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AN ACT relating to health care to provide for an all-payer claims database and 1
making an appropriation therefor. 2
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 3
SECTION 1. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 4
READ AS FOLLOWS: 5
(1) A Kentucky all-payer claims database is created and established in Sections 1 to 6 6
of this Act to effect the following purposes: 7
(a) Allow for targeted population health initiatives; 8
(b) Determine state health status needs; 9
(c) Inform state health care planning; 10
(d) Support research in the areas of health care cost, quality, and accessibility; 11
(e) Improve the accessibility, adequacy, and affordability of health care and 12
health care coverage through the review and dissemination of data; 13
(f) Review health care costs among various treatment settings, providers, and 14
modalities; 15
(g) Evaluate the effectiveness of health care programs and services to improve 16
patient outcomes; and 17
(h) Support the development of quality improvement initiatives. 18
(2) Nothing in Sections 1 to 6 of this Act shall be construed to supersede, 19
supplement, or limit the provisions of KRS Chapter 216B relating to certificates 20
of need. 21
SECTION 2. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 22
READ AS FOLLOWS: 23
As used in Sections 1 to 6 of this Act: 24
(1) "Executive director" means the executive director of the Office of Data Analytics 25
established under Sections 7, 8, and 9 of this Act; 26
(2) "Health care claims": 27 UNOFFICIAL COPY 24 RS BR 2423
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(a) Means claims made for the payment or reimbursement of the following 1
types of health care services: 2
1. Medical and hospital, which includes surgical, mental health, 3
substance use disorder, nursing, rehabilitative and habilitative 4
services, and laboratory services; 5
2. Dental; 6
3. Pharmacy; and 7
4. Any other health care service designated by the executive director by 8
administrative regulation; and 9
(b) Does not include claims made to a primary care provider for the provision 10
of primary care services under a direct primary care membership agreement 11
established under KRS 311.6201, 311.6202, 314.198, or 314.199; 12
(3) (a) "Health payer" means any person that pays, or administers the payment of, 13
health care claims. 14
(b) As used in paragraph (a) of this subsection, " person" includes but is not 15
limited to: 16
1. Medicare; 17
2. Medicaid; 18
3. The Kentucky Children's Health Insurance Program; 19
4. Workers' compensation insurers, self-insurers, and self-insured 20
groups; 21
5. Insurers, self-insurers, and self-insured groups, including self-insured 22
health plans and self-insured employer-organized associations, that 23
provide: 24
a. Coverage for health care services; 25
b. Health care benefits; or 26
c. Any kind of insurance regulated under KRS Chapter 304; 27 UNOFFICIAL COPY 24 RS BR 2423
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6. Health maintenance organizations; 1
7. Limited health service organizations; 2
8. Provider-sponsored integrated health delivery networks; 3
9. Nonprofit hospital, medical-surgical, dental, and health service 4
corporations; 5
10. Administrators; 6
11. Pharmacy benefit managers; 7
12. Any third-party payor that is not exempt by federal law from 8
regulation under the insurance laws of this state; 9
13. Any person that contracts with a state or federal agency to provide 10
coverage for health care services; and 11
14. Any vendor or contractor of any person listed in subparagraphs 1. to 12
13. of this paragraph; and 13
(4) "Kentucky all-payer claims database" means the all-payer claims database 14
established under Sections 1 to 6 of this Act. 15
SECTION 3. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 16
READ AS FOLLOWS: 17
(1) The Kentucky all-payer claims database fund is hereby created in the State 18
Treasury. 19
(2) The following shall be deposited into the fund: 20
(a) All grants and funds received or raised under Section 4 of this Act; 21
(b) Any fees collected under Section 6 of this Act; 22
(c) Any penalties collected under Section 11 of this Act; and 23
(d) Any appropriations made to the fund by the General Assembly. 24
(3) Notwithstanding KRS 45.229, moneys in the fund not expended at the close of a 25
fiscal year shall not lapse but shall be carried forward to the next fiscal year. Any 26
interest earnings of the fund shall become part of the fund and shall not lapse. 27 UNOFFICIAL COPY 24 RS BR 2423
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(4) Moneys in the fund are hereby appropriated by the General Assembly, and shall 1
be available to the executive director, to develop, implement, operate, and 2
maintain the Kentucky all-payer claims database. 3
SECTION 4. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 4
READ AS FOLLOWS: 5
(1) The executive director shall develop, implement, operate, and maintain the 6
Kentucky all-payer claims database in accordance with Sections 1 to 6 of this Act. 7
(2) In carrying out the duties under subsection (1) of this section, the executive 8
director: 9
(a) Shall make good-faith efforts to: 10
1. Seek and accept grants, or raise funds, from any available source, 11
public or private, to support the development, implementation, 12
operation, and maintenance of the database; and 13
2. Establish agreements: 14
a. For voluntary reporting of health care claims data from health 15
payers that are not subject to mandatory reporting requirements. 16
If feasible, the executive director shall implement the reporting 17
format for self-insured group health plans described in 29 U.S.C. 18
sec. 1191d, as amended; 19
b. With the federal Centers for Medicare and Medicaid Services to 20
obtain Medicare health care claims data; and 21
c. With all-payer claims databases in other states to establish a 22
single application for access to data by authorized users across 23
multiple states, if the executive director determines that the 24
agreements are feasible and beneficial for the operation of the 25
Kentucky all-payer claims database; 26
(b) Shall: 27 UNOFFICIAL COPY 24 RS BR 2423
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1. Determine the measures necessary to implement reporting 1
requirements in a manner that: 2
a. Is cost effective and reasonable for data sources; 3
b. Is timely, relevant, and reliable for data users; 4
c. Eliminates, or reduces to the greatest extent practicable, the 5
submission of duplicate or redundant health care claims data; 6
and 7
d. Does not violate any applicable laws; 8
2. Establish policies and procedures necessary for the administration 9
and oversight of the database, including all necessary communication, 10
coordination, and data sharing with the commissioner of insurance 11
for enforcement under Section 11 of this Act; 12
3. Ensure the integrity, privacy, and security of personal health 13
information and other proprietary information related to the collection 14
and release of data; 15
4. Ensure that the database is operated in compliance with all state and 16
federal law, including but not limited to: 17
a. The Health Insurance Portability and Accountability Act of 18
1996, Pub. L. No. 104-191, as amended, and any related federal 19
regulations, as amended; 20
