AN ACT relating to the Kentucky all-payer claims database.

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AN ACT relating to the Kentucky all-payer claims database. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 3
READ AS FOLLOWS: 4
(1) The Kentucky all -payer claims database is established in Sections 1 to 6 of this 5
Act to effectuate the following purposes: 6
(a) Allow for targeted population health initiatives; 7
(b) Determine state health status needs; 8
(c) Inform state health care planning; 9
(d) Support research in the areas of health care cost, quality, and accessibility; 10
(e) Improve the accessibility, adequacy, and affordability of health care and 11
health care coverage through the review and dissemination of data; 12
(f) Review health care costs among various treatment settings, providers, and 13
modalities; 14
(g) Evaluate the effectiv eness of health care programs and services to improve 15
patient outcomes; and 16
(h) Support the development of quality improvement initiatives. 17
(2) Sections 1 to 6 of this Act shall not be construed to supersede, supplement, or 18
limit the provisions of KRS Chapter 216B relating to certificates of need. 19
SECTION 2. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 20
READ AS FOLLOWS: 21
As used in Sections 1 to 6 of this Act: 22
(1) "Executive director" means the executive director of the Office of Data Analytics 23
created in Section 8 of this Act; 24
(2) "Health care claims": 25
(a) Means claims made for the payment or reimbursement of the following 26
types of health care services: 27
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1. Medical and hospital, which includes without limitation surgical, 1
mental health, substance use disorder, nursing, rehabilitative and 2
habilitative services, and laboratory services; 3
2. Dental; 4
3. Pharmacy; and 5
4. Any other health care service designated by the executive director in 6
an administrative regulation promulgate d in accordance with KRS 7
Chapter 13A; and 8
(b) Does not include claims made to a primary care provider for the provision 9
of primary care services under a direct primary care membership agreement 10
established under KRS 311.6201, 311.6202, 314.198, or 314.199; 11
(3) (a) "Health payer" means any person that pays, or administers the payment of, 12
health care claims. 13
(b) As used in paragraph (a) of this subsection, "person" includes but is not 14
limited to: 15
1. Medicare; 16
2. Medicaid; 17
3. The Kentucky Children's Health Insurance Program; 18
4. Workers' compensation insurers, including governmental and 19
nongovernmental workers' compensation self -insurers and self -20
insured groups; 21
5. Insurers, self -insurers, and self -insured groups, including 22
governmental and nongovernmental self -insured employers, self -23
insured health plans, and self -insured employer -organized 24
associations, that provide: 25
a. Coverage for health care services; 26
b. Health care benefits; or 27
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c. Any kind of insurance regulated under KRS Chapter 304; 1
6. Health maintenance organizations; 2
7. Limited health service organizations; 3
8. Provider-sponsored integrated health delivery networks; 4
9. Nonprofit hospital, medical -surgical, dental, and health serv ice 5
corporations; 6
10. Administrators, as defined in KRS 304.9-051; 7
11. Pharmacy benefit managers; 8
12. Any third -party payor that is not exempt by federal law from 9
regulation under the insurance laws of this state; 10
13. Any person that contracts with a state or federal agency to provide 11
coverage for health care services; and 12
14. Any vendor or contractor of a person listed in this paragraph; and 13
(4) "Kentucky all -payer claims database" means the all -payer claims database 14
established in Sections 1 to 6 of this Act. 15
SECTION 3. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 16
READ AS FOLLOWS: 17
(1) The Kentucky all-payer claims database fund is hereby established as a restricted 18
fund in the State Treasury. 19
(2) The following shall be deposited into the fund: 20
(a) All grants and funds received or raised under Section 4 of this Act; 21
(b) Any fees collected under Section 6 of this Act; 22
(c) Any penalties collected under Section 10 of this Act; and 23
(d) Any appropriations made to the fund by the General Assembly. 24
(3) Notwithstanding KRS 45.229, moneys in the fund not expended at the close of a 25
fiscal year shall not lapse but shall be carried forward to the next fiscal year. 26
(4) Moneys in the fund shall be available to the executive director t o develop, 27
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implement, operate, and maintain the Kentucky all-payer claims database. 1
SECTION 4. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 2
READ AS FOLLOWS: 3
(1) The executive director shall develop, implement, operate , and maintain the 4
Kentucky all-payer claims database in accordance with Sections 1 to 6 of this Act. 5
(2) In carrying out the duties under subsection (1) of this section, the executive 6
director: 7
(a) Shall make good-faith efforts to: 8
1. Seek and accept gran ts, or raise funds, from any available source, 9
public or private, to support the development, implementation, 10
operation, and maintenance of the database; and 11
2. Establish agreements: 12
a. For voluntary reporting of health care claims data from health 13
