UNOFFICIAL COPY 25 RS BR 1804
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AN ACT relating to fiscal impact statements. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
ď˘Section 1. KRS 6.948 is amended to read as follows: 3
(1) As used in this section: 4
(a) "Amendment" includes a committee substitute; 5
(b) "Department" means the Department of Insurance; 6
(c) "Federal cost defrayal impact statement" means a statement prepared and 7
transmitted in accordance with subsection (6) of this section; 8
(d) "Health benefit plan" has the same meaning as in KRS 304.17A-005, except 9
that for purposes of this section the term does not include: 10
1. A state employee health plan; or 11
2. Any other self-insured policy, certificate, plan, or contract; 12
(e) "Health mandate impact statement" means a statement prepared and 13
transmitted in accordance with subsection (5) of this section; 14
(f) "Mandated health benefit" means a requirement that any health benefit plan or 15
state employee health plan: 16
1. Provide a specified benefit, including but not limited to a specified 17
coverage; 18
2. Pay, indemnify, or reimburse for a specified medical service; or 19
3. Pay, indemnify, or reimburse specified health care providers for specific 20
health care services; 21
(g) "Sponsor" means a member of the General Assembly that has made a request 22
to the Legislative Research Commission for a bill or amendment; 23
(h) "State employee health plan" means any fully insured health benefit plan or 24
self-insured plan issued or renewed to public employees under KRS 18A.225 25
or 18A.2254; and 26
(i) "State employee health plan impact statement" means a statement prepared 27 UNOFFICIAL COPY 25 RS BR 1804
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and transmitted in accordance with subsection (7) of this section. 1
(2) (a) Any bill or amendment that contains a mandated health benefit shall be 2
identified by the staff of, and on a form specified by, the Legislative Research 3
Commission. 4
(b) If a bill or amendment is identified as having a mandated health benefit under 5
paragraph (a) of this subsection, the staff of the Legislative Research 6
Commission shall: 7
1. Notify the sponsor of the bill or amendment that a health mandate 8
impact statement, federal cost defrayal impact statement, and state 9
employee health plan impact statement, as applicable, are required; and 10
2. Upon introduction, adoption, or filing of the legislation: 11
a. For a mandated health benefit that applies to any health benefit 12
plan, request the department to prepare and transmit a health 13
mandate impact statement and federal cost defrayal impact 14
statement in accordance with this section; and 15
b. For a mandated health benefit that applies to any state employee 16
health plan, request the Department of Employee Insurance to 17
prepare and transmit a state employee health plan impact statement 18
in accordance with this section. 19
(3) (a) The individuals referenced in paragraph (b) of this subsection may, in 20
accordance with that paragraph, request the department or the Department of 21
Employee Insurance, as applicable, to prepare any or all of the following: 22
1. A health mandate impact statement; 23
2. A federal cost defrayal impact statement; or 24
3. A state employee health plan impact statement. 25
(b) Any or all of the following may make a request under paragraph (a) of this 26
subsection: 27 UNOFFICIAL COPY 25 RS BR 1804
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1. For any introduced bill or adopted or filed amendment: 1
a. The sponsor of the bill or amendment; or 2
b. Any of the following members from a chamber of the General 3
Assembly with possession of the legislation: 4
i. Any member of the majority or minority leadership; or 5
ii. A chair of a standing committee; and 6
2. For any bill or amendment that has not been introduced, filed, or 7
adopted, the sponsor of the bill or amendment. 8
(4) (a) Except as provided in paragraph (b) of this subsection, when a request is made 9
under this section, the department or Department of Employee Insurance, 10
including its staff and third-party contractors, shall: 11
1. Keep the bill or amendment confidential until the bill or amendment is 12
published for public distribution by the Legislative Research 13
Commission; and 14
2. Keep the impact statement, including the request for the statement and 15
any information relating thereto, confidential until the statement is 16
published for public distribution by the Legislative Research 17
Commission. 18
(b) Paragraph (a) of this subsection shall not apply to any communications with 19
or transmittals to: 20
1. Staff or third-party contractors designated by the department or 21
Department of Employee Insurance to receive and prepare the impact 22
statements required under this section; 23
2. Staff designated by the Legislative Research Commission; 24
3. The requester; or 25
4. Any other person designated by the requester. 26
(c) Any health mandate impact statement, federal cost defrayal impact statement, 27 UNOFFICIAL COPY 25 RS BR 1804
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or state employee health plan impact statement requested under this section 1
shall be prepared and transmitted by the department or Department of 2
Employee Insurance as provided in this section. 3
(5) A health mandate impact statement shall: 4
(a) Be in writing; 5
(b) Be signed by the commissioner of the department or the commissioner's 6
designee; 7
(c) Determine the extent to which the mandated health benefit will: 8