b. 42 U.S.C. sec. 290dd-2, as amended, and any related federal 21
regulations, as amended, including but not limited to 42 C.F.R. 22
pt. 2; and 23
c. All other applicable state and federal data privacy and security 24
laws relating to the collection, storage, and release of data, 25
except that the provisions of this section and Section 6 of this Act 26
shall control over any conflicting state laws; and 27 UNOFFICIAL COPY 24 RS BR 2423
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5. Promulgate any administrative regulations necessary to carry out 1
Sections 1 to 6 of this Act; and 2
(c) May: 3
1. a. Audit any data required to be submitted under Section 6 of this 4
Act as needed to corroborate the accuracy of submitted data. 5
b. Any audit conducted under this subparagraph shall, to the extent 6
practicable, be coordinated with other audits or examinations 7
performed by state or federal agencies; 8
2. a. Contract with one (1) or more qualified third parties: 9
i. To collect or process health care claims data; or 10
ii. For any other expertise, service, or function necessary to 11
carry out the provisions of Sections 1 to 6 of this Act. 12
b. The authority granted under this subparagraph shall include 13
without limitation designating a qualified third party to 14
implement, operate, and maintain the Kentucky all-payer claims 15
database; and 16
3. Share and receive data or other information, including confidential 17
and proprietary data or information, with and from state agencies, 18
federal agencies, and all-payer claims databases in other states if: 19
a. The recipient agrees in a written or electronic record to maintain 20
any confidential or proprietary status afforded to the data or 21
information; and 22
b. The data or information is shared or received in a manner that 23
does not violate any applicable laws. 24
(3) If the executive director contracts with a third-party under subsection (2)(c)2. of 25
this section, the executive director shall monitor and supervise the third party to 26
ensure that the third party complies with Sections 1 to 6 of this Act. 27 UNOFFICIAL COPY 24 RS BR 2423
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(4) A third party that contracts with the executive director under subsection (2)(c)2. 1
of this section shall not release, publish, or otherwise use any information to 2
which the third party has access under the contract without express permission in 3
a written or electronic record from the executive director. 4
(5) A waiver of any applicable privilege or claim of confidentiality in data or 5
information shall not occur as a result of a disclosure made under this section. 6
(6) (a) With regard to the Kentucky all-payer claims database, the executive 7
director shall file a written report with the Governor and the Legislative 8
Research Commission not later than September 1 of each year that details 9
the following: 10
1. The status of any development efforts, including efforts to obtain 11
funding for the database; 12
2. A detailed summary of database operations for the previous year; 13
3. The financial stability of the database; 14
4. An assessment of: 15
a. The cost, performance, and effectiveness of the database; 16
b. The performance of any third parties designated by the executive 17
director under subsection (2)(c)2. of this section; and 18
c. Whether the database has advanced the purposes set forth in 19
Section 1 of this Act; and 20
5. Any recommendations for database changes or improvements, 21
including statutory changes. 22
(b) In completing the determination required under paragraph (a)4.c. of this 23
subsection, the executive director shall, to the extent it is available, utilize 24
economic expertise. 25
SECTION 5. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 26
READ AS FOLLOWS: 27 UNOFFICIAL COPY 24 RS BR 2423
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(1) There is hereby created and established a Kentucky All-payer Claims Database 1
Advisory Council, whose duties shall be to make recommendations to the 2
executive director as to the development, implementation, operation, and 3
maintenance of the database. 4
(2) (a) The council shall consist of the following members: 5
1. A member of academia with experience in health care data research; 6
2. A representative from the Kentucky Hospital Association; 7
3. A representative from the Kentucky Medical Association; 8
4. A representative from the Kentucky Pharmacists Association; 9
5. A representative from the Kentucky Dental Association; 10
6. A representative from the Kentucky Primary Care Association; 11
7. A representative from a Medicaid managed care organization or an 12
organization that represents Medicaid managed care organizations; 13
8. A representative from a health insurer that offers health insurance 14
coverage in the private market or an organization that represents such 15
health insurers; 16
9. A representative from an employer that provides self-insured group 17
health insurance coverage to its employees; 18
10. A representative from a property and casualty insurer or an 19
organization that represents property and casualty insurers; 20
11. A representative from a workers' compensation insurer, self-insurer, 21
or self-insured group; 22
12. A person that advocates on behalf of, or promotes the interests of, 23
health care consumers; and 24
13. A person with expertise or experience in health care data collection or 25
storage. 26
(b) In addition to the members described in paragraph (a) of this subsection, 27 UNOFFICIAL COPY 24 RS BR 2423
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the following persons, or their designees, shall serve as ex officio members 1
of the council: 2
1. The commissioner of the Department of Insurance; 3
2. The executive director of the Commonwealth Office of Technology; 4
3. The commissioner of the Department of Employee Insurance; 5
4. The commissioner of the Department for Medicaid Services; 6
5. The commissioner of the Department for Public Health; and 7
6. The commissioner of the Department for Behavioral Health, 8
Developmental and Intellectual Disabilities. 9
(c) The council shall include the following nonvoting ex officio members: 10
1. The executive director, who shall serve as chair of the council; and 11
2. A representative of the Office of Application Technology Services. 12
(d) The members described in paragraph (a) of this subsection shall: 13
1. Be appointed by the Governor; and 14
2. Serve three (3) year terms. 15
(e) 1. The Governor shall fill all vacancies under paragraph (a) of this 16
subsection within sixty (60) days of the vacancy. 17
2. In the event a representative or person referenced in paragraph (a) of 18
this subsection is not available or willing to serve, the Governor shall 19
appoint a person with expertise or experience in the referenced 20
industry or subject matter. 21
(3) The council's recommendations shall include but not be limited to 22
recommendations that: 23
(a) Provide specific strategies for measuring and collecting data related to 24
health care safety, quality, utilization, health outcomes, and cost; 25
(b) Focus on data elements that foster quality improvement and peer group 26
comparisons; 27 UNOFFICIAL COPY 24 RS BR 2423
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(c) Facilitate value-based, cost-effective purchasing of health care services by 1
