AN ACT relating to coverage for perinatal mood and anxiety disorders screenings.

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AN ACT relating to coverage for perinatal mood and anxiety disorders screenings. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 3
READ AS FOLLOWS: 4
The Department for Medicaid Services and any managed care organization with which 5
the department contracts for the delivery of Medicaid services shall all ow perinatal 6
mood and anxiety disorders screenings for any accompanying parent or legal guardian 7
of a covered child that is less than two (2) years of age to be claimed as a service for the 8
child as part of the early and periodic screening, diagnostic, and treatment benefit 9
required under 42 U.S.C. sec. 1396a(a)(10), as amended, and described in 42 U.S.C. 10
sec. 1396d(a)(4)(B), as amended. 11
Section 2. KRS 205.6497 is amended to read as follows: 12
(1) As permitted by federal la w, in any plan submitted for federal Title XXI approval 13
of a children's health insurance program for Kentucky, the cabinet shall include 14
provisions for a preventive health insurance program for children with no 15
copayment, deductible, coinsurance, or premium. 16
(2) The plan referred to in subsection (1) of this section shall include: 17
(a) Preventive dental services, tooth extraction, and emergency dental services; [ 18
and] 19
(b) Coverage for certain s ervices rendered by certified community health 20
workers, as defined in KRS 309.460, equivalent to the coverage requirements 21
established in KRS 205.648; and 22
(c) Coverage for perinatal mood and anxiety disorders screenings for any 23
accompanying parent or legal guardian of a beneficiary that is less than two 24
(2) years of age provided in conjunction with preventive services rendered to 25
the beneficiary. 26
SECTION 3. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 27
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IS CREATED TO READ AS FOLLOWS: 1
(1) As used in this section, "health plan": 2
(a) Means any health insurance policy, certificate, contract, or plan that offers 3
or provides coverage in this state for a well -child visit, including well -baby 4
visits, whether such coverage is: 5
1. By direct payment, reimbursement, or otherwise; and 6
2. On a fully insured or self -insured basis or any combination thereof; 7
and 8
(b) Includes but is not limited to a health benefit plan. 9
(2) To the extent permitted by federal law and except as provided in subsection (5) of 10
this section, coverage under a health plan for a well -child visit, including a well -11
baby visit, shall include coverage for perinatal mood and anxiety disorders 12
screenings for any accompanying parent or legal guardian of a covered child that 13
is less than two (2) years of age. 14
(3) Except as provided in subsection (4) of this section, the coverage required by this 15
section shall not be subject to cost sharing. 16
(4) If the application of any requirement of this section would be the sole cause of a 17
health plan's failure to qualify as a Health Savings Account -qualified High 18
Deductible Health Plan under 26 U.S.C. sec. 223, as amended, then the 19
requirement shall not apply to that health plan until the minimum deductible 20
under 26 U.S.C. sec. 223, as amended, is satisfied. 21
(5) If the application of any requirement of this section to a qualified health plan, as 22
defined in 42 U.S.C. sec. 18021(a)(1), as amended, results, or would result, in a 23
determination that the state must make payments to defray the c ost of the 24
requirement under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as 25
amended, then the requirement shall not apply to the qualified health plan until 26
the requirement to make cost defrayal payments is no longer applicable. 27
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Section 4. KRS 304.17A-099 is amended to read as follows: 1
(1) As used in this section, "qualified health plan" has the same meaning as in 42 2
U.S.C. sec. 18021(a)(1), as amended. 3
(2) Notwithstanding any other provision of this chapter: 4
(a) Except as provided in paragraph (b) of this subsection, if the application of a 5
provision of this chapter results, or would result, in a determination that the 6
state must make payments to defray the cost of the provision under 42 U.S.C. 7
sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the provision 8
shall not apply to a qualified health plan or any other health insurance policy, 9
certificate, plan, or contract until the requirement to make cost defrayal 10
payments is no longer applicable; and 11
(b) This subsection shall not apply to any of the following: 12
1. A provision of this chapter that became effective on or before January 1, 13
2024; or 14
2. Section 3 of this Act. 15
