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AN ACT relating to public health and safety. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 214.450 is amended to read as follows: 3
As used in KRS 214.450[214.452] to 214.466, unless the context otherwise requires: 4
(1) "Autologous donation" means a donation of blood that a person provides for 5
their own medical use; 6
(2) "Blood" means any blood, blood product, blood component, or blood derivative 7
including plasma;[.] 8
(3) (a)[(2)] "Blood establishment" means a place of business under one (1) 9
management at one (1) general physical location which engages in the 10
collection, preparation, processing, labeling, packaging, and dispensing of 11
blood to any health care facility, health service, or health care provider and 12
which is licensed by the United States Food and Drug Administration. 13
(b) "Blood establishment" does not include autologous[ blood] donation 14
programs permitted under KRS 214.456;[.] 15
(4)[(3)] "Blood-borne communicable disease" means any of those diseases which are 16
specifically so defined and set forth in administrative regulation promulgated by the 17
United States Food and Drug Administration;[.] 18
(5)[(4)] "Directed donation" means a donation of blood for the purpose of 19
transfusion into a specified individual; 20
(6) "Donor" means either a paid or volunteer donor of blood; 21
(7) "Health facility" means any health facility set forth under KRS 216B.015 which 22
provides for the transfusion of blood into a living human body;[.] 23
(8)[(5)] "Health care provider" means any person licensed or certified under the laws 24
of the Commonwealth as a dentist, physician, osteopath, registered nurse, practical 25
nurse, paramedic, emergency medical technician, or physician assistant;[.] 26
(9)[(6)] "Health service" means any health service as set forth under KRS 216B.015 27 UNOFFICIAL COPY 25 RS BR 1414
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and which provides for the transfusion of blood into a living human body;[.] 1
(10)[(7)] "Transfuse" means to transfer blood from one (1) person to another; and[. 2
(8) "Donor" means either a paid or volunteer donor of blood.] 3
(11)[(9)] "Untested blood" means blood that has not been tested or blood for which test 4
results have not yet been returned. 5
Section 2. KRS 214.452 is amended to read as follows: 6
[The following policies shall apply to blood establishments and to donors of blood:] 7
(1) All blood establishments within the Commonwealth shall be licensed by the United 8
States Food and Drug Administration and remain in compliance with all applicable 9
federal regulations. The Cabinet for Health and Family Services shall, under 10
administrative regulations promulgated in accordance with[pursuant to] KRS 11
Chapter 13A, establish fees necessary to cover the cost of and adhere to a schedule 12
for regular inspection, by the Office of the Inspector General of the Cabinet for 13
Health and Family Services, of all blood establishments within the Commonwealth 14
to ascertain whether each blood establishment is licensed and in compliance with 15
KRS 214.450 to 214.464 and KRS 214.468. The Office of the Inspector General 16
shall commence its inspection program of blood establishments no later than 17
September 1, 1994. 18
(2) All blood establishments shall use tests approved by the United States Food and 19
Drug Administration to test blood for: 20
(a) The human immunodeficiency virus;[ and for] 21
(b) Any known causative agent for any blood-borne communicable disease; 22
(c) Spike proteins; 23
(d) Antibodies to the nucleocapsid protein on the SARS-CoV-2 virus; and 24
(e) Synthetic mRNA, upon approval of the United States Food and Drug 25
Administration of a test for the presence of mRNA[, using tests approved and 26
required, for purposes of blood donation, by the United States Food and Drug 27 UNOFFICIAL COPY 25 RS BR 1414
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Administration]. 1
(3) It shall be the duty of the administrator of any blood establishment which collects 2
blood for the purpose of distributing to another health service, health facility, or 3
health care[health-care] provider the blood for transfusion to: 4
(a) Secure donor consent and a signed written risk factor history and donor 5
consent form for each potential paid or volunteer donor for the purpose of 6
determining if the potential donor: 7
1. Is at high risk for infection with the human immunodeficiency virus;[, 8
or] 9
2. Has tested confirmatory positive for infection with the human 10
immunodeficiency virus;[ or] 11
3. Has acquired immune deficiency syndrome;[ or] 12
4. Has tested confirmatory positive for infection with any causative agent 13
for acquired immune deficiency syndrome recognized by the United 14
States Centers for Disease Control;[ or] 15
5. Has a blood-borne communicable disease; 16
6. Has received genetically engineered blood or blood products; or 17
7. Has received experimental therapies or medications of any kind 18
including but not limited to: 19
a. Engineered cell therapy; 20
b. Genetically modified or engineered blood products; 21
c. Drugs, blood, or blood-derived pharmaceuticals; or 22
d. Monoclonal antibody treatments, stem cell therapy, or any other 23
human cell derived medication, treatment, or therapy; 24
(b) Provide a means for a potential donor to self-elect not to donate blood; 25
(c) Refuse donation or sale of blood by persons listed under paragraph (a)1. to 26
5. of this subsection[at high risk for infection with the human 27 UNOFFICIAL COPY 25 RS BR 1414
