UNOFFICIAL COPY 24 RS BR 1262
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AN ACT relating to coverage for coronary calcium imaging tests. 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) (a) Except as provided in subsection (2) of this section, all health benefit plans 5
shall provide coverage for coronary calcium imaging testing when: 6
1. Ordered by a health care provider operating within the provider's 7
scope of practice; and 8
2. Supported by nationally recognized clinical practice guidelines. 9
(b) Coronary calcium imaging testing that is supported by nationally 10
recognized clinical practice guidelines shall not be considered experimental 11
or investigational. 12
(2) If the application of any requirement of subsection (1) of this section to a 13
qualified health plan as defined in 42 U.S.C. sec. 18021(a)(1), as amended, would 14
result in a determination that the state must make payments to defray the cost of 15
the requirement under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as 16
amended, then the requirement shall not apply to the qualified health plan until 17
the cost defrayal requirement is no longer applicable. 18
Section 2. KRS 205.522 is amended to read as follows: 19
(1) With respect to the administration and provision of Medicaid benefits pursuant to 20
this chapter, the Department for Medicaid Services,[ and] any managed care 21
organization contracted to provide Medicaid benefits pursuant to this chapter, and 22
the state's medical assistance program shall be subject to, and comply with, the 23
following, as applicable:[provisions of] 24
(a) KRS 304.17A-163;[,] 25
(b) KRS 304.17A-1631;[,] 26
(c) KRS 304.17A-167;[,] 27 UNOFFICIAL COPY 24 RS BR 1262
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(d) KRS 304.17A-235;[,] 1
(e) KRS 304.17A-257;[,] 2
(f) KRS 304.17A-259;[,] 3
(g) KRS 304.17A-263;[,] 4
(h) KRS 304.17A-515;[,] 5
(i) KRS 304.17A-580;[,] 6
(j) KRS 304.17A-600, 304.17A-603, and 304.17A-607;[, and] 7
(k) KRS 304.17A-740 to 304.17A-743; and[, as applicable] 8
(l) Section 1 of this Act. 9
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 10
this chapter shall comply with the reporting requirements of KRS 304.17A-732. 11
Section 3. Section 1 of this Act applies to health benefit plans issued or 12
renewed on or after January 1, 2025. 13
Section 4. If a qualified health plan, as defined in 42 U.S.C. sec. 18021(a)(1), is 14
exempt from the requirements of Section 1 of this Act under subsection (2) of Section 1 15
of this Act, the Department of Insurance shall apply for a waiver under 42 U.S.C. sec. 16
18052, as amended, or any other applicable federal law of any or all of the cost defrayal 17
requirements within 90 days of the effective date of this section. 18
Section 5. If the Cabinet for Health and Family Services determines that a 19
waiver or other authorization from a federal agency is necessary to implement Section 2 20
of this Act for any reason, including the loss of federal funds, the cabinet shall, within 90 21
days of the effective date of this section, request the waiver or other authorization, and 22
may only delay implementation of those provisions for which a waiver or authorization 23
was deemed necessary until the waiver or authorization is granted. 24
Section 6. Sections 1 to 3 of this Act take effect January 1, 2025. 25