public and private purchasers and consumers; 2
(d) Result in usable and comparable information that allows public and private 3
health care purchasers, consumers, and data analysts to identify and 4
compare health plans, health payers, health care facilities, and health care 5
providers regarding the provision of safe, cost-effective, and high-quality 6
health care services; 7
(e) Use and build upon existing data collection standards and methods that 8
establish and maintain the database in a cost-effective and efficient manner, 9
which includes incorporating and utilizing uniform data collection that 10
aligns, where possible, with national or federal uniform all-payer claims 11
database standards; 12
(f) Incorporate and utilize claims, eligibility, and other publicly available data 13
to the extent it is the most cost-effective method of collecting data to 14
minimize the cost and administrative burden on data sources; 15
(g) Address whether publicly available data, in addition to the data submitted by 16
health payers, should be included to measure or analyze health care quality, 17
safety, or cost issues, including data on the uninsured; 18
(h) Address the use of a master person identification process to enable 19
matching members across health plans; 20
(i) Ensure the integrity, privacy, and security of personal health information 21
and other proprietary information related to the collection and release of 22
data, including compliance with all state and federal laws as required under 23
subsection (2)(b) of Section 4 of this Act; 24
(j) Address ongoing oversight of database operations; and 25
(k) Address the feasibility and advisability of working with all-payer claims 26
databases in other states to establish a single application for access to data 27 UNOFFICIAL COPY 24 RS BR 2423
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by authorized users across multiple states. 1
(4) The first meeting of the council shall take place within thirty (30) days of 2
appointment of all the members described in subsection (2)(a) of this section. 3
(5) (a) The council shall meet upon the call of the executive director, but not less 4
than quarterly for the first two (2) years after the date of the first council 5
meeting. Thereafter, the council shall meet not less than biannually. 6
(b) A majority of the members shall constitute a quorum. 7
(c) Recommendations of the council shall require a majority of the members 8
present and eligible to vote. 9
(d) A member shall be permitted to participate and vote through distance 10
communication technology. 11
(6) The council shall be a budgetary unit of the cabinet, which shall: 12
(a) Pay all of the council's necessary operating expenses; and 13
(b) Furnish all office space, personnel, equipment, supplies, and technical or 14
administrative services required by the council in the performance of the 15
functions established in this section. 16
(7) Members of the council described in subsection (2)(a) of this section shall receive 17
no compensation for services, but shall receive actual and necessary travel 18
expenses associated with attending meetings, which shall be in accordance with 19
state administrative regulations relating to travel reimbursement. 20
SECTION 6. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 21
READ AS FOLLOWS: 22
(1) To the extent permitted under federal law, health payers shall submit data 23
relating to health care claims to the executive director, or a third party designated 24
by the executive director, beginning not later than three (3) months after the 25
Kentucky all-payer claims database becomes fully operational. 26
(2) (a) The executive director shall establish the following by administrative 27 UNOFFICIAL COPY 24 RS BR 2423
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regulation: 1
1. The data elements to be collected, the reporting format, and the 2
frequency of submissions under subsection (1) of this section; 3
2. The data available to data users under subsection (5) of this section, 4
including: 5
a. The manner in which the data will be made available; and 6
b. The process for accessing, requesting, and making the data 7
available; and 8
3. Data access fees, which shall be deposited into the fund established in 9
Section 3 of this Act. 10
(b) In carrying out the requirements of this subsection, the executive director 11
may require data users to enter into data service agreements or memoranda 12
of understanding. 13
(3) To the extent permitted under federal law, any health payer not required to 14
comply with this section under state or federal law may opt to submit data under 15
this section. 16
(4) All state and local government health plans or programs regulated, created, or 17
authorized under Kentucky law, including any insurers or administrators 18
offering or administering those plans or programs, shall comply with the data 19
submission requirements of this section, including: 20
(a) Any plan or program offered or administered in accordance with KRS 21
Chapter 205; and 22
(b) Any governmental plan, as defined in 29 U.S.C. sec. 1002, including any 23
plan offered to the Public Employee Health Insurance Program for public 24
employees under KRS 18A.225 or 18A.2254. 25
(5) Except as otherwise provided in this section, the Kentucky all-payer claims 26
database shall: 27 UNOFFICIAL COPY 24 RS BR 2423
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(a) Be available to provide data to: 1
1. Health payers, consumers, employers, health care facilities, health 2
care providers, purchasers of health care, and state agencies, in a 3
form and manner that ensures the privacy and security of personal 4
health information as required by state and federal law, for the 5
purpose of allowing continuous review of health care utilization, 6
expenditures, quality, and safety; and 7
2. A state agency or other public or private entity for the purpose of 8
supporting the agency's or entity's demonstrated efforts to improve or 9
benefit the health care system through research and analysis, subject 10
to administrative regulations promulgated by the executive director; 11
and 12
(b) Present data in a manner that: 13
1. Allows for comparisons of: 14
a. Geographic, demographic, and economic factors; and 15
b. Institutional size; and 16
2. Is consumer-friendly. 17
(6) (a) To the extent permitted under federal law, a health payer shall not be 18
required to obtain any individual's consent or permission in order to submit 19
the individual's data in accordance with this section. 20
(b) Compliance with the requirements of this section shall not be deemed a 21
violation of data or consumer privacy laws or any other laws. 22
(7) Except as provided in Section 4 of this Act and subsection (8) of this section, the 23
Kentucky all-payer claims database shall not disclose any data that: 24
(a) Could be used to identify an individual; 25
(b) Is determined by the executive director to be incomplete, preliminary, 26
substantially in error, or not representative; or 27 UNOFFICIAL COPY 24 RS BR 2423
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(c) Could, due to small sample size or other factors, reveal the identity of an 1
individual or produce misleading information. 2
(8) (a) The executive director may require health payers to submit or use direct 3
identifying information about individuals for the purpose of assigning a 4