payers that are not subject to mandatory reporting requirements. 14
If feasible, the executive director shall implement the reporting 15
format for self-insured group health plans described in 29 U.S.C. 16
sec. 1191d, as amended; 17
b. With the federal Centers for Medicare and Medicaid Services to 18
obtain Medicare health care claims data; and 19
c. With all -payer claims databases in other states to establish a 20
single application for access to data by authorized users across 21
multiple states, if the executive director determines that the 22
agreements are feasible and beneficial for the operation of the 23
Kentucky all-payer claims database; 24
(b) Shall: 25
1. Determine the measures necessary to implement reporting 26
requirements in a manner that: 27
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a. Is cost effective and reasonable for data sources; 1
b. Is timely, relevant, and reliable for data users; 2
c. Eliminates, or reduces to the greatest extent practicable, the 3
submission of duplicate or redundant health care claims data; 4
and 5
d. Does not violate any applicable laws; 6
2. Establish policies and procedures necessary for the administration 7
and oversight of the database, including all necessary communication, 8
coordination, and data sharing with the commissioner of insurance 9
for enforcement under Section 10 of this Act; 10
3. Ensure the integrity, privacy, and security of personal health 11
information and other proprietary information related to the collection 12
and release of data; 13
4. Ensure that the database is operated in compliance w ith all state and 14
federal law, including but not limited to: 15
a. The federal Health Insurance Portability and Accountability Act 16
of 1996, Pub. L. No. 104 -191, as amended, and any related 17
federal regulations, as amended; 18
b. 42 U.S.C. sec. 290dd -2, as amended , and any related federal 19
regulations, as amended, including but not limited to 42 C.F.R. 20
pt. 2; and 21
c. All other applicable state and federal data privacy and security 22
laws relating to the collection, storage, and release of data, 23
except that the provisions of this section and Section 6 of this Act 24
shall control over any conflicting state laws; and 25
5. Promulgate any administrative regulations in accordance with KRS 26
Chapter 13A that are necessary to carry out Sections 1 to 6 of this Act; 27
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and 1
(c) May: 2
1. a. Audit any data required to be submitted under Section 6 of this 3
Act as needed to corroborate the accuracy of submitted data. 4
b. Any audit conducted under this subparagraph shall, to the extent 5
practicable, be coordinated with other audits or examinations 6
performed by state or federal agencies; 7
2. a. Contract with one (1) or more qualified third parties: 8
i. To collect or process health care claims data; or 9
ii. For any other expertise, service, or function necessary to 10
carry out the provisions of Sections 1 to 6 of this Act. 11
b. The authority granted under this subparagraph shall include 12
without limitation designating a qualified third party to 13
implement, operate, and maintain the Kentucky all -payer claims 14
database; and 15
3. Share and receive data or other inform ation, including confidential 16
and proprietary data or information, with and from state agencies, 17
federal agencies, and all-payer claims databases in other states if: 18
a. The recipient agrees in a written or electronic record to maintain 19
any confidential or proprietary status afforded to the data or 20
information; and 21
b. The data or information is shared or received in a manner that 22
does not violate any applicable laws. 23
(3) If the executive director contracts with a third -party under subsection (2)(c)2. of 24
this section, the executive director shall monitor and supervise the third party to 25
ensure that the third party complies with Sections 1 to 6 of this Act. 26
(4) A third party that contracts with the executive director under subsection (2)(c)2. 27
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of this section shall not release, publish, or otherwise use any information to 1
which the third party has access under the contract without express permission in 2
a written or electronic record from the executive director. 3
(5) A waiver of any applicable privilege or claim of confidentiality in data or 4
information shall not occur as a result of a disclosure made under this section. 5
(6) (a) With regard to the Kentucky all -payer claims databas e, the executive 6
director shall, by September 1 of each year, file a written report with the 7
Governor and the Legislative Research Commission, for referral to the 8
appropriate interim joint committees or other appropriate committees, that 9
details the following: 10
1. The status of any development efforts, including efforts to obtain 11
funding for the database; 12
2. A detailed summary of database operations for the previous year; 13
3. The financial stability of the database; 14
4. An assessment of: 15
a. The cost, performance, and effectiveness of the database; 16
b. The performance of any third parties designated by the executive 17
director under subsection (2)(c)2. of this section; and 18
c. Whether the database has advanced the purposes set forth in 19
Section 1 of this Act; and 20
5. Any recommendations for database changes or improvements, 21
including statutory changes. 22
