rendered by physicians or 8
osteopaths. 9
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 10
public employees pursuant to this section shall comply with: 11
(a) KRS 304.12-237; 12
(b) KRS 304.17A-270 and 304.17A-525; 13
(c) KRS 304.17A-600 to 304.17A-633; 14
(d) KRS 205.593; 15
(e) KRS 304.17A-700 to 304.17A-730; 16
(f) KRS 304.14-135; 17
(g) KRS 304.17A-580 and 304.17A-641; 18
(h) KRS 304.99-123; 19
(i) KRS 304.17A-138; 20
(j) KRS 304.17A-148; 21
(k) KRS 304.17A-163 and 304.17A-1631; 22
(l) KRS 304.17A-265; 23
(m) KRS 304.17A-261; 24
(n) KRS 304.17A-262; 25
(o) Section 4 of this Act; and 26
(p)[(o)] Administrative regulations promulgated pursuant to statutes listed in this 27 UNOFFICIAL COPY 24 RS BR 2129
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subsection. 1
Section 9. Sections 4, 7, and 8 of this Act apply to health benefit plans issued or 2
renewed on or after January 1, 2025. 3
Section 10. If the Cabinet for Health and Family Services determines that a 4
state plan amendment, waiver, or any other form of approval or authorization from a 5
federal agency is necessary prior to the implementation of any provision of this Act, the 6
cabinet shall, within 90 days after the effective date of this section unless otherwise 7
specified in this Act, request the state plan amendment, waiver, approval, or authorization 8
and shall only delay full implementation of those provisions for which a state plan 9
amendment, waiver, approval, or authorization was deemed necessary until the state plan 10
amendment, waiver, approval, or authorization is granted. The cabinet shall, in 11
accordance with KRS 205.525, provide a copy of any state plan amendment, waiver, or 12
other approval or authorization submitted pursuant to this section to the Interim Joint 13
Committee on Health Services and the Interim Joint Committee on Appropriations and 14
Revenue and shall provide an update on the status of any application to the Legislative 15
Research Commission upon request. 16
Section 11. Sections 4 to 9 of this Act take effect on January 1, 2025. 17