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immunodeficiency virus, or who have been medically diagnosed as having 1
acquired immune deficiency syndrome, or who have tested confirmatory 2
positive for infection with the human immunodeficiency virus, or who have a 3
blood-borne communicable disease]; and 4
(d) Post a sign in the blood establishment which is visible to all potential donors 5
and which states: "Persons with acquired immune deficiency syndrome 6
(AIDS), or who have tested confirmatory positive for infection with the 7
human immunodeficiency virus (HIV), or who have a blood-borne 8
communicable disease or who have one (1) or more risk factors for the human 9
immunodeficiency virus as determined by the United States Centers for 10
Disease Control, are prohibited by law from donating or selling blood. 11
Persons violating the law are guilty of a Class D felony. ASK STAFF OF 12
THIS BLOOD ESTABLISHMENT." 13
(4) A person shall not be compelled to donate blood or tissue of any kind. 14
(5) Blood establishments shall inform donors of the potential uses for blood 15
donations. 16
(6) Any blood donated in the Commonwealth that is sold by a blood establishment 17
shall be offered for sale directly to hospitals before being offered for sale to any 18
other entity. 19
(7) If there is a hospital blood supply shortage as determined by the Cabinet for 20
Health and Family Services, blood establishments shall not sell blood to any 21
entity if the blood will be used to produce pharmaceuticals[The provisions of this 22
section shall not be construed to impose requirements which are in conflict with 23
donor eligibility requirements set out in United States Food and Drug 24
Administration or American Association of Blood Banks standards]. 25
Section 3. KRS 214.454 is amended to read as follows: 26
(1) A[No] person shall not donate blood if the person; 27 UNOFFICIAL COPY 25 RS BR 1414
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(a) Is at high risk for infection with the human immunodeficiency virus; 1
(b) Has tested confirmatory positive for infection with the human 2
immunodeficiency virus; 3
(c) Has acquired immune deficiency syndrome; 4
(d) Has tested confirmatory positive for infection with any causative agent for 5
acquired immune deficiency syndrome recognized by the United States 6
Centers for Disease Control; or 7
(e) Has a blood-borne communicable disease[is at high risk for infection with 8
the human immunodeficiency virus, or has acquired immunodeficiency 9
syndrome, or has tested confirmatory positive for the human 10
immunodeficiency virus or any other known causative agent of a blood-borne 11
communicable disease]. 12
(2) A[No] person shall not give false information to the staff of a blood establishment 13
regarding any item of the person's personal history which would affect the person's 14
suitability as a donor. 15
Section 4. KRS 214.456 is amended to read as follows: 16
[The following policies shall apply to autologous and directed blood donations:] 17
(1) Any person may make an autologous donation or a directed donation of 18
blood[otherwise qualified donor who wishes to direct a donation of blood to that 19
person or to another particular individual may do so. The surcharge for any 20
autologous or directed donation of blood shall not exceed twenty percent (20%) of 21
the charge for a regular unit of blood]. 22
(2) [If the donation is to another particular individual, ]The requirements of KRS 23
214.454 shall be met if the recipient and the recipient's attending physician have 24
requested a directed[the] donation. 25
(3) Blood collected as a directed donation may be used for someone other than, or in 26
addition to, the designated recipient if the donor's blood is not compatible with that 27 UNOFFICIAL COPY 25 RS BR 1414
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of the designated recipient or if any part of the donation is not needed by the 1
designated recipient. 2
(4) Each blood establishment shall advise prospective donors of the opportunity for 3
autologous donations and directed donations and of the provisions of[ this section 4
and of] KRS 214.450[214.452] to 214.466. 5
(5) Blood establishments, health facilities, health services, and health care providers 6
shall not: 7
(a) Prevent or prohibit autologous donations or directed donations or 8
transfusions; or 9
(b) Impose fees for a donation or transfusion using an autologous donation or 10
directed donation of blood that exceed twenty percent (20%) of the charge 11
for a regular unit of blood. 12
(6) Autologous[ blood] donation programs shall be exempt from KRS 214.454. 13
Section 5. KRS 214.458 is amended to read as follows: 14
(1) Each unit of blood collected by a blood establishment for transfusion shall be 15
affixed with the United States Food and Drug Administration required label 16
and[which includes] a donor identification number through which the following 17
information can be obtained: 18
(a) Date the blood was collected; 19
(b) Name of blood establishment; 20
(c) Nonidentifying code representing the name of the blood donor; 21
(d) A blood establishment serial number for the blood; 22
(e) The date of laboratory testing of the blood; 23
(f) The name of the person and laboratory testing the blood; 24
(g) The laboratory test results; and 25
(h) The mRNA status of the blood and the type of mRNA treatment or therapy 26
received by the donor, upon approval of the United States Food and Drug 27 UNOFFICIAL COPY 25 RS BR 1414
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Administration of a test for the presence of mRNA. 1
(2) Each unit of blood received by a blood establishment, [or ]health facility, health 2