(b) In completing the determination required under paragraph (a)4.c. of this 23
subsection, the executive director shall, to the extent it is available, utilize 24
economic expertise. 25
SECTION 5. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 26
READ AS FOLLOWS: 27
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(1) There is hereby established the Kentucky All -Payer Claims Database Advisory 1
Council, whose duties shall be to make recommendations to the executive director 2
as to the development, implementation, operation, and maintenance of the 3
database. 4
(2) (a) The council shall consist of the following individual members: 5
1. A member of academia with experience in health care data research; 6
2. A representative from the Kentucky Hospital Association; 7
3. A representative from the Kentucky Medical Association; 8
4. A representative from the Kentucky Pharmacists Association; 9
5. A representative from the Kentucky Dental Association; 10
6. A representative from the Kentucky Primary Care Association; 11
7. A representative from a Medicaid managed care organization or an 12
organization that represents Medicaid managed care organizations; 13
8. A representative from a health insurer that offers health insurance 14
coverage in the private market or an organization that represents such 15
health insurers; 16
9. A representative from an employer that provides self -insured group 17
health insurance coverage to its employees; 18
10. A representative from a property and casualty insurer or an 19
organization that represents property and casualty insurers; 20
11. A representative from a workers' compensation insurer, self -insurer, 21
or self-insured group; 22
12. A person that adv ocates on behalf of, or promotes the interests of, 23
health care consumers; and 24
13. A person with expertise or experience in health care data collection or 25
storage. 26
(b) In addition to the members listed in paragraph (a) of this subsection, the 27
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following persons, or their designees, shall serve as ex officio members of 1
the council: 2
1. The commissioner of the Department of Insurance; 3
2. The executive director of the Commonwealth Office of Technology; 4
3. The commissioner of the Department of Employee Insurance; 5
4. The commissioner of the Department for Medicaid Services; 6
5. The commissioner of the Department for Public Health; and 7
6. The commissioner of the Department for Behavioral Health, 8
Developmental and Intellectual Disabilities. 9
(c) The council shall include the following nonvoting ex officio members: 10
1. The executive director, who shall serve as chair of the council; and 11
2. A representative of the Office of Application Technology Services. 12
(d) The members listed in paragraph (a) of this subsection shall: 13
1. Be appointed by the Governor; and 14
2. Serve a term of three (3) years. 15
(e) 1. The Governor shall fill all vacancies under paragraph (a) of this 16
subsection within sixty (60) days of the vacancy. 17
2. In the event a representative or person referenced in parag raph (a) of 18
this subsection is not available or willing to serve, the Governor shall 19
appoint a person with expertise or experience in the applicable 20
referenced industry or subject matter. 21
(3) The council's recommendations shall include but not be limited t o 22
recommendations that: 23
(a) Provide specific strategies for measuring and collecting data related to 24
health care safety, quality, utilization, health outcomes, and cost; 25
(b) Focus on data elements that foster quality improvement and peer group 26
comparisons; 27
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(c) Facilitate value -based, cost-effective purchasing of health care services by 1
public and private purchasers and consumers; 2
(d) Result in usable and comparable information that allows public and private 3
health care purchasers, consumers, and data analys ts to identify and 4
compare health plans, health payers, health care facilities, and health care 5
providers regarding the provision of safe, cost -effective, and high -quality 6
health care services; 7
(e) Use and build upon existing data collection standards and methods that 8
establish and maintain the database in a cost-effective and efficient manner, 9
which includes incorporating and utilizing uniform data collection that 10
aligns, where possible, with nation al or federal uniform all -payer claims 11
database standards; 12
(f) Incorporate and utilize claims, eligibility, and other publicly available data 13
to the extent it is the most cost -effective method of collecting data to 14
minimize the cost and administrative burden on data sources; 15
(g) Address whether publicly available data, in addition to the data submitted by 16
health payers, should be included to measure or analyze health care quality, 17
safety, or cost issues, including data on the uninsured; 18
(h) Address the use of a master person identification process to enable 19
matching members across health plans; 20
(i) Ensure the integrity, privacy, and security of personal health information 21
and other proprietary information related to the collection and release of 22
data, including compliance with all state and federal laws as required under 23
subsection (2)(b) of Section 4 of this Act; 24
(j) Address ongoing oversight of database operations; and 25
