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AN ACT relating to advisory oversight of the Medicaid program. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 205.540 is amended to read as follows: 3
(1) The Medicaid[An] Advisory Committee[Council for Medical Assistance] shall be 4
established in accordance with 42 C.F.R. sec. 431.12[the state government]. 5
(2) The Medicaid Advisory Committee shall advise the Cabinet for Health and 6
Family Services and the Department for Medicaid Services on matters related to 7
policy development and effective administration of the Medicaid program and 8
may advise on any topic identified in 42 C.F.R. sec. 431.12(g). 9
(3) The Medicaid Advisory Committee[council] shall consist of thirty-five (35)[twenty-10
two (22)] members as follows: 11
(a) The commissioner of the Department for Medicaid Services, or his or her 12
designee, who shall serve as an ex officio, nonvoting member and co-chair 13
of the committee; 14
(b) The commissioner of the Department for Public Health, or his or her 15
designee, who shall serve as an ex officio, nonvoting member of the 16
committee; 17
(c) The commissioner of the Department for Behavioral Health, Development 18
and Intellectual Disabilities, who shall serve as an ex officio, nonvoting 19
member of the committee; and 20
(d) The following thirty-two (32) members who[. The secretary for health and 21
family services shall be an ex officio member. The other twenty-one (21) 22
members of the council] shall be appointed by the commissioner of the 23
Department for Medicaid Services as follows and in accordance with 24
subsections (4) and (5) of this section:[Governor] 25
1. Fifteen (15) appointments shall be made one (1) from each list of 26
three (3) nominees submitted by the following organizations, or their 27 UNOFFICIAL COPY 25 RS BR 946
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successor organizations: 1
a. The Brain Injury Alliance of Kentucky; 2
b. The Kentucky Association of Health Care Facilities; 3
c. The Kentucky Association of Private Providers; 4
d. The Kentucky Association of Regional Programs; 5
e. The Kentucky Chapter of the American Academy of Pediatrics; 6
f. The Kentucky Dental Association; 7
g. The Kentucky Home Health Association; 8
h. The Kentucky Hospital Association; 9
i. The Kentucky Medical Equipment Suppliers Association; 10
j. The Kentucky Nurses' Association; 11
k. The Kentucky Optometric Association; 12
l. The Kentucky Pharmacists Associations; 13
m. The Kentucky Primary Care Association; 14
n. The Kentucky Psychological Association; and 15
o. Leading Age Kentucky; 16
2. Two (2) appointments shall be made from a list of five (5) nominees 17
submitted by the Kentucky Medical Association of which at least one 18
(1) shall be a licensed and Medicaid-enrolled obstetrician; 19
3. One (1) appointment shall be made from a list of three (3) nominees 20
submitted by the Kentucky Association of Health Plans who shall 21
represent current managed care organizations with whom the 22
Department for Medicaid Services has contracted for the delivery of 23
Medicaid services; 24
4. Eight (8) appointments shall be made from the membership of the 25
Beneficiary Advisory Council established in Section 4 of this Act; and 26
5. The other six (6) appointive members shall, to ensure that membership 27 UNOFFICIAL COPY 25 RS BR 946
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of the committee is representative of the varied experiences of 1
Medicaid beneficiaries, be healthcare advocates knowledgeable about 2
health care and the healthcare industry of which: 3
a. One (1) shall be a representative of a recognized consumer 4
advocacy group representing the elderly; 5
b. One (1) shall be a representative of a recognized consumer 6
advocacy group representing individuals with behavioral health 7
needs; 8
c. One (1) shall be a representative of a recognized consumer 9
advocacy group representing persons reentering society 10
following incarceration; and 11
d. Three (3) shall be representatives of recognized consumer 12
advocacy groups whose membership includes low-income 13
individuals, children and youth, women, minorities, and disabled 14
persons. 15
(4) (a) Members of the Medicaid Advisory Committee appointed pursuant to 16
subsection (3)(d) of this section[ and] shall hold office for a term of not more 17
than four (4) years, except that: 18
1. The member appointed pursuant to subsection (3)(d)3. shall serve a 19