(3) To the extent permitted by federal law, if the state is required under 42 U.S.C. sec. 16
18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, to make payments to defray 17
the cost of a provision of this chapter: 18
(a) 1. Each qualified health plan issuer shall determine, and provide to the 19
commissioner, the cost attributable to the provision f or the qualified 20
health plan. 21
2. The cost attributable to a provision for a qualified health plan under 22
subparagraph 1. of this paragraph shall be: 23
a. Calculated in accordance with generally accepted actuarial 24
principles and methodologies; 25
b. Conducted by a member of the American Academy of Actuaries; 26
and 27
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c. Reported by the qualified health plan issuer to: 1
i. The commissioner; and 2
ii. The Division of Health Benefit Exchange within the Office 3
of Data Analytics; 4
(b) The commissioner shall use the information obtained under paragraph (a) of 5
this subsection to determine the statewide average of the cost attributable to 6
the provision for all qualified health plan issuers to which the provision is 7
applicable; and 8
(c) The required payments shall be: 9
1. Calculated based on the statewide average of the cost attributable to the 10
provision as determined by the commissioner under paragraph (b) of this 11
subsection; and 12
2. Submitted directly to qualified health plan issuers by the department 13
through a process established by the commissioner. 14
(4) A qualified health plan issuer that receives a payment under subsection (3)(c)2. of 15
this section shall: 16
(a) Reduce the premium charged to an individual on whose behalf the issuer 17
received the payment in an amount equal to the amount of the payment; or 18
(b) Notwithstanding KRS 304.12-090, provide a premium rebate to an individual 19
on whose behalf the issuer received the payment in an amount equal to the 20
amount of the payment. 21
(5) Any fines collected for violations of this section shall be: 22
(a) Placed in a trust and agency account within the department, which shall not 23
lapse; and 24
(b) Used solely by the department to make payments in accordance with 25
subsection (3)(c)2. of this section. 26
(6) The commissioner shall promulgate any a dministrative regulations necessary to 27
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enforce and effectuate this section. 1
Section 5. KRS 164.2871 is amended to read as follows: 2
(1) The governing board of each state postsecondary educational institution is 3
authorized to purchase liability insurance for the protection of the individual 4
members of the governing board, faculty, and staff of such institutions from liability 5
for acts and omissions committed in the course and scope of the individual's 6
employment or service. Each institution may purchase the type and amount of 7
liability coverage deemed to best serve the interest of such institution. 8
(2) All retirement annuity allowances accrued or accruing to any employee of a state 9
postsecondary educational institution throu gh a retirement program sponsored by 10
the state postsecondary educational institution are hereby exempt from any state, 11
county, or municipal tax, and shall not be subject to execution, attachment, 12
garnishment, or any other process whatsoever, nor shall any assignment thereof be 13
enforceable in any court. Except retirement benefits accrued or accruing to any 14
employee of a state postsecondary educational institution through a retirement 15
program sponsored by the state postsecondary educational institution on or after 16
January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent 17
provided in KRS 141.010 and 141.0215. 18
(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 19
members of governing boards, faculty and staff of institutions of higher education 20
in this state shall not be construed to be a waiver of sovereign immunity or any 21
other immunity or privilege. 22
(4) The governing board of each state postsecondary education institution is authorized 23
to provide a self -insured employer group health plan to its employees, which plan 24
shall: 25
(a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and 26
(b) Except as provided in subsection (5) of this section, be exempt from 27
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conformity with Subtitle 17A of KRS Chapter 304. 1
(5) A self -insured employer group health plan provided by the governing board of a 2
state postsecondary education institution to its employees shall comply with: 3
(a) KRS 304.17A-129; 4
(b) KRS 304.17A-133; 5
(c) KRS 304.17A-145; 6
(d) KRS 304.17A-163 and 304.17A-1631; 7
(e) KRS 304.17A-261; 8
(f) KRS 304.17A-262; 9
(g) KRS 304.17A-264;[ and] 10
(h) KRS 304.17A-265; and 11