service, or health care provider within the Commonwealth from an out-of-state 3
blood establishment shall contain a label in accordance with the provisions of 4
subsection (1) of this section and the blood establishment, [or ]health facility, 5
health service, or health care provider shall either test the blood in accordance 6
with the requirements for blood establishments within the Commonwealth under the 7
provisions of KRS 214.452(2) or may accept documented evidence of the test 8
results as are required under subsection (1) of this section for blood collected within 9
the Commonwealth. 10
(3) Each laboratory testing blood for transfusion shall maintain for ten (10) years from 11
the date of testing, and each blood establishment shall maintain for ten (10) years 12
from the date of collection, a list containing the information set forth in subsection 13
(1) of this section. 14
(4) No blood may be transfused into any patient in any health facility or health service 15
or by any health care provider unless the unit of blood has affixed to it the label as 16
required under this section and the blood has tested negative for: 17
(a) The human immunodeficiency virus or any causative agent of AIDS; and[, 18
or] 19
(b) Any blood-borne communicable disease as provided under KRS 214.452. 20
(5) When a unit of blood is transfused, a label containing the donor identification 21
number required under this section shall be removed from the unit and affixed to 22
the patient's medical chart or the blood donor identification number for the unit of 23
blood shall be recorded in the patient's medical chart. 24
(6)[(5)] Any unit of blood not containing the label required under this section shall be 25
destroyed by the health facility, health service, or health care provider. 26
(7)[(6)] Any unit of blood testing confirmatory positive for an agent of a blood-borne 27 UNOFFICIAL COPY 25 RS BR 1414
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communicable disease and in the possession of a health facility, health service, or 1
health care provider may be donated to educational or scientific research 2
institutions for the purpose of scientific research only and not for transfusion. 3
(8) Upon approval of the United States Food and Drug Administration of a test for 4
the presence of mRNA, a health facility, health service, or health care provider 5
shall: 6
(a) Inform a patient of the presence of mRNA in blood to be administered; 7
(b) Obtain written consent from the patient before administering blood with the 8
presence of mRNA; 9
(c) Provide counseling on the risks, benefits, and alternatives to receiving blood 10
with mRNA present; and 11
(d) Record the mRNA status of blood transfusions administered in the patient's 12
medical record. 13
(9) A patient shall not receive different care or services based on the consent or 14
refusal to receive blood with mRNA present. 15
(10) A patient may consent or refuse to receive blood with mRNA present regardless of 16
any past medical decisions made by the patient. 17
Section 6. KRS 214.464 is amended to read as follows: 18
(1) (a) Untested blood may be transfused only in an emergency situation in which the 19
attending physician determines a patient is in imminent danger of death or 20
serious physical injury and no tested and labeled blood as set forth under KRS 21
214.458 is readily available to alleviate the emergency situation; provided, 22
however, that the attending physician shall obtain specific prior consent for 23
the transfusion from the patient in the emergency situation or if the patient's 24
condition renders the patient incapable of giving consent, seek from the next 25
of kin of the patient, if available, prior informed consent to transfuse any 26
untested blood. As used in[For purposes of] this section, the patient's "next of 27 UNOFFICIAL COPY 25 RS BR 1414
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kin" means, in the following order; 1
1. The spouse of the patient; 2
2. If there is none, then the mother or father of the patient; 3
3. If there is none, then any adult son or daughter of the patient; or 4
4. If there is none, then any brother or sister of the patient. 5
(b) Physical evidence of consent shall become a part of the patient's permanent 6
medical record. 7
(2) Blood establishments may release untested blood, collected under standards set 8
forth in KRS 214.452, at the request of a physician, or health facility, or health 9
service in an emergency as provided under this section. If blood has not been tested, 10
the test shall be performed as soon after the transfusion as possible. If the blood 11
subsequently tests positive on any tests required under Section 2 of this Act[for 12
any blood-borne communicable disease], the patient's attending physician shall be 13
immediately notified. The attending physician shall, in turn, notify the patient of the 14
test results. The patient or next of kin shall indicate notification of receipt of the test 15
results and any offer of treatment or referral to another health care[health-care] 16
provider on a form provided by the health facility or health service and approved by 17
the Cabinet for Health and Family Services. 18
SECTION 7. A NEW SECTION OF KRS CHAPTER 214 IS CREATED TO 19
READ AS FOLLOWS: 20
A state agency shall not acquire or maintain a list containing the vaccination status of 21
the citizens of the Commonwealth. 22
SECTION 8. A NEW SECTION OF KRS CHAPTER 216B IS CREATED TO 23
READ AS FOLLOWS: 24
Each hospital licensed under this chapter shall: 25
(1) Invest in blood transfusion prevention strategies; and 26
