UNOFFICIAL COPY 25 RS BR 1246
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AN ACT relating to reproductive health care. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 205.592 is amended to read as follows: 3
(1) Except as provided in subsection (2) of this section, pregnant women[,] and new 4
mothers up to twelve (12) months postpartum, regardless of citizenship or national 5
origin, and children up to age one (1) shall be eligible for participation in the 6
Kentucky Medical Assistance Program if: 7
(a) They have family income up to but not exceeding one hundred [and ]eighty-8
five percent (185%) of the nonfarm income official poverty guidelines as 9
promulgated by the Department of Health and Human Services of the United 10
States as revised annually; and 11
(b) They are otherwise eligible for the program. 12
(2) The percentage established in subsection (1)(a) of this section may be increased to 13
the extent: 14
(a) Permitted under federal law; and 15
(b) Funding is available. 16
SECTION 2. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 17
READ AS FOLLOWS: 18
(1) As used in this section, unless the context requires otherwise: 19
(a) "Eligible individual" means an individual who: 20
1. Is not pregnant; 21
2. Has a family combined income up to, but not exceeding, two hundred 22
sixty percent (260%) of the nonfarm income official poverty guidelines 23
as promulgated by the United States Department of Health and 24
Human Services; and 25
3. a. Is eligible for the Kentucky Medical Assistance Program; or 26
b. Would otherwise be eligible for the Kentucky Medical Assistance 27 UNOFFICIAL COPY 25 RS BR 1246
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Program, except that the individual is not a citizen of the United 1
States and is not considered an eligible noncitizen pursuant to 8 2
U.S.C. sec. 1611 or 1612; 3
(b) "Family planning services" means all the following services, regardless of 4
an individual’s age, sex, or gender identity, or the age, sex, or gender 5
identity of the individual’s partner, including but not limited to: 6
1. All contraceptive drugs, devices, and other products approved by the 7
United States Food and Drug Administration, including: 8
a. Over-the-counter contraceptive drugs, devices, and products; 9
and 10
b. A twelve (12) month supply of self-administered contraceptive 11
drugs, devices, and supplies, unless the individual requests a 12
smaller supply or the prescribing provider restricts the enrollee 13
to a smaller supply; 14
2. Voluntary sterilization procedures; 15
3. Activities that enable individuals to determine the number and spacing 16
of their children and to select the means by which this may be 17
achieved; 18
4. The consultations, examinations, and medical services that are 19
necessary to prescribe, dispense, insert, deliver, distribute, administer, 20
or remove contraceptive drugs, devices, and other products; and 21
5. Follow-up visits to evaluate or manage problems associated with 22
contraceptive drugs, devices, or products; and 23
(c) "Family planning-related services" means educational, medical, and social 24
services, including but not limited to: 25
1. Medically necessary evaluations or preventive services such as tobacco 26
utilization screening, counseling, testing, and cessation services; 27 UNOFFICIAL COPY 25 RS BR 1246
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2. Cervical cancer screening and prevention; 1
3. Diagnosis of treatment of a sexually transmitted infection and 2
medication and supplies to prevent a sexually transmitted infection; 3
and 4
4. Any other medical diagnosis, treatment, or preventive service that is 5
routinely provided as part of a family planning visit. 6
(2) The cabinet shall establish a family planning program within the Department for 7
Medicaid Services to provide family planning services and family planning-8
related services to eligible individuals. 9
(3) In administering this program, the cabinet shall not: 10
(a) Infringe upon an eligible individual’s choice of contraceptive drug, device, 11
or product by requiring prior authorization, step therapy, or other 12
utilization control techniques for medically appropriate contraceptive drugs, 13
devices, or products approved by the United States Food and Drug 14
Administration; 15
(b) Impose any cost-sharing requirements for enrolled individuals; or 16
(c) Deny coverage based on the sex, sexual orientation, or gender identity of 17
the eligible individual, or the sex, sexual orientation, or gender identity of 18
the eligible individual’s partner. 19
(4) The Department for Medicaid Services shall: 20
(a) Promulgate administrative regulations in accordance with KRS Chapter 21
13A, and amend any contract with a managed care organization as is 22
necessary, to implement this section; and 23
(b) Collaborate with the Division of Health Benefit Exchange within the 24
cabinet, health care consumer advocates, family planning providers, and 25
other interested stakeholders to establish a comprehensive community 26
education and outreach campaign to provide culturally and linguistically 27 UNOFFICIAL COPY 25 RS BR 1246
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accessible information to facilitate participation in the program, including 1
but not limited to enrollment procedures, program services, and benefit 2
utilization. 3
Section 3. If the Cabinet for Health and Family Services or the Department for 4
Medicaid Services determines that a waiver or any other authorization from a federal 5
agency is necessary prior to the implementation of any provision of Sections 1 and 2 of 6
this Act, the cabinet or department shall, within 90 days after the effective date of this 7
Act, request the waiver or authorization and shall only delay full implementation of those 8
provisions for which a waiver or authorization was deemed necessary until the waiver or 9
authorization is granted. 10