(k) Address the feasibility and advisability of working with all -payer claims 26
databases in other states to establish a single application for access to data 27
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by authorized users across multiple states. 1
(4) The first meeting of the council shall take place within thirty (30) days of 2
appointment of all the members listed in subsection (2)(a) of this section. 3
(5) (a) The council shall meet upon the call of the executive director, but not less 4
than quarterly for the first two (2) years after the date of the first council 5
meeting. Thereafter, the council shall meet not less than semiannually. 6
(b) A majority of the voting members shall constitute a quorum to do business. 7
(c) Recommendations of the council shall require a: 8
1. Quorum; and 9
2. Majority of the voting members present. 10
(d) A member shall be permitted to participate and vote in council busines s 11
through distance communication technology. 12
(6) The council shall be a budgetary unit of the cabinet, which shall: 13
(a) Pay the council's necessary operating expenses; and 14
(b) Furnish all office space, personnel, equipment, supplies, and technical or 15
administrative services required by the council in the performance of the 16
functions established in this section. 17
(7) Members of the council listed in subsection (2)(a) of this section shall receive no 18
compensation for services, but shall receive actual and nece ssary travel expenses 19
associated with attending meetings in accordance with state administrative 20
regulations relating to travel reimbursement. 21
SECTION 6. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 22
READ AS FOLLOWS: 23
(1) To the extent permitted under federal law, health payers shall submit data 24
relating to health care claims to the executive director, or a third party designated 25
by the executive director, beginning not later than the last of the following to 26
occur: 27
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(a) Three (3) months after the Kentucky all -payer claims database becomes 1
fully operational; or 2
(b) The date the person begins to do business, operate, or otherwise engage in 3
activity in Kentucky. 4
(2) (a) The executive director shall establish the following by administrative 5
regulation: 6
1. The data elements to be collected, the reporting format, and the 7
frequency of submissions under subsection (1) of this section; 8
2. The data available to data users under subsection (5) of this section, 9
including: 10
a. The manner in which the data will be made available; and 11
b. The process for accessing, requesting, and making the data 12
available; and 13
3. Data access fees, which shall be deposited into the fund established in 14
Section 3 of this Act. 15
(b) In carrying out the requirements of this subsection, the executive director 16
may require data users to enter into data service agreements or memoranda 17
of understanding. 18
(3) To the extent permitted under federal law, any health payer not required to 19
comply with this section und er state or federal law may opt to submit data under 20
this section. 21
(4) All state and local government health plans or programs regulated, created, or 22
authorized under Kentucky law, including any insurers or administrators 23
offering or administering those pl ans or programs, shall comply with the data 24
submission requirements of this section, including without limitation: 25
(a) Any plan or program offered or administered under KRS Chapter 205; and 26
(b) Any governmental plan, as defined in 29 U.S.C. sec. 1002, incl uding any 27
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plan offered to the Public Employee Health Insurance Program for public 1
employees under KRS 18A.225 or 18A.2254. 2
(5) Except as otherwise provided in this section, the Kentucky all -payer claims 3
database shall: 4
(a) Be available to provide data to: 5
1. Health payers, consumers, employers, health care facilities, health 6
care providers, purchasers of health care, and state agencies, in a 7
form and manner that ensures the privacy and security of personal 8
health information as required by state and federal law, for the 9
purpose of allowing continuous review of health care utilization, 10
expenditures, quality, and safety; and 11
2. A state agency or other public or private entity for the purpose of 12
supporting the agency's or entity's demonstrated efforts to improv e or 13
benefit the health care system through research and analysis, subject 14
to administrative regulations promulgated by the executive director; 15
and 16
(b) Present data in a manner that: 17
1. Allows for comparisons of: 18
a. Geographic, demographic, and economic factors; and 19
b. Institutional size; and 20
2. Is consumer-friendly. 21
(6) (a) To the extent permitted under federal law, a health payer shall not be 22
required to obtain any individual's consent or permission in order to submit 23
the individual's data in accordance with this section. 24
(b) Compliance with the requirements of this section shall not be deemed a 25
violation of data or consumer privacy laws or any other laws. 26
(7) Except as provided in Section 4 of this Act and subsection (8) of this section, the 27
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Kentucky all-payer claims database shall not disclose any data that: 1
(a) Could be used to identify an individual; 2