(2) By January 1, 2026, establish a task force for bloodless medicine and surgery to 27 UNOFFICIAL COPY 25 RS BR 1414
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design and implement strategies to reduce the need for blood transfusions. 1
SECTION 9. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 2
IS CREATED TO READ AS FOLLOWS: 3
(1) All health benefit plans shall provide coverage for any directed or autologous 4
blood transfusion. 5
(2) Except as provided in subsection (3) of this section, the coverage required by this 6
section shall not be subject to copayments, coinsurance, deductibles, or any other 7
cost-sharing requirements. 8
(3) If the application of any requirement of this section would be the sole cause of a 9
health benefit plan's failure to qualify as a Health Savings Account-qualified 10
High Deductible Health Plan under 26 U.S.C. sec. 223, as amended, then the 11
requirement shall not apply to that health benefit plan until the minimum 12
deductible under 26 U.S.C. sec. 223, as amended, is satisfied. 13
Section 10. KRS 205.522 is amended to read as follows: 14
(1) With respect to the administration and provision of Medicaid benefits pursuant to 15
this chapter, the Department for Medicaid Services, any managed care organization 16
contracted to provide Medicaid benefits pursuant to this chapter, and the state's 17
medical assistance program shall be subject to, and comply with, the following, as 18
applicable: 19
(a) KRS 304.17A-129; 20
(b) KRS 304.17A-145; 21
(c) KRS 304.17A-163; 22
(d) KRS 304.17A-1631; 23
(e) KRS 304.17A-167; 24
(f) KRS 304.17A-235; 25
(g) KRS 304.17A-257; 26
(h) KRS 304.17A-259; 27 UNOFFICIAL COPY 25 RS BR 1414
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(i) KRS 304.17A-263; 1
(j) KRS 304.17A-264; 2
(k) KRS 304.17A-515; 3
(l) KRS 304.17A-580; 4
(m) KRS 304.17A-600, 304.17A-603, and 304.17A-607;[ and] 5
(n) KRS 304.17A-740 to 304.17A-743; and 6
(o) Section 9 of this Act. 7
(2) A managed care organization contracted to provide Medicaid benefits pursuant to 8
this chapter shall comply with the reporting requirements of KRS 304.17A-732. 9
Section 11. KRS 164.2871 is amended to read as follows: 10
(1) The governing board of each state postsecondary educational institution is 11
authorized to purchase liability insurance for the protection of the individual 12
members of the governing board, faculty, and staff of such institutions from liability 13
for acts and omissions committed in the course and scope of the individual's 14
employment or service. Each institution may purchase the type and amount of 15
liability coverage deemed to best serve the interest of such institution. 16
(2) All retirement annuity allowances accrued or accruing to any employee of a state 17
postsecondary educational institution through a retirement program sponsored by 18
the state postsecondary educational institution are hereby exempt from any state, 19
county, or municipal tax, and shall not be subject to execution, attachment, 20
garnishment, or any other process whatsoever, nor shall any assignment thereof be 21
enforceable in any court. Except retirement benefits accrued or accruing to any 22
employee of a state postsecondary educational institution through a retirement 23
program sponsored by the state postsecondary educational institution on or after 24
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 25
provided in KRS 141.010 and 141.0215. 26
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 27 UNOFFICIAL COPY 25 RS BR 1414
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members of governing boards, faculty and staff of institutions of higher education 1
in this state shall not be construed to be a waiver of sovereign immunity or any 2
other immunity or privilege. 3
(4) The governing board of each state postsecondary education institution is authorized 4
to provide a self-insured employer group health plan to its employees, which plan 5
shall: 6
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 7
(b) Except as provided in subsection (5) of this section, be exempt from 8
conformity with Subtitle 17A of KRS Chapter 304. 9
(5) A self-insured employer group health plan provided by the governing board of a 10
state postsecondary education institution to its employees shall comply with: 11
(a) KRS 304.17A-129; 12
(b) KRS 304.17A-133; 13
(c) KRS 304.17A-145; 14
(d) KRS 304.17A-163 and 304.17A-1631; 15
(e) KRS 304.17A-261; 16
(f) KRS 304.17A-262; 17
(g) KRS 304.17A-264;[ and] 18
(h) KRS 304.17A-265; and 19
(i) Section 9 of this Act. 20
(6) (a) A self-insured employer group health plan provided by the governing board of 21
a state postsecondary education institution to its employees shall provide a 22
special enrollment period to pregnant women who are eligible for coverage in 23
accordance with the requirements set forth in KRS 304.17-182. 24
(b) The governing board of a state postsecondary education institution shall, at or 25
before the time an employee is initially offered the opportunity to enroll in the 26
plan or coverage, provide the employee a notice of the special enrollment 27 UNOFFICIAL COPY 25 RS BR 1414
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rights under this subsection. 1
Section 12. KRS 18A.225 is amended to read as follows: 2
(1) (a) The term "employee" for purposes of this section means: 3
1. Any person, including an elected public official, who is regularly 4
employed by any department, office, board, agency, or branch of state 5
government; or by a public postsecondary educational institution; or by 6
any city, urban-county, charter county, county, or consolidated local 7