term of one (1) year; and 20
2. The other members first appointed upon the creation of the committee 21
shall serve as follows: 22
a. One-third (1/3) of the members shall be appointed for a term of 23
two (2) years; 24
b. One-third (1/3) of the members shall be appointed for a term of 25
three (3) years; and 26
c. One-third (1/3) of the members shall be appointed for a term of 27 UNOFFICIAL COPY 25 RS BR 946
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four (4) years; 1
with the respective terms of each member initially appointed upon 2
creation of the committee being designated by the commissioner at the 3
time of their appointments.[ and until their successors are appointed and 4
qualify, except that the members appointed to fill the first vacancy 5
occurring for a term beginning on July 1, 1960, shall be as follows: Two 6
(2) members shall be appointed for one (1) year, two (2) for two (2) 7
years, two (2) for three (3) years, and three (3) for four (4) years, and the 8
respective terms of the first members shall be designated by the 9
Governor at the time of their appointments.] Upon the expiration of the 10
respective terms of the members first appointed upon creation of the 11
committee, the term of each successor shall be for four (4) years[ and 12
until his successor is appointed and qualified. Thirteen (13) of the 13
appointments shall be made one (1) from each list of three (3) nominees 14
submitted by the following organizations: the Kentucky State Medical 15
Association; the Kentucky Dental Association; the Kentucky Hospital 16
Association; the Kentucky Medical Equipment Suppliers Association; 17
the Kentucky Pharmacists Association; the Kentucky Association of 18
Health Care Facilities; the Kentucky Nurses' Association; the State 19
Board of Podiatry; the Kentucky Home Care Association; the Kentucky 20
Optometric Association; the Kentucky Primary Care Association; the 21
Kentucky Association of Hospice and Palliative Care; and the Kentucky 22
Association of Homes and Services for the Aging, Inc. The other eight 23
(8) appointive members shall be healthcare advocates knowledgeable 24
about health care and the healthcare industry, and shall include three (3) 25
medical assistance recipients; one (1) representative of a recognized 26
consumer advocacy group representing the elderly; one (1) 27 UNOFFICIAL COPY 25 RS BR 946
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representative of a recognized consumer advocacy group representing 1
persons reentering society following incarceration; and three (3) 2
representatives of recognized consumer advocacy groups whose 3
membership includes low-income persons, children and youth, women, 4
minorities, and disabled persons]. 5
(b) A member of the committee appointed pursuant to subsection (3)(d) of this 6
section shall not serve more than one (1) consecutive term after which time 7
he or she may not be reappointed to the board for a period of at least four 8
(4) years. 9
(5)[(2)] Each appointed[appointive] member of the Medicaid Advisory Committee[ 10
Council] shall serve without compensation, but each council member not otherwise 11
compensated for his or her time or expenses shall be entitled to reimbursement for 12
his or her actual and necessary expenses in carrying out his or her duties with 13
reimbursement for expenses being made in accordance with state regulations 14
relating to travel reimbursement. 15
(6)[(3)] Vacancies shall be filled for the unexpired term in the same manner as 16
original appointments, maintaining representations as set out in subsection (3)[(1)] 17
of this section. 18
(7)[(4)] The Medicaid Advisory Committee[council] shall elect a co-chair, 19
vicechair[chairman, vice chairman], and secretary from among its members at its 20
first regular meeting in each fiscal year and shall adopt rules governing its 21
proceedings. The committee[council] shall hold a meeting at least once every three 22
(3) months and such other special or regular meetings as may be desired. 23
(8)[(5)] The six (6) members appointed pursuant to subsection (3)(d)5. of this 24
section[eight (8) appointive members who are healthcare advocates] shall not have 25
a fiduciary relationship or interest in any healthcare[health-care] facility or service. 26
Section 2. KRS 205.550 is amended to read as follows: 27 UNOFFICIAL COPY 25 RS BR 946
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(1) The Medicaid Advisory Committee and the Beneficiary Advisory Council[council] 1