(b) Is determined by the executive director to be incomplete, preliminary, 3
substantially in error, or not representative; or 4
(c) Could, due to small sample size or other factors, reveal the identity of an 5
individual or produce misleading information. 6
(8) (a) The executive director may require health payers to submit or use direct 7
identifying information about individuals for the purpose of assigning a 8
unique patient identifier. 9
(b) Upon the assignment of a unique patient identifier, all direct identifying 10
information about the individual shall be stripped from any data collected, 11
and not be retained, by the executive director or any third party designated 12
by the executive director. 13
(9) (a) A person shall not access, request, receive, or use any data or information 14
disclosed under subsection (5) of this section: 15
1. To obtain or disclose trade secrets; 16
2. To reidentify or attempt to reidentify an individual's data or 17
information; 18
3. To sell the data or information; 19
4. To distribute the data or information for commercial purposes; 20
5. To take any action in violation of any applicable data privacy or 21
security laws; or 22
6. For any purpose not identified in subsection (5) of this section. 23
(b) A perso n shall not access or receive data from the Kentucky all -payer 24
claims database unless the person agrees in a written or electronic record to 25
comply with this subsection. 26
(10) All information and data acquired by the executive director or a third party 27
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designated by the executive director under this section shall: 1
(a) Be disclosed only to the extent provided in Section 4 of this Act and this 2
section; and 3
(b) Not be subject to disclosure under KRS 61.870 to 61.884. 4
Section 7. KRS 194A.030 is amended to read as follows: 5
The cabinet consists of the following major organizational units, which are hereby 6
created: 7
(1) Office of the Secretary. Within the Office of the Secretary, there shall be an Office 8
of Legal Services, an Offic e of Inspector General, an Office of Public Affairs, an 9
Office of Human Resource Management, an Office of Finance and Budget, an 10
Office of Legislative and Regulatory Affairs, an Office of Administrative Services, 11
an Office of Application Technology Service s, an Office of Data Analytics, and an 12
Office of Medical Cannabis as follows: 13
(a) The Office of Legal Services shall provide legal advice and assistance to all 14
units of the cabinet in any legal action in which it may be involved. The 15
Office of Legal Servic es shall employ all attorneys of the cabinet who serve 16
the cabinet in the capacity of attorney, giving legal advice and opinions 17
concerning the operation of all programs in the cabinet. The Office of Legal 18
Services shall be headed by a general counsel who shall be appointed by the 19
secretary with the approval of the Governor under KRS 12.050 and 12.210. 20
The general counsel shall be the chief legal advisor to the secretary and shall 21
be directly responsible to the secretary. The Attorney General, on the reques t 22
of the secretary, may designate the general counsel as an assistant attorney 23
general under the provisions of KRS 15.105; 24
(b) The Office of Inspector General shall be headed by an inspector general who 25
shall be appointed by the secretary with the approval of the Governor. The 26
inspector general shall be directly responsible to the secretary. The Office of 27
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Inspector General shall be responsible for: 1
1. The conduct of audits and investigations for detecting the perpetration of 2
fraud or abuse of any program by any client, or by any vendor of 3
services with whom the cabinet has contracted; and the conduct of 4
special investigations requested by the secretary, commissioners, or 5
office heads of the cabinet into matters related to the cabinet or its 6
programs; 7
2. Licensing and regulatory functions as the secretary may delegate; 8
3. Review of health facilities participating in transplant programs, as 9
determined by the secretary, for the purpose of determining any 10
violations of KRS 311.1911 to 311.1959, 311.1961, and 311.1963; 11
4. The duties, responsibilities, and authority pertaining to the certificate of 12
need functions and the licensure appeals functions, pursuant to KRS 13
Chapter 216B; 14
5. The notification and forwarding of any information relevant to possible 15
criminal violations to the appropriate prosecuting authority; 16
6. The oversight of the operations of the Kentucky Health Information 17
Exchange; and 18
7. The support and guidance to health care providers related to telehealth 19
services, including the development of policy, s tandards, resources, and 20
education to expand telehealth services across the Commonwealth; 21
(c) The Office of Public Affairs shall be headed by an executive director 22
appointed by the secretary with the approval of the Governor in accordance 23
with KRS 12.050. The office shall provide information to the public and news 24
media about the programs, services, and initiatives of the cabinet; 25
(d) The Office of Human Resource Management shall be headed by an executive 26
director appointed by the secretary with the approva l of the Governor in 27
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accordance with KRS 12.050. The office shall coordinate, oversee, and 1