government, whose legislative body has opted to participate in the state-8
sponsored health insurance program pursuant to KRS 79.080; and who 9
is either a contributing member to any one (1) of the retirement systems 10
administered by the state, including but not limited to the Kentucky 11
Retirement Systems, County Employees Retirement System, Kentucky 12
Teachers' Retirement System, the Legislators' Retirement Plan, or the 13
Judicial Retirement Plan; or is receiving a contractual contribution from 14
the state toward a retirement plan; or, in the case of a public 15
postsecondary education institution, is an individual participating in an 16
optional retirement plan authorized by KRS 161.567; or is eligible to 17
participate in a retirement plan established by an employer who ceases 18
participating in the Kentucky Employees Retirement System pursuant to 19
KRS 61.522 whose employees participated in the health insurance plans 20
administered by the Personnel Cabinet prior to the employer's effective 21
cessation date in the Kentucky Employees Retirement System; 22
2. Any certified or classified employee of a local board of education or a 23
public charter school as defined in KRS 160.1590; 24
3. Any elected member of a local board of education; 25
4. Any person who is a present or future recipient of a retirement 26
allowance from the Kentucky Retirement Systems, County Employees 27 UNOFFICIAL COPY 25 RS BR 1414
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Retirement System, Kentucky Teachers' Retirement System, the 1
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 2
Kentucky Community and Technical College System's optional 3
retirement plan authorized by KRS 161.567, except that a person who is 4
receiving a retirement allowance and who is age sixty-five (65) or older 5
shall not be included, with the exception of persons covered under KRS 6
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 7
employed pursuant to subparagraph 1. of this paragraph; and 8
5. Any eligible dependents and beneficiaries of participating employees 9
and retirees who are entitled to participate in the state-sponsored health 10
insurance program; 11
(b) The term "health benefit plan" for the purposes of this section means a health 12
benefit plan as defined in KRS 304.17A-005; 13
(c) The term "insurer" for the purposes of this section means an insurer as defined 14
in KRS 304.17A-005; and 15
(d) The term "managed care plan" for the purposes of this section means a 16
managed care plan as defined in KRS 304.17A-500. 17
(2) (a) The secretary of the Finance and Administration Cabinet, upon the 18
recommendation of the secretary of the Personnel Cabinet, shall procure, in 19
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 20
from one (1) or more insurers authorized to do business in this state, a group 21
health benefit plan that may include but not be limited to health maintenance 22
organization (HMO), preferred provider organization (PPO), point of service 23
(POS), and exclusive provider organization (EPO) benefit plans 24
encompassing all or any class or classes of employees. With the exception of 25
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 26
all employers of any class of employees or former employees shall enter into 27 UNOFFICIAL COPY 25 RS BR 1414
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a contract with the Personnel Cabinet prior to including that group in the state 1
health insurance group. The contracts shall include but not be limited to 2
designating the entity responsible for filing any federal forms, adoption of 3
policies required for proper plan administration, acceptance of the contractual 4
provisions with health insurance carriers or third-party administrators, and 5
adoption of the payment and reimbursement methods necessary for efficient 6
administration of the health insurance program. Health insurance coverage 7
provided to state employees under this section shall, at a minimum, contain 8
the same benefits as provided under Kentucky Kare Standard as of January 1, 9
1994, and shall include a mail-order drug option as provided in subsection 10
(13) of this section. All employees and other persons for whom the health care 11
coverage is provided or made available shall annually be given an option to 12
elect health care coverage through a self-funded plan offered by the 13
Commonwealth or, if a self-funded plan is not available, from a list of 14
coverage options determined by the competitive bid process under the 15
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 16
during annual open enrollment. 17
(b) The policy or policies shall be approved by the commissioner of insurance 18
and may contain the provisions the commissioner of insurance approves, 19
whether or not otherwise permitted by the insurance laws. 20
(c) Any carrier bidding to offer health care coverage to employees shall agree to 21
provide coverage to all members of the state group, including active 22
employees and retirees and their eligible covered dependents and 23
beneficiaries, within the county or counties specified in its bid. Except as 24
provided in subsection (20) of this section, any carrier bidding to offer health 25
care coverage to employees shall also agree to rate all employees as a single 26
entity, except for those retirees whose former employers insure their active 27 UNOFFICIAL COPY 25 RS BR 1414
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employees outside the state-sponsored health insurance program and as 1
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 2
(d) Any carrier bidding to offer health care coverage to employees shall agree to 3