unique patient identifier. 5
(b) Upon the assignment of a unique patient identifier, all direct identifying 6
information about the individual shall be stripped from any data collected, 7
and not be retained, by the executive director or any third party designated 8
by the executive director. 9
(9) (a) A person shall not access, request, receive, or use any data or information 10
disclosed under subsection (5) of this section: 11
1. To obtain or disclose trade secrets; 12
2. To reidentify or attempt to reidentify an individual's data or 13
information; 14
3. To sell the data or information; 15
4. To distribute the data or information for commercial purposes; 16
5. To take any action in violation of any applicable data privacy or 17
security laws; or 18
6. For any purpose not identified in subsection (5) of this section. 19
(b) A person shall not access or receive data from the Kentucky all-payer 20
claims database unless the person agrees in a written or electronic record to 21
comply with this subsection. 22
(10) All information and data acquired by the executive director or a third party 23
designated by the executive director under this section shall: 24
(a) Be disclosed only to the extent provided in Section 4 of this Act and this 25
section; and 26
(b) Not be subject to disclosure under KRS 61.870 to 61.884. 27 UNOFFICIAL COPY 24 RS BR 2423
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Section 7. KRS 194A.030 (Effective between July 1, 2024, and July 1, 2025) is 1
amended to read as follows: 2
The cabinet consists of the following major organizational units, which are hereby 3
created: 4
(1) Office of the Secretary. Within the Office of the Secretary, there shall be an Office 5
of Legal Services, an Office of Inspector General, an Office of Public Affairs, an 6
Office of Human Resource Management, an Office of Finance and Budget, an 7
Office of Legislative and Regulatory Affairs, an Office of Administrative Services, 8
an Office of Application Technology Services, and an Office of Data Analytics, as 9
follows: 10
(a) The Office of Legal Services shall provide legal advice and assistance to all 11
units of the cabinet in any legal action in which it may be involved. The 12
Office of Legal Services shall employ all attorneys of the cabinet who serve 13
the cabinet in the capacity of attorney, giving legal advice and opinions 14
concerning the operation of all programs in the cabinet. The Office of Legal 15
Services shall be headed by a general counsel who shall be appointed by the 16
secretary with the approval of the Governor under KRS 12.050 and 12.210. 17
The general counsel shall be the chief legal advisor to the secretary and shall 18
be directly responsible to the secretary. The Attorney General, on the request 19
of the secretary, may designate the general counsel as an assistant attorney 20
general under the provisions of KRS 15.105; 21
(b) The Office of Inspector General shall be headed by an inspector general who 22
shall be appointed by the secretary with the approval of the Governor. The 23
inspector general shall be directly responsible to the secretary. The Office of 24
Inspector General shall be responsible for: 25
1. The conduct of audits and investigations for detecting the perpetration of 26
fraud or abuse of any program by any client, or by any vendor of 27 UNOFFICIAL COPY 24 RS BR 2423
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services with whom the cabinet has contracted; and the conduct of 1
special investigations requested by the secretary, commissioners, or 2
office heads of the cabinet into matters related to the cabinet or its 3
programs; 4
2. Licensing and regulatory functions as the secretary may delegate; 5
3. Review of health facilities participating in transplant programs, as 6
determined by the secretary, for the purpose of determining any 7
violations of KRS 311.1911 to 311.1959, 311.1961, and 311.1963; 8
4. The duties, responsibilities, and authority pertaining to the certificate of 9
need functions and the licensure appeals functions, pursuant to KRS 10
Chapter 216B; 11
5. The notification and forwarding of any information relevant to possible 12
criminal violations to the appropriate prosecuting authority; 13
6. The oversight of the operations of the Kentucky Health Information 14
Exchange; and 15
7. The support and guidance to health care providers related to telehealth 16
services, including the development of policy, standards, resources, and 17
education to expand telehealth services across the Commonwealth; 18
(c) The Office of Public Affairs shall be headed by an executive director 19
appointed by the secretary with the approval of the Governor in accordance 20
with KRS 12.050. The office shall provide information to the public and news 21
media about the programs, services, and initiatives of the cabinet; 22
(d) The Office of Human Resource Management shall be headed by an executive 23
director appointed by the secretary with the approval of the Governor in 24
accordance with KRS 12.050. The office shall coordinate, oversee, and 25
execute all personnel, training, and management functions of the cabinet. The 26
office shall focus on the oversight, development, and implementation of 27 UNOFFICIAL COPY 24 RS BR 2423
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quality improvement services; curriculum development and delivery of 1
instruction to staff; the administration, management, and oversight of training 2
operations; health, safety, and compliance training; and equal employment 3
opportunity compliance functions; 4
(e) The Office of Finance and Budget shall be headed by an executive director 5
appointed by the secretary with the approval of the Governor in accordance 6
with KRS 12.050. The office shall provide central review and oversight of 7
budget, contract, and cabinet finances. The office shall provide coordination, 8
assistance, and support to program departments and independent review and 9
analysis on behalf of the secretary; 10
(f) The Office of Legislative and Regulatory Affairs shall be headed by an 11
executive director appointed by the secretary with the approval of the 12
Governor in accordance with KRS 12.050. The office shall provide central 13
review and oversight of legislation, policy, and administrative regulations. 14
The office shall provide coordination, assistance, and support to program 15
departments and independent review and analysis on behalf of the secretary; 16
(g) The Office of Administrative Services shall be headed by an executive 17
director appointed by the secretary with the approval of the Governor in 18
accordance with KRS 12.050. The office shall provide central review and 19
oversight of procurement, general accounting including grant monitoring, and 20
facility management. The office shall provide coordination, assistance, and 21
support to program departments and independent review and analysis on 22
behalf of the secretary; 23
(h) The Office of Application Technology Services shall be headed by an 24
executive director appointed by the secretary with the approval of the 25
Governor in accordance with KRS 12.050. The office shall provide 26
application technology services including central review and oversight. The 27 UNOFFICIAL COPY 24 RS BR 2423
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office shall provide coordination, assistance, and support to program 1