(i) Section 3 of this Act. 12
(6) (a) A self-insured employer group health plan provided by the governing board of 13
a state postseco ndary education institution to its employees shall provide a 14
special enrollment period to pregnant women who are eligible for coverage in 15
accordance with the requirements set forth in KRS 304.17-182. 16
(b) The governing board of a state postsecondary educati on institution shall, at or 17
before the time an employee is initially offered the opportunity to enroll in the 18
plan or coverage, provide the employee a notice of the special enrollment 19
rights under this subsection. 20
Section 6. KRS 18A.225 is amended to read as follows: 21
(1) (a) The term "employee" for purposes of this section means: 22
1. Any person, including an elected public official, who is regularly 23
employed by any department, office, board, agency, or branch of state 24
government; or by a public postsecondary educational institution; or by 25
any city, urban -county, charter county, county, or consolidated local 26
government, whose legislative body has opted to participate in the state -27
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sponsored health insurance program pursuant t o KRS 79.080; and who 1
is either a contributing member to any one (1) of the retirement systems 2
administered by the state, including but not limited to the Kentucky 3
Retirement Systems, County Employees Retirement System, Kentucky 4
Teachers' Retirement System , the Legislators' Retirement Plan, or the 5
Judicial Retirement Plan; or is receiving a contractual contribution from 6
the state toward a retirement plan; or, in the case of a public 7
postsecondary education institution, is an individual participating in an 8
optional retirement plan authorized by KRS 161.567; or is eligible to 9
participate in a retirement plan established by an employer who ceases 10
participating in the Kentucky Employees Retirement System pursuant to 11
KRS 61.522 whose employees participated in the health insurance plans 12
administered by the Personnel Cabinet prior to the employer's effective 13
cessation date in the Kentucky Employees Retirement System; 14
2. Any certified or classified employee of a local board of education or a 15
public charter school as defined in KRS 160.1590; 16
3. Any elected member of a local board of education; 17
4. Any person who is a present or future recipient of a retirement 18
allowance from the Kentucky Retirement Systems, County Employees 19
Retirement System, Kentucky Teachers' Retireme nt System, the 20
Legislators' Retirement Plan, the Judicial Retirement Plan, or the 21
Kentucky Community and Technical College System's optional 22
retirement plan authorized by KRS 161.567, except that a person who is 23
receiving a retirement allowance and who is age sixty-five (65) or older 24
shall not be included, with the exception of persons covered under KRS 25
61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively 26
employed pursuant to subparagraph 1. of this paragraph; and 27
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5. Any eligible dependents and beneficiaries of participating employees 1
and retirees who are entitled to participate in the state -sponsored health 2
insurance program; 3
(b) The term "health benefit plan" for the purposes of this section means a health 4
benefit plan as defined in KRS 304.17A-005; 5
(c) The term "insurer" for the purposes of this section means an insurer as defined 6
in KRS 304.17A-005; and 7
(d) The term "managed care plan" for the purposes of this section means a 8
managed care plan as defined in KRS 304.17A-500. 9
(2) (a) The secreta ry of the Finance and Administration Cabinet, upon the 10
recommendation of the secretary of the Personnel Cabinet, shall procure, in 11
compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, 12
from one (1) or more insurers authorized to do business in this state, a group 13
health benefit plan that may include but not be limited to health maintenance 14
organization (HMO), preferred provider organization (PPO), point of service 15
(POS), and exclusive provider organization (EPO) benefit plans 16
encompassing all or any class or classes of employees. With the exception of 17
employers governed by the provisions of KRS Chapters 16, 18A, and 151B, 18
all employers of any class of employees or former employees shall enter into 19
a contract with the Personnel Cabinet prior to including that group in the state 20
health insurance group. The contracts shall include but not be limited to 21
designating the entity responsible for filing any federal forms, adoption of 22
policies required for proper plan administration, acceptance of the co ntractual 23
provisions with health insurance carriers or third -party administrators, and 24