provide enrollment, claims, and utilization data to the Commonwealth in a 4
format specified by the Personnel Cabinet with the understanding that the data 5
shall be owned by the Commonwealth; to provide data in an electronic form 6
and within a time frame specified by the Personnel Cabinet; and to be subject 7
to penalties for noncompliance with data reporting requirements as specified 8
by the Personnel Cabinet. The Personnel Cabinet shall take strict precautions 9
to protect the confidentiality of each individual employee; however, 10
confidentiality assertions shall not relieve a carrier from the requirement of 11
providing stipulated data to the Commonwealth. 12
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 13
for timely analysis of data received from carriers and, to the extent possible, 14
provide in the request-for-proposal specifics relating to data requirements, 15
electronic reporting, and penalties for noncompliance. The Commonwealth 16
shall own the enrollment, claims, and utilization data provided by each carrier 17
and shall develop methods to protect the confidentiality of the individual. The 18
Personnel Cabinet shall include in the October annual report submitted 19
pursuant to the provisions of KRS 18A.226 to the Governor, the General 20
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 21
financial stability of the program, which shall include but not be limited to 22
loss ratios, methods of risk adjustment, measurements of carrier quality of 23
service, prescription coverage and cost management, and statutorily required 24
mandates. If state self-insurance was available as a carrier option, the report 25
also shall provide a detailed financial analysis of the self-insurance fund 26
including but not limited to loss ratios, reserves, and reinsurance agreements. 27 UNOFFICIAL COPY 25 RS BR 1414
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(f) If any agency participating in the state-sponsored employee health insurance 1
program for its active employees terminates participation and there is a state 2
appropriation for the employer's contribution for active employees' health 3
insurance coverage, then neither the agency nor the employees shall receive 4
the state-funded contribution after termination from the state-sponsored 5
employee health insurance program. 6
(g) Any funds in flexible spending accounts that remain after all reimbursements 7
have been processed shall be transferred to the credit of the state-sponsored 8
health insurance plan's appropriation account. 9
(h) Each entity participating in the state-sponsored health insurance program shall 10
provide an amount at least equal to the state contribution rate for the employer 11
portion of the health insurance premium. For any participating entity that used 12
the state payroll system, the employer contribution amount shall be equal to 13
but not greater than the state contribution rate. 14
(3) The premiums may be paid by the policyholder: 15
(a) Wholly from funds contributed by the employee, by payroll deduction or 16
otherwise; 17
(b) Wholly from funds contributed by any department, board, agency, public 18
postsecondary education institution, or branch of state, city, urban-county, 19
charter county, county, or consolidated local government; or 20
(c) Partly from each, except that any premium due for health care coverage or 21
dental coverage, if any, in excess of the premium amount contributed by any 22
department, board, agency, postsecondary education institution, or branch of 23
state, city, urban-county, charter county, county, or consolidated local 24
government for any other health care coverage shall be paid by the employee. 25
(4) If an employee moves his or her place of residence or employment out of the 26
service area of an insurer offering a managed health care plan, under which he or 27 UNOFFICIAL COPY 25 RS BR 1414
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she has elected coverage, into either the service area of another managed health care 1
plan or into an area of the Commonwealth not within a managed health care plan 2
service area, the employee shall be given an option, at the time of the move or 3
transfer, to change his or her coverage to another health benefit plan. 4
(5) No payment of premium by any department, board, agency, public postsecondary 5
educational institution, or branch of state, city, urban-county, charter county, 6
county, or consolidated local government shall constitute compensation to an 7
insured employee for the purposes of any statute fixing or limiting the 8
compensation of such an employee. Any premium or other expense incurred by any 9
department, board, agency, public postsecondary educational institution, or branch 10
of state, city, urban-county, charter county, county, or consolidated local 11
government shall be considered a proper cost of administration. 12
(6) The policy or policies may contain the provisions with respect to the class or classes 13
of employees covered, amounts of insurance or coverage for designated classes or 14
groups of employees, policy options, terms of eligibility, and continuation of 15
insurance or coverage after retirement. 16
(7) Group rates under this section shall be made available to the disabled child of an 17
employee regardless of the child's age if the entire premium for the disabled child's 18
coverage is paid by the state employee. A child shall be considered disabled if he or 19
she has been determined to be eligible for federal Social Security disability benefits. 20
(8) The health care contract or contracts for employees shall be entered into for a 21