departments and independent review and analysis on behalf of the secretary; 2
and 3
(i) The Office of Data Analytics shall be headed by an executive director who 4
shall be appointed by the secretary with the approval of the Governor under 5
KRS 12.050 and shall: 6
1. Identify and innovate strategic initiatives to inform public policy 7
initiatives and provide opportunities for improved health outcomes for 8
all Kentuckians though data analytics;[. The office shall ] 9
2. Provide leadership in the redesign of the health care delivery system 10
using electronic information technology to improve patient care and 11
reduce medical errors and duplicative services; and 12
3. Implement and administer the Kentucky all-payer claims database in 13
accordance with Sections 1 to 6 of this Act; 14
(2) Department for Medicaid Services. The Department for Medicaid Services shall 15
serve as the single state agency in the Commonwealth to administer Title XIX of 16
the Federal Social Security Act. The Department for Medicaid Services shall be 17
headed by a commissioner for Medicaid services, who shall be appointed by the 18
secretary with the approval of the Governor under KRS 12.050. The commissioner 19
for Medicaid services shall be a person who by experience and training in 20
administration and management is qualified to perform the duties of this office. The 21
commissioner for Medicaid services shall exercise authority over the Department 22
for Medicaid Services under the direction of the secretary and shall only fulfill 23
those responsibilities as delegated by the secretary; 24
(3) Department for Public Health. The Department for Public Health shall develop and 25
operate all programs of the cabinet that provide health services and all programs for 26
assessing the health status of the population for the promotion of health and the 27 UNOFFICIAL COPY 24 RS BR 2423
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prevention of disease, injury, disability, and premature death. This shall include but 1
not be limited to oversight of the Division of Women's Health and the Office for 2
Children with Special Health Care Needs. The duties, responsibilities, and authority 3
set out in KRS 200.460 to 200.490 shall be performed by the Department for Public 4
Health. The Department for Public Health shall advocate for the rights of children 5
with disabilities and, to the extent that funds are available, shall ensure the 6
administration of services for children with disabilities as are deemed appropriate 7
by this office pursuant to Title V of the Social Security Act. The Department for 8
Public Health may promulgate administrative regulations under KRS Chapter 13A 9
as may be necessary to implement and administer its responsibilities. The Office for 10
Children with Special Health Care Needs may be headed by an executive director 11
appointed by the secretary with the approval of the Governor in accordance with 12
KRS 12.050. The Department for Public Health shall be headed by a commissioner 13
for public health who shall be appointed by the secretary with the approval of the 14
Governor under KRS 12.050. The commissioner for public health shall be a duly 15
licensed physician who by experience and training in administration and 16
management is qualified to perform the duties of this office. The commissioner 17
shall advise the head of each major organizational unit enumerated in this section 18
on policies, plans, and programs relating to all matters of public health, including 19
any actions necessary to safeguard the health of the citizens of the Commonwealth. 20
The commissioner shall serve as chief medical officer of the Commonwealth. The 21
commissioner for public health shall exercise authority over the Department for 22
Public Health under the direction of the secretary and shall only fulfill those 23
responsibilities as delegated by the secretary; 24
(4) Department for Behavioral Health, Developmental and Intellectual Disabilities. The 25
Department for Behavioral Health, Developmental and Intellectual Disabilities shall 26
develop and administer programs for the prevention of mental illness, intellectual 27 UNOFFICIAL COPY 24 RS BR 2423
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disabilities, brain injury, developmental disabilities, and substance use disorders 1
and shall develop and administer an array of services and support for the treatment, 2
habilitation, and rehabilitation of persons who have a mental illness or emotional 3
disability, or who have an intellectual disability, brain injury, developmental 4
disability, or a substance use disorder. The Department for Behavioral Health, 5
Developmental and Intellectual Disabilities shall be headed by a commissioner for 6
behavioral health, developmental and intellectual disabilities who shall be 7
appointed by the secretary with the approval of the Governor under KRS 12.050. 8
The commissioner for behavioral health, developmental and intellectual disabilities 9
shall be by training and experience in administration and management qualified to 10
perform the duties of the office. The commissioner for behavioral health, 11
developmental and intellectual disabilities shall exercise authority over the 12
department under the direction of the secretary, and shall only fulfill those 13
responsibilities as delegated by the secretary; 14
(5) Department for Family Resource Centers and Volunteer Services. The Department 15
for Family Resource Centers and Volunteer Services shall streamline the various 16
responsibilities associated with the human services programs for which the cabinet 17
is responsible. This shall include, but not be limited to, oversight of the Division of 18
Family Resource and Youth Services Centers and Serve Kentucky. The Department 19
for Family Resource Centers and Volunteer Services shall be headed by a 20
commissioner who shall be appointed by the secretary with the approval of the 21
Governor under KRS 12.050. The commissioner for family resource centers and 22
volunteer services shall be by training and experience in administration and 23
management qualified to perform the duties of the office, shall exercise authority 24
over the department under the direction of the secretary, and shall only fulfill those 25
responsibilities as delegated by the secretary; 26
(6) Department for Community Based Services. The Department for Community Based 27 UNOFFICIAL COPY 24 RS BR 2423
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Services shall administer and be responsible for child and adult protection, 1
guardianship services, violence prevention resources, foster care and adoption, 2
permanency, and services to enhance family self-sufficiency, including child care, 3
social services, public assistance, and family support. The department shall be 4
headed by a commissioner appointed by the secretary with the approval of the 5
Governor in accordance with KRS 12.050; 6
(7) Department for Income Support. The Department for Income Support shall be 7
responsible for child support enforcement and disability determination. The 8
department shall serve as the state unit as required by Title II and Title XVI of the 9
Social Security Act, and shall have responsibility for determining eligibility for 10
disability for those citizens of the Commonwealth who file applications for 11