execute all personnel, training, and management functions of the cabinet. The 2
office shall focus on the oversight, development, and implementation of 3
quality improve ment services; curriculum development and delivery of 4
instruction to staff; the administration, management, and oversight of training 5
operations; health, safety, and compliance training; and equal employment 6
opportunity compliance functions; 7
(e) The Office of Finance and Budget shall be headed by an executive director 8
appointed by the secretary with the approval of the Governor in accordance 9
with KRS 12.050. The office shall provide central review and oversight of 10
budget, contract, and cabinet fin ances. The office shall provide coordination, 11
assistance, and support to program departments and independent review and 12
analysis on behalf of the secretary; 13
(f) The Office of Legislative and Regulatory Affairs shall be headed by an 14
executive director appoi nted by the secretary with the approval of the 15
Governor in accordance with KRS 12.050. The office shall provide central 16
review and oversight of legislation, policy, and administrative regulations. 17
The office shall provide coordination, assistance, and supp ort to program 18
departments and independent review and analysis on behalf of the secretary; 19
(g) The Office of Administrative Services shall be headed by an executive 20
director appointed by the secretary with the approval of the Governor in 21
accordance with KR S 12.050. The office shall provide central review and 22
oversight of procurement, general accounting including grant monitoring, and 23
facility management. The office shall provide coordination, assistance, and 24
support to program departments and independent re view and analysis on 25
behalf of the secretary; 26
(h) The Office of Application Technology Services shall be headed by an 27
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executive director appointed by the secretary with the approval of the 1
Governor in accordance with KRS 12.050. The office shall provide 2
application technology services including central review and oversight. The 3
office shall provide coordination, assistance, and support to program 4
departments and independent review and analysis on behalf of the secretary; 5
(i) The Office of Data Analytics sha ll be headed by an executive director who 6
shall be appointed by the secretary with the approval of the Governor under 7
KRS 12.050, and shall: 8
1. Identify and innovate strategic initiatives to inform public policy 9
initiatives and provide opportunities for im proved health outcomes for 10
all Kentuckians though data analytics;[. The office shall] 11
2. Provide leadership in the redesign of the health care delivery system 12
using electronic information technology to improve patient care and 13
reduce medical errors and duplicative services; and 14
3. Develop, implement, operate, and maintain the Kentucky all -payer 15
claims database in accordance with Sections 1 to 6 of this Act; and 16
(j) The Office of Medical Cannabis shall be headed by an executive director 17
appointed by the Gove rnor in accordance with KRS 12.040 and shall 18
implement, operate, oversee, and regulate the medicinal cannabis program. 19
The office shall be composed of the Division of Enforcement and Compliance 20
and the Division of Licensure and Access. Each division in the office shall be 21
headed by a director appointed by the secretary with the approval of the 22
Governor in accordance with KRS 12.050. 23
(2) Department for Medicaid Services. The Department for Medicaid Services shall 24
serve as the single state agency in the Commo nwealth to administer Title XIX of 25
the Federal Social Security Act. The Department for Medicaid Services shall be 26
headed by a commissioner for Medicaid services, who shall be appointed by the 27
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secretary with the approval of the Governor under KRS 12.050. Th e commissioner 1
for Medicaid services shall be a person who by experience and training in 2
administration and management is qualified to perform the duties of this office. The 3
commissioner for Medicaid services shall exercise authority over the Department 4
for Medicaid Services under the direction of the secretary and shall only fulfill 5
those responsibilities as delegated by the secretary; 6
(3) Department for Public Health. The Department for Public Health shall develop and 7
operate all programs of the cabinet that provide health services and all programs for 8
assessing the health status of the population for the promotion of health and the 9
prevention of disease, injury, disability, and premature death. This shall include but 10
not be limited to oversight of the Div ision of Women's Health and the Office for 11
Children with Special Health Care Needs. The duties, responsibilities, and authority 12
set out in KRS 200.460 to 200.490 shall be performed by the Department for Public 13
Health. The Department for Public Health shall advocate for the rights of children 14
with disabilities and, to the extent that funds are available, shall ensure the 15
administration of services for children with disabilities as are deemed appropriate 16
by this office pursuant to Title V of the Social Securi ty Act. The Department for 17
Public Health may promulgate administrative regulations under KRS Chapter 13A 18