adoption of the payment and reimbursement methods necessary for efficient 25
administration of the health insurance program. Health insurance coverage 26
provided to state emp loyees under this section shall, at a minimum, contain 27
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the same benefits as provided under Kentucky Kare Standard as of January 1, 1
1994, and shall include a mail -order drug option as provided in subsection 2
(13) of this section. All employees and other persons for whom the health care 3
coverage is provided or made available shall annually be given an option to 4
elect health care coverage through a self -funded plan offered by the 5
Commonwealth or, if a self -funded plan is not available, from a list of 6
coverage o ptions determined by the competitive bid process under the 7
provisions of KRS 45A.080, 45A.085, and 45A.090 and made available 8
during annual open enrollment. 9
(b) The policy or policies shall be approved by the commissioner of insurance 10
and may contain the p rovisions the commissioner of insurance approves, 11
whether or not otherwise permitted by the insurance laws. 12
(c) Any carrier bidding to offer health care coverage to employees shall agree to 13
provide coverage to all members of the state group, including acti ve 14
employees and retirees and their eligible covered dependents and 15
beneficiaries, within the county or counties specified in its bid. Except as 16
provided in subsection (20) of this section, any carrier bidding to offer health 17
care coverage to employees sha ll also agree to rate all employees as a single 18
entity, except for those retirees whose former employers insure their active 19
employees outside the state -sponsored health insurance program and as 20
otherwise provided in KRS 61.702(2)(b)3.b. and 78.5536(2)(b)3.b. 21
(d) Any carrier bidding to offer health care coverage to employees shall agree to 22
provide enrollment, claims, and utilization data to the Commonwealth in a 23
format specified by the Personnel Cabinet with the understanding that the data 24
shall be owned by the Commonwealth; to provide data in an electronic form 25
and within a time frame specified by the Personnel Cabinet; and to be subject 26
to penalties for noncompliance with data reporting requirements as specified 27
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by the Personnel Cabinet. The Personnel Cabi net shall take strict precautions 1
to protect the confidentiality of each individual employee; however, 2
confidentiality assertions shall not relieve a carrier from the requirement of 3
providing stipulated data to the Commonwealth. 4
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities 5
for timely analysis of data received from carriers and, to the extent possible, 6
provide in the request -for-proposal specifics relating to data requirements, 7
electronic reporting, and penalties for nonc ompliance. The Commonwealth 8
shall own the enrollment, claims, and utilization data provided by each carrier 9
and shall develop methods to protect the confidentiality of the individual. The 10
Personnel Cabinet shall include in the October annual report submitt ed 11
pursuant to the provisions of KRS 18A.226 to the Governor, the General 12
Assembly, and the Chief Justice of the Supreme Court, an analysis of the 13
financial stability of the program, which shall include but not be limited to 14
loss ratios, methods of risk ad justment, measurements of carrier quality of 15
service, prescription coverage and cost management, and statutorily required 16
mandates. If state self -insurance was available as a carrier option, the report 17
also shall provide a detailed financial analysis of th e self -insurance fund 18
including but not limited to loss ratios, reserves, and reinsurance agreements. 19
(f) If any agency participating in the state -sponsored employee health insurance 20
program for its active employees terminates participation and there is a state 21
appropriation for the employer's contribution for active employees' health 22
insurance coverage, then neither the agency nor the employees shall receive 23
the state -funded contribution after termination from the state -sponsored 24
employee health insurance program. 25
(g) Any funds in flexible spending accounts that remain after all reimbursements 26
have been processed shall be transferred to the credit of the state -sponsored 27
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health insurance plan's appropriation account. 1
(h) Each entity participating in the state-sponsored health insurance program shall 2
provide an amount at least equal to the state contribution rate for the employer 3
portion of the health insurance premium. For any participating entity that used 4