disability with the Social Security Administration. The department shall be headed 12
by a commissioner appointed by the secretary with the approval of the Governor in 13
accordance with KRS 12.050; and 14
(8) Department for Aging and Independent Living. The Department for Aging and 15
Independent Living shall serve as the state unit as designated by the Administration 16
on Aging Services under the Older Americans Act and shall have responsibility for 17
administration of the federal community support services, in-home services, meals, 18
family and caregiver support services, elder rights and legal assistance, senior 19
community services employment program, the state health insurance assistance 20
program, state home and community based services including home care, 21
Alzheimer's respite services and the personal care attendant program, certifications 22
of assisted living facilities, and the state Council on Alzheimer's Disease and other 23
related disorders. The department shall also administer the Long-Term Care 24
Ombudsman Program and the Medicaid Home and Community Based Waivers 25
Participant Directed Services Option (PDS) Program. The department shall serve as 26
the information and assistance center for aging and disability services and 27 UNOFFICIAL COPY 24 RS BR 2423
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administer multiple federal grants and other state initiatives. The department shall 1
be headed by a commissioner appointed by the secretary with the approval of the 2
Governor in accordance with KRS 12.050. 3
Section 8. KRS 194A.030 (Effective July 1, 2025) is amended to read as 4
follows: 5
The cabinet consists of the following major organizational units, which are hereby 6
created: 7
(1) Office of the Secretary. Within the Office of the Secretary, there shall be an Office 8
of Legal Services, an Office of Inspector General, an Office of Public Affairs, an 9
Office of Human Resource Management, an Office of Finance and Budget, an 10
Office of Legislative and Regulatory Affairs, an Office of Administrative Services, 11
an Office of Application Technology Services and an Office of Data Analytics, as 12
follows: 13
(a) The Office of Legal Services shall provide legal advice and assistance to all 14
units of the cabinet in any legal action in which it may be involved. The 15
Office of Legal Services shall employ all attorneys of the cabinet who serve 16
the cabinet in the capacity of attorney, giving legal advice and opinions 17
concerning the operation of all programs in the cabinet. The Office of Legal 18
Services shall be headed by a general counsel who shall be appointed by the 19
secretary with the approval of the Governor under KRS 12.050 and 12.210. 20
The general counsel shall be the chief legal advisor to the secretary and shall 21
be directly responsible to the secretary. The Attorney General, on the request 22
of the secretary, may designate the general counsel as an assistant attorney 23
general under the provisions of KRS 15.105; 24
(b) The Office of Inspector General shall be headed by an inspector general who 25
shall be appointed by the secretary with the approval of the Governor. The 26
inspector general shall be directly responsible to the secretary. The Office of 27 UNOFFICIAL COPY 24 RS BR 2423
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Inspector General shall be responsible for: 1
1. The conduct of audits and investigations for detecting the perpetration of 2
fraud or abuse of any program by any client, or by any vendor of 3
services with whom the cabinet has contracted; and the conduct of 4
special investigations requested by the secretary, commissioners, or 5
office heads of the cabinet into matters related to the cabinet or its 6
programs; 7
2. Licensing and regulatory functions as the secretary may delegate; 8
3. Review of health facilities participating in transplant programs, as 9
determined by the secretary, for the purpose of determining any 10
violations of KRS 311.1911 to 311.1959, 311.1961, and 311.1963; 11
4. The duties, responsibilities, and authority pertaining to the certificate of 12
need functions and the licensure appeals functions, pursuant to KRS 13
Chapter 216B; 14
5. The notification and forwarding of any information relevant to possible 15
criminal violations to the appropriate prosecuting authority; 16
6. The oversight of the operations of the Kentucky Health Information 17
Exchange; and 18
7. The support and guidance to health care providers related to telehealth 19
services, including the development of policy, standards, resources, and 20
education to expand telehealth services across the Commonwealth; 21
(c) The Office of Public Affairs shall be headed by an executive director 22
appointed by the secretary with the approval of the Governor in accordance 23
with KRS 12.050. The office shall provide information to the public and news 24
media about the programs, services, and initiatives of the cabinet; 25
(d) The Office of Human Resource Management shall be headed by an executive 26
director appointed by the secretary with the approval of the Governor in 27 UNOFFICIAL COPY 24 RS BR 2423
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accordance with KRS 12.050. The office shall coordinate, oversee, and 1
execute all personnel, training, and management functions of the cabinet. The 2
office shall focus on the oversight, development, and implementation of 3
quality improvement services; curriculum development and delivery of 4
instruction to staff; the administration, management, and oversight of training 5
operations; health, safety, and compliance training; and equal employment 6
opportunity compliance functions; 7
(e) The Office of Finance and Budget shall be headed by an executive director 8
appointed by the secretary with the approval of the Governor in accordance 9
with KRS 12.050. The office shall provide central review and oversight of 10
budget, contract, and cabinet finances. The office shall provide coordination, 11
assistance, and support to program departments and independent review and 12
analysis on behalf of the secretary; 13
(f) The Office of Legislative and Regulatory Affairs shall be headed by an 14
executive director appointed by the secretary with the approval of the 15
Governor in accordance with KRS 12.050. The office shall provide central 16
review and oversight of legislation, policy, and administrative regulations. 17
The office shall provide coordination, assistance, and support to program 18
departments and independent review and analysis on behalf of the secretary; 19
(g) The Office of Administrative Services shall be headed by an executive 20
director appointed by the secretary with the approval of the Governor in 21
accordance with KRS 12.050. The office shall provide central review and 22
oversight of procurement, general accounting including grant monitoring, and 23
facility management. The office shall provide coordination, assistance, and 24
support to program departments and independent review and analysis on 25
behalf of the secretary; 26
(h) The Office of Application Technology Services shall be headed by an 27 UNOFFICIAL COPY 24 RS BR 2423
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executive director appointed by the secretary with the approval of the 1
Governor in accordance with KRS 12.050. The office shall provide 2