shall advise the Cabinet for Health and Family Services about health and medical 2
care services. 3
(2) The Medicaid Advisory Committee and the Beneficiary Advisory Council[council] 4
shall have the opportunity for participation in policy development and program 5
administration and shall advise the Cabinet for Health and Family Services on such 6
matters. 7
(3) The Medicaid Advisory Committee and the Beneficiary Advisory Council[council] 8
shall give advice regarding how to further the participation of recipient members in 9
the policy development and program administration of the Medical Assistance 10
Program. 11
Section 3. KRS 205.590 is amended to read as follows: 12
(1) The following technical advisory committees shall be established for the purpose of 13
acting in an advisory capacity to the Medicaid Advisory Committee[Advisory 14
Council for Medical Assistance] with respect to the administration of the Medical 15
Assistance Program and in performing the function of peer review: 16
(a) A Technical Advisory Committee on Physician Services consisting of five (5) 17
physicians appointed by the council of the Kentucky State Medical 18
Association; 19
(b) A Technical Advisory Committee on Hospital Care consisting of five (5) 20
hospital administrators appointed by the board of trustees of the Kentucky 21
Hospital Association; 22
(c) A Technical Advisory Committee on Dental Care consisting of five (5) 23
dentists appointed by the Kentucky Dental Association; 24
(d) A Technical Advisory Committee on Nursing Service consisting of five (5) 25
nurses appointed by the board of directors of the Kentucky State Association 26
of Registered Nurses; 27 UNOFFICIAL COPY 25 RS BR 946
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(e) A Technical Advisory Committee on Nursing Home Care consisting of six (6) 1
members of which five (5) members shall be appointed by the Kentucky 2
Association of Health Care Facilities, and one (1) member shall be appointed 3
by the Kentucky Association of Nonprofit Homes and Services for the Aging, 4
Inc.; 5
(f) A Technical Advisory Committee on Optometric Care consisting of five (5) 6
members appointed by the Kentucky Optometric Association; 7
(g) A Technical Advisory Committee on Podiatric Care consisting of five (5) 8
podiatrists appointed by the Kentucky Podiatry Association; 9
(h) A Technical Advisory Committee on Primary Care consisting of five (5) 10
primary care providers, two (2) of whom shall represent licensed health 11
maintenance organizations, appointed by the Governor, until such time as an 12
association of primary care providers is established, whereafter the association 13
shall appoint the members; 14
(i) A Technical Advisory Committee on Home Health Care consisting of five (5) 15
members appointed by the board of directors of the Kentucky Home Health 16
Association; 17
(j) A Technical Advisory Committee on Consumer Rights and Client Needs 18
consisting of seven (7) members, with one (1) member to be appointed by 19
each of the following organizations: the American Association of Retired 20
Persons Kentucky, the Family Resource Youth Services Coalition of 21
Kentucky, the Kentucky Association of Community Health Workers, the 22
Kentucky Legal Services Corporation, the Arc of Kentucky, the Department 23
of Public Advocacy, and the National Association of Social Workers-24
Kentucky Chapter; 25
(k) A Technical Advisory Committee on Behavioral Health consisting of seven 26
(7) members, with one (1) member to be appointed by each of the following 27 UNOFFICIAL COPY 25 RS BR 946
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organizations: the Kentucky Mental Health Coalition, the Kentucky 1
Association of Regional Programs, the National Alliance on Mental Illness 2
(NAMI) Kentucky, a statewide mental health consumer organization, the 3
People Advocating Recovery (PAR), the Brain Injury Association of 4
America-Kentucky Chapter, and the Kentucky Brain Injury Alliance; 5
(l) A Technical Advisory Committee on Children's Health consisting of ten (10) 6
members, with one (1) member to be appointed by each of the following 7
organizations: the Kentucky Chapter of the American Academy of Pediatrics, 8
the Kentucky PTA, the Kentucky Psychological Association, the Kentucky 9
School Nurses Association, the Kentucky Association for Early Childhood 10
Education, the Family Resource and Youth Services Coalition of Kentucky, 11
the Kentucky Youth Advocates, the Kentucky Association of Hospice and 12