the state payro ll system, the employer contribution amount shall be equal to 5
but not greater than the state contribution rate. 6
(3) The premiums may be paid by the policyholder: 7
(a) Wholly from funds contributed by the employee, by payroll deduction or 8
otherwise; 9
(b) Wholly from funds contributed by any department, board, agency, public 10
postsecondary education institution, or branch of state, city, urban -county, 11
charter county, county, or consolidated local government; or 12
(c) Partly from each, except that any premium due f or health care coverage or 13
dental coverage, if any, in excess of the premium amount contributed by any 14
department, board, agency, postsecondary education institution, or branch of 15
state, city, urban -county, charter county, county, or consolidated local 16
government for any other health care coverage shall be paid by the employee. 17
(4) If an employee moves his or her place of residence or employment out of the 18
service area of an insurer offering a managed health care plan, under which he or 19
she has elected coverage, into either the service area of another managed health care 20
plan or into an area of the Commonwealth not within a managed health care plan 21
service area, the employee shall be given an option, at the time of the move or 22
transfer, to change his or her coverage to another health benefit plan. 23
(5) No payment of premium by any department, board, agency, public postsecondary 24
educational institution, or branch of state, city, urban -county, charter county, 25
county, or consolidated local government shall consti tute compensation to an 26
insured employee for the purposes of any statute fixing or limiting the 27
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compensation of such an employee. Any premium or other expense incurred by any 1
department, board, agency, public postsecondary educational institution, or branc h 2
of state, city, urban -county, charter county, county, or consolidated local 3
government shall be considered a proper cost of administration. 4
(6) The policy or policies may contain the provisions with respect to the class or classes 5
of employees covered, a mounts of insurance or coverage for designated classes or 6
groups of employees, policy options, terms of eligibility, and continuation of 7
insurance or coverage after retirement. 8
(7) Group rates under this section shall be made available to the disabled chil d of an 9
employee regardless of the child's age if the entire premium for the disabled child's 10
coverage is paid by the state employee. A child shall be considered disabled if he or 11
she has been determined to be eligible for federal Social Security disability benefits. 12
(8) The health care contract or contracts for employees shall be entered into for a 13
period of not less than one (1) year. 14
(9) The secretary shall appoint thirty -two (32) persons to an Advisory Committee of 15
State Health Insurance Subscribers to advise the secretary or the secretary's 16
designee regarding the state -sponsored health insurance program for employees. 17
The secretary shall appoint, from a list of names submitted by appointing 18
authorities, members representing school districts from each of the seven (7) 19
Supreme Court districts, members representing state government from each of the 20
seven (7) Supreme Court districts, two (2) members representing retirees under age 21
sixty-five (65), one (1) member representing local health departments, two (2) 22
members representing the Kentucky Teachers' Retirement System, and three (3) 23
members at large. The secretary shall also appoint two (2) members from a list of 24
five (5) names submitted by the Kentucky Education Association, two (2) members 25
from a list of five (5) names submitted by the largest state employee organization of 26
nonschool state employees, two (2) members from a list of five (5) names submitted 27
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by the Kentucky Association of Counties, two (2) members from a list of five (5) 1
names submitted by the Kentucky League of Cities, and two (2) members from a 2
list of names consisting of five (5) names submitted by each state employee 3
organization that has two thousand (2,000) or more members on state payroll 4
deduction. The advisory committee shall be appoin ted in January of each year and 5
shall meet quarterly. 6
(10) Notwithstanding any other provision of law to the contrary, the policy or policies 7
provided to employees pursuant to this section shall not provide coverage for 8
obtaining or performing an abortion, nor shall any state funds be used for the 9
purpose of obtaining or performing an abortion on behalf of employees or their 10
dependents. 11
(11) Interruption of an established treatment regime with maintenance drugs shall be 12