1. Increase or decrease administrative expenses of insurers offering health 9
benefit plans; 10
2. Increase or decrease health benefit plan premiums in the market or 11
markets to which the mandate applies; and 12
3. Impact the total cost of health care for health benefit plan insureds, 13
which shall include[including] any potential future cost savings that 14
may be realized;[ and] 15
(d) 1. Provide any documentation, studies, written opinions, calculations, 16
and citations in support of the commissioner's or his or her designee's 17
findings and conclusions; 18
2. Include in the statement an estimate of any potential future cost 19
savings, with an explanation why the bill would or would not provide 20
future cost savings; and 21
3. Include a certification by the commissioner or his or her designee that 22
the information provided is accurate; and 23
(e)[(d)] Be completed and transmitted to staff designated by the Legislative 24
Research Commission and the requester as soon as possible, but not later than 25
thirty (30) days after the request is made to the department, unless the 26
requestor and commissioner of the department agree otherwise. 27 UNOFFICIAL COPY 25 RS BR 1804
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(6) (a) A federal cost defrayal impact statement shall: 1
1. Be in writing; 2
2. Be signed by the commissioner of the department or the commissioner's 3
designee; 4
3. a. Indicate: 5
i. Whether a bill or amendment that contains a mandated health 6
benefit may result in the state being required to make 7
payments to defray costs under 42 U.S.C. sec. 18031(d)(3) 8
and 45 C.F.R. sec. 155.170, as amended; and 9
ii. If applicable, which provision or provisions of the bill or 10
amendment may trigger the requirement to make payments 11
to defray costs under 42 U.S.C. sec. 18031(d)(3) and 45 12
C.F.R. sec. 155.170, as amended. 13
b. When making a determination under subdivision a. of this 14
subparagraph, the department shall consider whether the provision 15
or provisions would apply under KRS 304.17A-099(2); 16
4. If it is indicated under subparagraph 3. of this paragraph that the bill or 17
amendment may result in the state being required to make payments, 18
include a cost defrayal fiscal analysis prepared in accordance with 19
paragraph (b) of this subsection;[ and] 20
5. Comply with paragraph (c) of this subsection; and 21
6. Be completed and transmitted to staff designated by the Legislative 22
Research Commission and the requestor as soon as possible, but not 23
later than the following, unless the requestor and the commissioner of 24
the department agree otherwise: 25
a. For an indication required under subparagraph 3. of this paragraph, 26
ten (10) business days after the request is made to the department; 27 UNOFFICIAL COPY 25 RS BR 1804
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and 1
b. For a cost defrayal fiscal analysis required under subparagraph 4. 2
of this paragraph, thirty (30) days after the request is made to the 3
department. 4
(b) A cost defrayal fiscal analysis shall: 5
1. Be conducted by: 6
a. The department; and 7
b. An actuary selected by the department; 8
2. Be based on an analysis performed in accordance with generally 9
accepted actuarial principles and methodologies; 10
3. Determine the extent to which benefits required under the bill or 11
amendment are already covered by health insurers; and 12
4. Include an estimate of the payments the state may be required to make 13
under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as 14
amended, if the bill or amendment is enacted into law. 15
(c) In addition to the requirements of paragraphs (a) and (b) of this subsection, 16
the federal cost defrayal impact statement shall: 17
1. Provide any documentation, studies, written opinions, calculations, 18
and citations in support of the commissioner's or his or her designee's 19
findings and conclusions; and 20
2. Include a certification by the commissioner or his or her designee that 21
the information provided is accurate. 22
(7) A state employee health plan impact statement shall: 23
(a) Be in writing; 24
(b) Be signed by the commissioner of the Department of Employee Insurance or 25
the commissioner's designee; 26
(c) Determine the extent to which: 27 UNOFFICIAL COPY 25 RS BR 1804
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1. The mandated health benefit will increase or decrease state employee 1
health plan premiums;[ and] 2
2. The increased or decreased premiums identified in subparagraph 1. of 3
this paragraph may be passed on to state employee health plan 4
insureds[public employees]; and 5
3. The mandated health benefit will impact the total cost of health care 6
for state employee health plan insureds, which shall include any 7
potential future cost savings that may be realized; 8
(d) 1. Provide any documentation, studies, written opinions, calculations, 9
and citations in support of the commissioner's or his or her designee's 10
findings and conclusions; 11
2. Include in the statement an estimate of any potential future cost 12
savings, with an explanation why the bill would or would not provide 13
future cost savings; and 14
3. Include a certification by the commissioner or his or her designee that 15
the information provided is accurate; and 16
(e) Be completed and transmitted to staff designated by the Legislative Research 17
Commission and the requester as soon as possible, but not later than thirty 18
(30) days after the request is made to the Department of Employee Insurance, 19
unless the requestor and commissioner of the Department of Employee 20
Insurance agree otherwise. 21