Palliative Care, a parent of a child enrolled in Medicaid or the Kentucky 13
Children's Health Insurance Program appointed by the Kentucky Head Start 14
Association, and a pediatric dentist appointed by the Kentucky Dental 15
Association; 16
(m) A Technical Advisory Committee on Intellectual and Developmental 17
Disabilities consisting of nine (9) members, one (1) of whom shall be a 18
consumer who participates in a nonresidential community Medicaid waiver 19
program, one (1) of whom shall be a consumer who participates in a 20
residential community Medicaid waiver program, one (1) of whom shall be a 21
consumer representative of a family member who participates in a community 22
Medicaid waiver program, and one (1) of whom shall be a consumer 23
representative of a family member who resides in an ICF/ID facility that 24
accepts Medicaid payments, all of whom shall be appointed by the Governor; 25
one (1) member shall be appointed by the Arc of Kentucky; one (1) member 26
shall be appointed by the Commonwealth Council on Developmental 27 UNOFFICIAL COPY 25 RS BR 946
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Disabilities; one (1) member shall be appointed by the Kentucky Association 1
of Homes and Services for the Aging; and two (2) members shall be 2
appointed by the Kentucky Association of Private Providers, one (1) of whom 3
shall be a nonprofit provider and one (1) of whom shall be a for-profit 4
provider; 5
(n) A Technical Advisory Committee on Therapy Services consisting of six (6) 6
members, two (2) of whom shall be occupational therapists and shall be 7
appointed by the Kentucky Occupational Therapists Association, two (2) of 8
whom shall be physical therapists and shall be appointed by the Kentucky 9
Physical Therapy Association, and two (2) of whom shall be speech therapists 10
and shall be appointed by the Kentucky Speech-Language-Hearing 11
Association; 12
(o) A Technical Advisory Committee on Pharmacy consisting of seven (7) 13
members, two (2) of whom shall be Kentucky licensed pharmacists who own 14
fewer than ten (10) pharmacies in the Commonwealth and shall be appointed 15
by the Kentucky Independent Pharmacy Alliance, two (2) of whom shall be 16
Kentucky licensed pharmacists and shall be appointed by the Kentucky 17
Pharmacy Association, and one (1) member to be appointed by each of the 18
following organizations: the Kentucky Hospital Association, the Kentucky 19
Primary Care Association, and the National Association of Chain Drug 20
Stores; 21
(p) A Technical Advisory Committee on Persons Returning to Society from 22
Incarceration consisting of twelve (12) members of whom: 23
1. One (1) shall be appointed by each of the following organizations: the 24
Kentucky Jailers Association, the Kentucky Medical Association, the 25
Kentucky Association of Nurse Practitioners and Nurse-Midwives, 26
Community Action of Kentucky, the Homeless and Housing Coalition 27 UNOFFICIAL COPY 25 RS BR 946
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of Kentucky, the Kentucky Office of Drug Control Policy, a Kentucky 1
civil legal aid program, the Kentucky Department of Corrections, the 2
Kentucky Department of Public Advocacy, the Kentucky Association of 3
Regional Programs, and the Kentucky Administrative Office of the 4
Courts; and 5
2. One (1) formerly incarcerated individual who is a current or former 6
Medicaid recipient shall be appointed by Mental Health America of 7
Kentucky; and 8
(q) A Technical Advisory Committee on Emergency Medical Services consisting 9
of seven (7) members, one (1) of whom shall represent the air medical 10
industry and shall be appointed by the Kentucky Chapter of the Association of 11
Air Medical Services; one (1) of whom shall be appointed by the Kentucky 12
Board of Emergency Medical Services; two (2) of whom shall represent the 13
emergency medical services billing industry and shall be members of and 14
appointed by the Kentucky Ambulance Providers Association; two (2) of 15
whom shall represent ground ambulance providers and shall be appointed by 16
the Kentucky Ambulance Providers Association; and one (1) of whom shall 17
represent a fire-based emergency medical service and shall be appointed by 18
the Kentucky Association of Fire Chiefs. All members appointed to this 19
committee shall represent emergency medical services providers that operate 20
in Kentucky and shall have experience in interpreting, implementing, or 21