grounds for an insured to appeal a fo rmulary change through the established appeal 13
procedures approved by the Department of Insurance, if the physician supervising 14
the treatment certifies that the change is not in the best interests of the patient. 15
(12) Any employee who is eligible for and el ects to participate in the state health 16
insurance program as a retiree, or the spouse or beneficiary of a retiree, under any 17
one (1) of the state-sponsored retirement systems shall not be eligible to receive the 18
state health insurance contribution toward h ealth care coverage as a result of any 19
other employment for which there is a public employer contribution. This does not 20
preclude a retiree and an active employee spouse from using both contributions to 21
the extent needed for purchase of one (1) state spons ored health insurance policy 22
for that plan year. 23
(13) (a) The policies of health insurance coverage procured under subsection (2) of 24
this section shall include a mail -order drug option for maintenance drugs for 25
state employees. Maintenance drugs may be dis pensed by mail order in 26
accordance with Kentucky law. 27
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(b) A health insurer shall not discriminate against any retail pharmacy located 1
within the geographic coverage area of the health benefit plan and that meets 2
the terms and conditions for participation e stablished by the insurer, including 3
price, dispensing fee, and copay requirements of a mail -order option. The 4
retail pharmacy shall not be required to dispense by mail. 5
(c) The mail -order option shall not permit the dispensing of a controlled 6
substance classified in Schedule II. 7
(14) The policy or policies provided to state employees or their dependents pursuant to 8
this section shall provide coverage for obtaining a hearing aid and acquiring hearing 9
aid-related services for insured individuals under eighteen (18) years of age, subject 10
to a cap of one thousand four hundred dollars ($1,400) every thirty -six (36) months 11
pursuant to KRS 304.17A-132. 12
(15) Any policy provided to state employees or their dependents pursuant to this section 13
shall provide coverage for the diagnosis and treatment of autism spectrum disorders 14
consistent with KRS 304.17A-142. 15
(16) Any policy provided to state employees or their dependents pursuant to this section 16
shall provide coverage for obtaining amino acid -based elemental formula pu rsuant 17
to KRS 304.17A-258. 18
(17) If a state employee's residence and place of employment are in the same county, 19
and if the hospital located within that county does not offer surgical services, 20
intensive care services, obstetrical services, level II neonata l services, diagnostic 21
cardiac catheterization services, and magnetic resonance imaging services, the 22
employee may select a plan available in a contiguous county that does provide 23
those services, and the state contribution for the plan shall be the amount available 24
in the county where the plan selected is located. 25
(18) If a state employee's residence and place of employment are each located in 26
counties in which the hospitals do not offer surgical services, intensive care 27
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services, obstetrical services, leve l II neonatal services, diagnostic cardiac 1
catheterization services, and magnetic resonance imaging services, the employee 2
may select a plan available in a county contiguous to the county of residence that 3
does provide those services, and the state contrib ution for the plan shall be the 4
amount available in the county where the plan selected is located. 5
(19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 6
in the best interests of the state group to allow any carrier bidding to offer health 7
care coverage under this section to submit bids that may vary county by county or 8
by larger geographic areas. 9
(20) Notwithstanding any other provision of this section, the bid for proposals for health 10
insurance coverage for calendar year 2 004 shall include a bid scenario that reflects 11
the statewide rating structure provided in calendar year 2003 and a bid scenario that 12
allows for a regional rating structure that allows carriers to submit bids that may 13
vary by region for a given product offering as described in this subsection: 14
(a) The regional rating bid scenario shall not include a request for bid on a 15
statewide option; 16
(b) The Personnel Cabinet shall divide the state into geographical regions which 17
shall be the same as the partnership regi ons designated by the Department for 18
Medicaid Services for purposes of the Kentucky Health Care Partnership 19
Program established pursuant to 907 KAR 1:705; 20