as may be necessary to implement and administer its responsibilities. The Office for 19
Children with Special Health Care Needs may be headed by an execut ive director 20
appointed by the secretary with the approval of the Governor in accordance with 21
KRS 12.050. The Department for Public Health shall be headed by a commissioner 22
for public health who shall be appointed by the secretary with the approval of the 23
Governor under KRS 12.050. The commissioner for public health shall be a duly 24
licensed physician who by experience and training in administration and 25
management is qualified to perform the duties of this office. The commissioner 26
shall advise the head of eac h major organizational unit enumerated in this section 27
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on policies, plans, and programs relating to all matters of public health, including 1
any actions necessary to safeguard the health of the citizens of the Commonwealth. 2
The commissioner shall serve as c hief medical officer of the Commonwealth. The 3
commissioner for public health shall exercise authority over the Department for 4
Public Health under the direction of the secretary and shall only fulfill those 5
responsibilities as delegated by the secretary; 6
(4) Department for Behavioral Health, Developmental and Intellectual Disabilities. The 7
Department for Behavioral Health, Developmental and Intellectual Disabilities shall 8
develop and administer programs for the prevention of mental illness, intellectual 9
disabilities, brain injury, developmental disabilities, and substance use disorders 10
and shall develop and administer an array of services and support for the treatment, 11
habilitation, and rehabilitation of persons who have a mental illness or emotional 12
disability, or who have an intellectual disability, brain injury, developmental 13
disability, or a substance use disorder. The Department for Behavioral Health, 14
Developmental and Intellectual Disabilities shall be headed by a commissioner for 15
behavioral health, deve lopmental and intellectual disabilities who shall be 16
appointed by the secretary with the approval of the Governor under KRS 12.050. 17
The commissioner for behavioral health, developmental and intellectual disabilities 18
shall be by training and experience in a dministration and management qualified to 19
perform the duties of the office. The commissioner for behavioral health, 20
developmental and intellectual disabilities shall exercise authority over the 21
department under the direction of the secretary, and shall onl y fulfill those 22
responsibilities as delegated by the secretary; 23
(5) Department for Family Resource Centers and Volunteer Services. The Department 24
for Family Resource Centers and Volunteer Services shall streamline the various 25
responsibilities associated wi th the human services programs for which the cabinet 26
is responsible. This shall include, but not be limited to, oversight of the Division of 27
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Family Resource and Youth Services Centers and Serve Kentucky. The Department 1
for Family Resource Centers and Volun teer Services shall be headed by a 2
commissioner who shall be appointed by the secretary with the approval of the 3
Governor under KRS 12.050. The commissioner for family resource centers and 4
volunteer services shall be by training and experience in administr ation and 5
management qualified to perform the duties of the office, shall exercise authority 6
over the department under the direction of the secretary, and shall only fulfill those 7
responsibilities as delegated by the secretary; 8
(6) Department for Community Based Services. The Department for Community Based 9
Services shall administer and be responsible for child and adult protection, 10
guardianship services, violence prevention resources, foster care and adoption, 11
permanency, and services to enhance family self -sufficiency, including child care, 12
social services, public assistance, and family support. The department shall be 13
headed by a commissioner appointed by the secretary with the approval of the 14
Governor in accordance with KRS 12.050; and 15
(7) Department for Aging and Independent Living. The Department for Aging and 16
Independent Living shall serve as the state unit as designated by the Administration 17
on Aging Services under the Older Americans Act and shall have responsibility for 18
administration of the federal community support services, in -home services, meals, 19
family and caregiver support services, elder rights and legal assistance, senior 20
community services employment program, the state health insurance assistance 21
program, state home and community based servi ces including home care, 22
Alzheimer's respite services and the personal care attendant program, certifications 23
of assisted living facilities, and the state Council on Alzheimer's Disease and other 24
related disorders. The department shall also administer the Long-Term Care 25
Ombudsman Program and the Medicaid Home and Community Based Waivers 26
Participant Directed Services Option (PDS) Program. The department shall serve as 27
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the information and assistance center for aging and disability services and 1
administer multiple federal grants and other state initiatives. The department shall 2