ensuring compliance with Medicaid regulations. 22
(2) The members of the technical advisory committees shall each serve for a term of 23
four (4) years and until their successors are appointed and qualified. Members of 24
the technical advisory committees shall not serve more than one (1) consecutive 25
term, after which time a member may not be reappointed to a technical advisory 26
committee for a period of at least four (4) years. 27 UNOFFICIAL COPY 25 RS BR 946
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(3) Each appointed[appointive] member of a committee shall serve without 1
compensation but shall be entitled to reimbursement for actual and necessary 2
expenses in carrying out their duties with reimbursement for expenses being made 3
in accordance with state regulations relating to travel reimbursement. 4
SECTION 4. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 5
READ AS FOLLOWS: 6
(1) The Beneficiary Advisory Council shall be established in accordance with 42 7
C.F.R. sec. 431.12. 8
(2) The Beneficiary Advisory Council shall advise the Cabinet for Health and Family 9
Services and the Department for Medicaid Services on matters related to policy 10
development and effective administration of the Medicaid program and may 11
advise on any topic identified in 42 C.F.R. sec. 431.12(g). 12
(3) The Beneficiary Advisory Council shall: 13
(a) Be separate from the Medicaid Advisory Committee established in Section 1 14
of this Act; 15
(b) Meet separately from the Medicaid Advisory Committee; 16
(c) Meet in advance of each Medicaid Advisory Committee meeting in order to 17
prepare council members for meetings of the committee; and 18
(d) Consist of the following nineteen (19) members appointed by the 19
commissioner of the Department for Medicaid Services in accordance with 20
subsections (4) and (5) of this section: 21
1. Eight (8) current Medicaid beneficiaries; 22
2. Five (5) former Medicaid beneficiaries; 23
3. Four (4) individuals who are the parents or guardians of a current 24
Medicaid beneficiary; and 25
4. Two (2) individuals who are paid or unpaid caregivers of a Medicaid 26
beneficiary. 27 UNOFFICIAL COPY 25 RS BR 946
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(4) In appointing members to the council, the commissioner of the Department for 1
Medicaid Services shall ensure that the council membership consist of 2
individuals who are currently or were previously Medicaid beneficiaries, have 3
direct experience supporting Medicaid beneficiaries including family members or 4
paid or unpaid caregivers of individuals enrolled in Medicaid, or who may have 5
experience with Medicaid managed care organizations, the foster care system, 6
1915(c) waivers, or behavioral health services. 7
(5) (a) Members of the Beneficiary Advisory Council shall serve for a term of not 8
more than four (4) years, except that the members first appointed upon 9
creation of the council shall serve as follows: 10
1. One-third (1/3) of the members shall be appointed for a term of two (2) 11
years; 12
2. One-third (1/3) of the members shall be appointed for a term of three 13
(3) years; and 14
3. One-third (1/3) of the members shall be appointed for a term of four 15
(4) years; 16
with the respective terms of each member initially appointed upon creation 17
of the council being designated by the commissioner at the time of their 18
appointments. 19
(b) A member of the council shall not serve more than one (1) consecutive term 20
after which time he or she may not be reappointed to the board for a period 21
of at least four (4) years. 22
(6) Members of the Beneficiary Advisory Council, including those who also serve on 23
the Medicaid Advisory Committee, shall be entitled to reimbursement, if 24
requested, for his or her actual and necessary expenses in carrying out his or her 25
duties with reimbursement for expenses being made in accordance with state 26
regulations relating to travel reimbursement. 27 UNOFFICIAL COPY 25 RS BR 946
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(7) Meetings of the Beneficiary Advisory Council shall be exempt from KRS 61.800 1
to 61.884. Consistent with 42 C.F.R. 431.12, a member of the council shall have 2
the option to include or exclude his or her name from documents posted by the 3
Department for Medicaid Services that include a list of members of the 4
Beneficiary Advisory Council, the Medicaid Advisory Committee, or the actions 5
of members record in publicly post meeting minutes. 6