(c) The request for proposal shall require a carrier's bid to include every county 21
within the region or regions for which the bid is submitted and include but not 22
be restricted to a preferred provider organization (PPO) option; 23
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the 24
carrier all of the counties included in its bid within the region. If the Personnel 25
Cabinet deems the bids submitted in accordance with this subsection to be in 26
the best interest s of state employees in a region, the cabinet may award the 27
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contract for that region to no more than two (2) carriers; and 1
(e) Nothing in this subsection shall prohibit the Personnel Cabinet from including 2
other requirements or criteria in the request for proposal. 3
(21) Any fully insured health benefit plan or self -insured plan issued or renewed on or 4
after July 12, 2006, to public employees pursuant to this section which provides 5
coverage for services rendered by a physician or osteopath duly licensed under KRS 6
Chapter 311 that are within the scope of practice of an optometrist duly licensed 7
under the provisions of KRS Chapter 320 shall provide the same payment of 8
coverage to optometrists as allowed for those services rendered by physicians or 9
osteopaths. 10
(22) Any fully insured health benefit plan or self -insured plan issued or renewed to 11
public employees pursuant to this section shall comply with: 12
(a) KRS 304.12-237; 13
(b) KRS 304.17A-270 and 304.17A-525; 14
(c) KRS 304.17A-600 to 304.17A-633; 15
(d) KRS 205.593; 16
(e) KRS 304.17A-700 to 304.17A-730; 17
(f) KRS 304.14-135; 18
(g) KRS 304.17A-580 and 304.17A-641; 19
(h) KRS 304.99-123; 20
(i) KRS 304.17A-138; 21
(j) KRS 304.17A-148; 22
(k) KRS 304.17A-163 and 304.17A-1631; 23
(l) KRS 304.17A-265; 24
(m) KRS 304.17A-261; 25
(n) KRS 304.17A-262; 26
(o) KRS 304.17A-145; 27
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(p) KRS 304.17A-129; 1
(q) KRS 304.17A-133; 2
(r) KRS 304.17A-264;[ and] 3
(s) Section 3 of this Act; and 4
(t) Administrative regulations promulgated pursuant to statutes listed in this 5
subsection. 6
(23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to 7
public employees pursuant to this section shall provide a special enrollment 8
period to pregnant women who are eligible for coverage in accordance with 9
the requirements set forth in KRS 304.17-182. 10
(b) The Department of Employee Insurance shall, at or before the time a public 11
employee is initially offered the opportunity to enroll in the plan or coverage, 12
provide the employee a notice of the special enrollment rights under this 13
subsection. 14
Section 7. Sections 3, 5, and 6 of this Act apply to health plans issued or 15
renewed on or after January 1, 2027. 16
Section 8. If the Cabinet for Health and Family Services or the Department for 17
Medicaid Services determines that a state plan amendment, waiver, or any other form of 18
authorization or approval from any federal agency to implement Section 1 or 2 of this Act 19
is necessary to prevent the loss of federal funds or to comply with federal law, the cabinet 20
or department: 21
(1) Shall, within 90 days after the effective date of this section, request the 22
necessary federal authorization or approval to implement Section 1 or 2 of this Act; and 23
(2) May only delay implementation of the provisions of Section 1 or 2 of this Act 24
for which federal authorization or approval was deemed necessary until the federal 25
authorization or approval is granted. 26
Section 9. Sections 1, 2, and 8 of this Act shall constitute the specific 27
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authorization required under KRS 205.5372(1). 1
Section 10. Notwithstanding KRS 194A.099, if it is determined that the 2
application of any requirement o f Section 3 of this Act to a qualified health plan is in 3
addition to the essential health benefits required under federal law, then the department 4
shall, within 90 days of the effective date of this section, apply for a waiver under 42 5
U.S.C. sec. 18052, a s amended, or any other applicable federal law of all or any of the 6
cost defrayal requirements under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, 7
as amended, that would apply but for the application of subsection (5) of Section 3 of this 8
Act. 9
Section 11. If any provision of this Act, or this Act's application to any person 10
or circumstance, is held invalid, the invalidity shall not affect other provisions or 11
applications of the Act, which shall be given effect wi thout the invalid provision or 12
application, and to this end the provisions and applications of this Act are severable. 13
Section 12. Sections 3 to 7 of this Act take effect January 1, 2027. 14