period of not less than one (1) year. 22
(9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of 23
State Health Insurance Subscribers to advise the secretary or the secretary's 24
designee regarding the state-sponsored health insurance program for employees. 25
The secretary shall appoint, from a list of names submitted by appointing 26
authorities, members representing school districts from each of the seven (7) 27 UNOFFICIAL COPY 25 RS BR 1414
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Supreme Court districts, members representing state government from each of the 1
seven (7) Supreme Court districts, two (2) members representing retirees under age 2
sixty-five (65), one (1) member representing local health departments, two (2) 3
members representing the Kentucky Teachers' Retirement System, and three (3) 4
members at large. The secretary shall also appoint two (2) members from a list of 5
five (5) names submitted by the Kentucky Education Association, two (2) members 6
from a list of five (5) names submitted by the largest state employee organization of 7
nonschool state employees, two (2) members from a list of five (5) names submitted 8
by the Kentucky Association of Counties, two (2) members from a list of five (5) 9
names submitted by the Kentucky League of Cities, and two (2) members from a 10
list of names consisting of five (5) names submitted by each state employee 11
organization that has two thousand (2,000) or more members on state payroll 12
deduction. The advisory committee shall be appointed in January of each year and 13
shall meet quarterly. 14
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 15
provided to employees pursuant to this section shall not provide coverage for 16
obtaining or performing an abortion, nor shall any state funds be used for the 17
purpose of obtaining or performing an abortion on behalf of employees or their 18
dependents. 19
(11) Interruption of an established treatment regime with maintenance drugs shall be 20
grounds for an insured to appeal a formulary change through the established appeal 21
procedures approved by the Department of Insurance, if the physician supervising 22
the treatment certifies that the change is not in the best interests of the patient. 23
(12) Any employee who is eligible for and elects to participate in the state health 24
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 25
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 26
state health insurance contribution toward health care coverage as a result of any 27 UNOFFICIAL COPY 25 RS BR 1414
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other employment for which there is a public employer contribution. This does not 1
preclude a retiree and an active employee spouse from using both contributions to 2
the extent needed for purchase of one (1) state sponsored health insurance policy 3
for that plan year. 4
(13) (a) The policies of health insurance coverage procured under subsection (2) of 5
this section shall include a mail-order drug option for maintenance drugs for 6
state employees. Maintenance drugs may be dispensed by mail order in 7
accordance with Kentucky law. 8
(b) A health insurer shall not discriminate against any retail pharmacy located 9
within the geographic coverage area of the health benefit plan and that meets 10
the terms and conditions for participation established by the insurer, including 11
price, dispensing fee, and copay requirements of a mail-order option. The 12
retail pharmacy shall not be required to dispense by mail. 13
(c) The mail-order option shall not permit the dispensing of a controlled 14
substance classified in Schedule II. 15
(14) The policy or policies provided to state employees or their dependents pursuant to 16
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 17
aid-related services for insured individuals under eighteen (18) years of age, subject 18
to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months 19
pursuant to KRS 304.17A-132. 20
(15) Any policy provided to state employees or their dependents pursuant to this section 21
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 22
consistent with KRS 304.17A-142. 23
(16) Any policy provided to state employees or their dependents pursuant to this section 24
shall provide coverage for obtaining amino acid-based elemental formula pursuant 25
to KRS 304.17A-258. 26
(17) If a state employee's residence and place of employment are in the same county, 27 UNOFFICIAL COPY 25 RS BR 1414
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and if the hospital located within that county does not offer surgical services, 1
intensive care services, obstetrical services, level II neonatal services, diagnostic 2
cardiac catheterization services, and magnetic resonance imaging services, the 3
employee may select a plan available in a contiguous county that does provide 4
those services, and the state contribution for the plan shall be the amount available 5
in the county where the plan selected is located. 6
(18) If a state employee's residence and place of employment are each located in 7
counties in which the hospitals do not offer surgical services, intensive care 8
services, obstetrical services, level II neonatal services, diagnostic cardiac 9
catheterization services, and magnetic resonance imaging services, the employee 10
may select a plan available in a county contiguous to the county of residence that 11
does provide those services, and the state contribution for the plan shall be the 12
amount available in the county where the plan selected is located. 13
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 14