application technology services including central review and oversight. The 3
office shall provide coordination, assistance, and support to program 4
departments and independent review and analysis on behalf of the secretary; 5
and 6
(i) The Office of Data Analytics shall be headed by an executive director who 7
shall be appointed by the secretary with the approval of the Governor under 8
KRS 12.050 and shall: 9
1. Identify and innovate strategic initiatives to inform public policy 10
initiatives and provide opportunities for improved health outcomes for 11
all Kentuckians though data analytics;[. The office shall ] 12
2. Provide leadership in the redesign of the health care delivery system 13
using electronic information technology to improve patient care and 14
reduce medical errors and duplicative services; and 15
3. Implement and administer the Kentucky all-payer claims database in 16
accordance with Sections 1 to 6 of this Act; 17
(2) Department for Medicaid Services. The Department for Medicaid Services shall 18
serve as the single state agency in the Commonwealth to administer Title XIX of 19
the Federal Social Security Act. The Department for Medicaid Services shall be 20
headed by a commissioner for Medicaid services, who shall be appointed by the 21
secretary with the approval of the Governor under KRS 12.050. The commissioner 22
for Medicaid services shall be a person who by experience and training in 23
administration and management is qualified to perform the duties of this office. The 24
commissioner for Medicaid services shall exercise authority over the Department 25
for Medicaid Services under the direction of the secretary and shall only fulfill 26
those responsibilities as delegated by the secretary; 27 UNOFFICIAL COPY 24 RS BR 2423
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(3) Department for Public Health. The Department for Public Health shall develop and 1
operate all programs of the cabinet that provide health services and all programs for 2
assessing the health status of the population for the promotion of health and the 3
prevention of disease, injury, disability, and premature death. This shall include but 4
not be limited to oversight of the Division of Women's Health and the Office for 5
Children with Special Health Care Needs. The duties, responsibilities, and authority 6
set out in KRS 200.460 to 200.490 shall be performed by the Department for Public 7
Health. The Department for Public Health shall advocate for the rights of children 8
with disabilities and, to the extent that funds are available, shall ensure the 9
administration of services for children with disabilities as are deemed appropriate 10
by this office pursuant to Title V of the Social Security Act. The Department for 11
Public Health may promulgate administrative regulations under KRS Chapter 13A 12
as may be necessary to implement and administer its responsibilities. The Office for 13
Children with Special Health Care Needs may be headed by an executive director 14
appointed by the secretary with the approval of the Governor in accordance with 15
KRS 12.050. The Department for Public Health shall be headed by a commissioner 16
for public health who shall be appointed by the secretary with the approval of the 17
Governor under KRS 12.050. The commissioner for public health shall be a duly 18
licensed physician who by experience and training in administration and 19
management is qualified to perform the duties of this office. The commissioner 20
shall advise the head of each major organizational unit enumerated in this section 21
on policies, plans, and programs relating to all matters of public health, including 22
any actions necessary to safeguard the health of the citizens of the Commonwealth. 23
The commissioner shall serve as chief medical officer of the Commonwealth. The 24
commissioner for public health shall exercise authority over the Department for 25
Public Health under the direction of the secretary and shall only fulfill those 26
responsibilities as delegated by the secretary; 27 UNOFFICIAL COPY 24 RS BR 2423
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(4) Department for Behavioral Health, Developmental and Intellectual Disabilities. The 1
Department for Behavioral Health, Developmental and Intellectual Disabilities shall 2
develop and administer programs for the prevention of mental illness, intellectual 3
disabilities, brain injury, developmental disabilities, and substance use disorders 4
and shall develop and administer an array of services and support for the treatment, 5
habilitation, and rehabilitation of persons who have a mental illness or emotional 6
disability, or who have an intellectual disability, brain injury, developmental 7
disability, or a substance use disorder. The Department for Behavioral Health, 8
Developmental and Intellectual Disabilities shall be headed by a commissioner for 9
behavioral health, developmental and intellectual disabilities who shall be 10
appointed by the secretary with the approval of the Governor under KRS 12.050. 11
The commissioner for behavioral health, developmental and intellectual disabilities 12
shall be by training and experience in administration and management qualified to 13
perform the duties of the office. The commissioner for behavioral health, 14
developmental and intellectual disabilities shall exercise authority over the 15
department under the direction of the secretary, and shall only fulfill those 16
responsibilities as delegated by the secretary; 17
(5) Department for Family Resource Centers and Volunteer Services. The Department 18
for Family Resource Centers and Volunteer Services shall streamline the various 19
responsibilities associated with the human services programs for which the cabinet 20
is responsible. This shall include, but not be limited to, oversight of the Division of 21
Family Resource and Youth Services Centers and Serve Kentucky. The Department 22
for Family Resource Centers and Volunteer Services shall be headed by a 23
commissioner who shall be appointed by the secretary with the approval of the 24
Governor under KRS 12.050. The commissioner for family resource centers and 25
volunteer services shall be by training and experience in administration and 26
management qualified to perform the duties of the office, shall exercise authority 27 UNOFFICIAL COPY 24 RS BR 2423
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over the department under the direction of the secretary, and shall only fulfill those 1
responsibilities as delegated by the secretary; 2
(6) Department for Community Based Services. The Department for Community Based 3
Services shall administer and be responsible for child and adult protection, 4
guardianship services, violence prevention resources, foster care and adoption, 5
permanency, and services to enhance family self-sufficiency, including child care, 6
social services, public assistance, and family support. The department shall be 7
headed by a commissioner appointed by the secretary with the approval of the 8
Governor in accordance with KRS 12.050; and 9
(7) Department for Aging and Independent Living. The Department for Aging and 10
Independent Living shall serve as the state unit as designated by the Administration 11
on Aging Services under the Older Americans Act and shall have responsibility for 12
administration of the federal community support services, in-home services, meals, 13