in the best interests of the state group to allow any carrier bidding to offer health 15
care coverage under this section to submit bids that may vary county by county or 16
by larger geographic areas. 17
(20) Notwithstanding any other provision of this section, the bid for proposals for health 18
insurance coverage for calendar year 2004 shall include a bid scenario that reflects 19
the statewide rating structure provided in calendar year 2003 and a bid scenario that 20
allows for a regional rating structure that allows carriers to submit bids that may 21
vary by region for a given product offering as described in this subsection: 22
(a) The regional rating bid scenario shall not include a request for bid on a 23
statewide option; 24
(b) The Personnel Cabinet shall divide the state into geographical regions which 25
shall be the same as the partnership regions designated by the Department for 26
Medicaid Services for purposes of the Kentucky Health Care Partnership 27 UNOFFICIAL COPY 25 RS BR 1414
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Program established pursuant to 907 KAR 1:705; 1
(c) The request for proposal shall require a carrier's bid to include every county 2
within the region or regions for which the bid is submitted and include but not 3
be restricted to a preferred provider organization (PPO) option; 4
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 5
carrier all of the counties included in its bid within the region. If the Personnel 6
Cabinet deems the bids submitted in accordance with this subsection to be in 7
the best interests of state employees in a region, the cabinet may award the 8
contract for that region to no more than two (2) carriers; and 9
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 10
other requirements or criteria in the request for proposal. 11
(21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 12
after July 12, 2006, to public employees pursuant to this section which provides 13
coverage for services rendered by a physician or osteopath duly licensed under KRS 14
Chapter 311 that are within the scope of practice of an optometrist duly licensed 15
under the provisions of KRS Chapter 320 shall provide the same payment of 16
coverage to optometrists as allowed for those services rendered by physicians or 17
osteopaths. 18
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to 19
public employees pursuant to this section shall comply with: 20
(a) KRS 304.12-237; 21
(b) KRS 304.17A-270 and 304.17A-525; 22
(c) KRS 304.17A-600 to 304.17A-633; 23
(d) KRS 205.593; 24
(e) KRS 304.17A-700 to 304.17A-730; 25
(f) KRS 304.14-135; 26
(g) KRS 304.17A-580 and 304.17A-641; 27 UNOFFICIAL COPY 25 RS BR 1414
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(h) KRS 304.99-123; 1
(i) KRS 304.17A-138; 2
(j) KRS 304.17A-148; 3
(k) KRS 304.17A-163 and 304.17A-1631; 4
(l) KRS 304.17A-265; 5
(m) KRS 304.17A-261; 6
(n) KRS 304.17A-262; 7
(o) KRS 304.17A-145; 8
(p) KRS 304.17A-129; 9
(q) KRS 304.17A-133; 10
(r) KRS 304.17A-264;[ and] 11
(s) Section 9 of this Act; and 12
(t) Administrative regulations promulgated pursuant to statutes listed in this 13
subsection. 14
(23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to 15
public employees pursuant to this section shall provide a special enrollment 16
period to pregnant women who are eligible for coverage in accordance with 17
the requirements set forth in KRS 304.17-182. 18
(b) The Department of Employee Insurance shall, at or before the time a public 19
employee is initially offered the opportunity to enroll in the plan or coverage, 20
provide the employee a notice of the special enrollment rights under this 21
subsection. 22
Section 13. Sections 9, 11, and 12 of this Act apply to health benefit plans 23
issued or renewed on or after January 1, 2026. 24
Section 14. If the Department for Medicaid Services or the Cabinet for Health 25
and Family Services determines that a state plan amendment, waiver, or any other form 26
of authorization or approval from any federal agency is necessary prior to implementation 27 UNOFFICIAL COPY 25 RS BR 1414
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of Section 10 of this Act for any reason, including the loss of federal funds, the 1
department or cabinet shall, within 90 days after the effective date of this section, request 2
any necessary state plan amendment, waiver, authorization, or approval, and may only 3
delay full implementation of those provisions for which a state plan amendment, waiver, 4
authorization, or approval was deemed necessary until the state plan amendment, waiver, 5
authorization, or approval is granted or approved. 6
Section 15. The Department for Medicaid Services or the Cabinet for Health 7
and Family Services shall, in accordance with KRS 205.525, provide a copy of any state 8
plan amendment, waiver application, or other request for authorization or approval 9
submitted pursuant to Section 14 of this Act to the Legislative Research Commission for 10
referral to the Interim Joint Committees on Health Services and Appropriations and 11
Revenue and shall provide an update on the status of any application or request submitted 12
pursuant to Section 14 of this Act at the request of the Legislative Research Commission 13
or any committee thereof. 14
Section 16. All health facilities, health services, and health care providers, as 15
defined in Section 1 of this Act, shall have appropriate infrastructure in place to store and 16
label blood in accordance with Section 5 of this Act within 90 days of the effective date 17
of this section. 18
Section 17. Sections 9 to 13 of this Act take effect January 1, 2026. 19