family and caregiver support services, elder rights and legal assistance, senior 14
community services employment program, the state health insurance assistance 15
program, state home and community based services including home care, 16
Alzheimer's respite services and the personal care attendant program, certifications 17
of assisted living facilities, and the state Council on Alzheimer's Disease and other 18
related disorders. The department shall also administer the Long-Term Care 19
Ombudsman Program and the Medicaid Home and Community Based Waivers 20
Participant Directed Services Option (PDS) Program. The department shall serve as 21
the information and assistance center for aging and disability services and 22
administer multiple federal grants and other state initiatives. The department shall 23
be headed by a commissioner appointed by the secretary with the approval of the 24
Governor in accordance with KRS 12.050. 25
Section 9. KRS 194A.101 is amended to read as follows: 26
(1) The Office of Data Analytics is hereby created in the Office of the Secretary. The 27 UNOFFICIAL COPY 24 RS BR 2423
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office shall: 1
(a) Provide oversight and strategic direction for, and be responsible for the 2
coordinating of, the data analysis initiatives of[for] the various departments 3
that regulate health care and social services to ensure that policy is consistent 4
with the long-term goals across the Commonwealth; and 5
(b) Implement and administer the Kentucky all-payer claims database in 6
accordance with Sections 1 to 6 of this Act. 7
(2) The office shall have the authority to review all data requests received by the 8
cabinet from the public, review the requests for content to determine the cabinet's 9
response, and approve the release of the requested information. The office shall 10
review data analyses conducted by the departments within the cabinet to ensure the 11
consistency, quality, and validity of the analysis prior to its use in operational and 12
policy decisions. The office shall facilitate the process of data integration by 13
initiating and maintaining data-sharing agreements in order to improve inter-agency 14
and cross-cabinet collaboration. 15
(3) The Office of Data Analytics shall promulgate administrative regulations in 16
accordance with KRS Chapter 13A to implement this section. 17
Section 10. KRS 304.2-100 is amended to read as follows: 18
(1) The commissioner shall personally supervise the operations of the department. 19
(2) The commissioner shall examine and inquire into violations of this code, shall 20
enforce the provisions of this code with impartiality and shall execute the duties 21
imposed upon him or her by this code. 22
(3) The commissioner shall have the powers and authority expressly conferred upon 23
him or her by or reasonably implied from the provisions of this code. 24
(4) The commissioner may conduct such examinations and investigations of insurance 25
matters, in addition to examinations and investigations expressly authorized, as the 26
commissioner may deem proper upon reasonable and probable cause to determine 27 UNOFFICIAL COPY 24 RS BR 2423
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whether any person has violated any provisions of this code or to secure 1
information useful in the lawful administration of any such provision. The cost of 2
such additional examinations and investigations shall be borne by the state. 3
(5) The commissioner may establish and maintain such branch offices in this state as 4
may be reasonably required for the efficient administration of this code. 5
(6) The commissioner shall have such additional powers and duties as may be provided 6
by other laws of this state. 7
(7) The commissioner shall assist the Office of[ Health] Data[ and] Analytics in 8
carrying out Subtitle 17B of this chapter,[ and] KRS 194A.099, and Sections 1 to 6 9
of this Act. 10
SECTION 11. A NEW SECTION OF SUBTITLE 99 OF KRS CHAPTER 304 11
IS CREATED TO READ AS FOLLOWS: 12
(1) (a) The commissioner shall enforce the reporting requirements for health 13
payers under Section 6 of this Act. 14
(b) In carrying out the duties under paragraph (a) of this subsection, the 15
commissioner: 16
1. May assess a civil penalty in accordance with this section; and 17
2. Shall have the authority, powers, and duties set forth in Subtitle 2 of 18
this chapter for violations of this code, including the requirements for 19
orders, notices, and hearings. 20
(2) (a) Subject to paragraphs (b), (c), (d), and (e) of this subsection, the 21
commissioner shall promulgate an administrative regulation designating a 22
schedule of penalties, not to exceed one thousand dollars ($1,000) per day, 23
for any health payer that fails to comply with the reporting requirements for 24
that person under Section 6 of this Act. 25
(b) State and federal agencies shall not be assessed or subject to a penalty 26
under this subsection. 27 UNOFFICIAL COPY 24 RS BR 2423
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(c) The commissioner may, by administrative regulation, adjust the maximum 1
penalty established under paragraph (a) of this subsection every two (2) 2
years based on the percent change in the nonseasonally adjusted annual 3
average Consumer Price Index for All Urban Consumers (CPI-U), U.S. City 4
Average, Medical Care, as published by the United States Bureau of Labor 5
Statistics. 6
(d) The commissioner shall promulgate an administrative regulation 7
designating the process for notice, hearing, and collection of any penalty 8
assessed under paragraph (a) of this subsection. 9
(e) The commissioner may, upon such terms and conditions that are 10
determined by the commissioner to be in the public interest, remit or 11
mitigate any penalty assessed under paragraph (a) of this subsection. 12
(3) Any penalties collected by the department under this section shall be deposited 13
into the fund established in Section 3 of this Act. 14
(4) The commissioner may promulgate any additional administrative regulations 15
necessary to implement or aid in the effectuation of this section. 16
Section 12. (1) The Governor shall make all initial appointments under 17
subsection (2)(a) of Section 5 of this Act within 90 days of the effective date of this Act. 18
(2) Notwithstanding subsection (2)(d)2. of Section 5 of this Act, initial 19
appointments under subsection (2)(a) of Section 5 of this Act shall be staggered so that, 20
of the initial 13 appointments: 21
(a) Five of the appointments expire at four years after the initial appointment; 22
(b) Four of the appointments expire at three years after the initial appointment; 23
and 24
(c) Four of the appointments expire at two years after the initial appointment. 25
Section 13. If the Cabinet for Health and Family Services determines that a 26
waiver or any other authorization from a federal agency is necessary to implement 27 UNOFFICIAL COPY 24 RS BR 2423
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Section 6 of this Act for any reason, including the loss of federal funds, the cabinet shall, 1
within 90 days after the effective date of this Act, request the waiver or authorization, and 2
may only delay implementation of those provisions for which a waiver or authorization 3
was deemed necessary until the waiver or authorization is granted. 4