be headed by a commissioner appointed by the secretary with the approval of the 3
Governor in accordance with KRS 12.050. 4
Section 8. KRS 194A.101 is amended to read as follows: 5
(1) The Office of Data Analytics is hereby created in the Office of the Secretary. The 6
office shall: 7
(a) Provide oversight and strategic direction for, and be responsible for the 8
coordinating of, the data ana lysis initiatives of[for] the various departments 9
that regulate health care and social services to ensure that policy is consistent 10
with the long-term goals across the Commonwealth; and 11
(b) Develop, implement, operate, and maintain the Kentucky all -payer c laims 12
database in accordance with Sections 1 to 6 of this Act. 13
(2) The office shall have the authority to review all data requests received by the 14
cabinet from the public, review the requests for content to determine the cabinet's 15
response, and approve the release of the requested information. The office shall 16
review data analyses conducted by the departments within the cabinet to ensure the 17
consistency, quality, and validity of the analysis prior to its use in operational and 18
policy decisions. The office s hall facilitate the process of data integration by 19
initiating and maintaining data-sharing agreements in order to improve inter-agency 20
and cross-cabinet collaboration. 21
(3) The Office of Data Analytics shall promulgate administrative regulations in 22
accordance with KRS Chapter 13A to implement this section. 23
Section 9. KRS 304.2-100 is amended to read as follows: 24
(1) The commissioner shall personally supervise the operations of the department. 25
(2) The commissioner shall exam ine and inquire into violations of this code, shall 26
enforce the provisions of this code with impartiality and shall execute the duties 27
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imposed upon him or her by this code. 1
(3) The commissioner shall have the powers and authority expressly conferred upon 2
him or her by or reasonably implied from the provisions of this code. 3
(4) The commissioner may conduct such examinations and investigations of insurance 4
matters, in addition to examinations and investigations expressly authorized, as the 5
commissioner may de em proper upon reasonable and probable cause to determine 6
whether any person has violated any provisions of this code or to secure 7
information useful in the lawful administration of any such provision. The cost of 8
such additional examinations and investigations shall be borne by the state. 9
(5) The commissioner may establish and maintain such branch offices in this state as 10
may be reasonably required for the efficient administration of this code. 11
(6) The commissioner shall have such additional powers and duties as may be provided 12
by other laws of this state. 13
(7) The commissioner shall assist the Office of [ Health] Data[ and] Analytics in 14
carrying out Subtitle 17B of this chapter,[ and] KRS 194A.099, and Sections 1 to 6 15
of this Act. 16
SECTION 10. A NEW SECTION OF S UBTITLE 99 OF KRS CHAPTER 304 17
IS CREATED TO READ AS FOLLOWS: 18
(1) (a) The commissioner shall enforce the reporting requirements for health 19
payers under Section 6 of this Act. 20
(b) In carrying out the duties under paragraph (a) of this subsection, the 21
commissioner: 22
1. May assess a civil penalty in accordance with this section; and 23
2. Shall have the authority, powers, and duties set forth in Subtitle 2 of 24
this chapter for violations of this code, including the requirements for 25
orders, notices, and hearings. 26
(2) (a) Subject to paragraphs (b), (c), (d), and (e) of this subsection, the 27
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commissioner shall promulgate an administrative regulation designating a 1
schedule of penalties, not to exceed one thousand dollars ($1,000) per day, 2
for any health payer that fails to comply with the reporting requirements for 3
that person under Section 6 of this Act. 4
(b) Local government, state, and federal agencies shall not be assessed or 5
subject to a penalty under this subsection. 6
(c) The commissioner may, by administrative regulat ion, adjust the maximum 7
penalty established under paragraph (a) of this subsection every two (2) 8
years based on the percent change in the nonseasonally adjusted annual 9
average Consumer Price Index for All Urban Consumers (CPI-U), U.S. City 10
Average, Medical Care, between the two (2) most recent calendar years 11
available, as published by the United States Bureau of Labor Statistics. 12
(d) The commissioner shall promulgate an administrative regulation in 13
accordance with KRS Chapter 13A designating the process for notice, 14
hearing, and collection of any penalty assessed under paragraph (a) of this 15
subsection. 16
(e) The commissioner may, upon such terms and conditions that are 17
determined by the commissioner to be in the public interest, remit or 18
mitigate any penalty assessed under paragraph (a) of this subsection. 19
(3) Any penalties collected by the department under this section shall be deposited 20
into the Kentucky all -payer claims database fund established in Section 3 of this 21
Act. 22
(4) The commissioner may promulgate an y additional administrative regulations in 23
accordance with KRS Chapter 13A necessary to implement or aid in the 24
effectuation of this section. 25
Section 11. (1) The Governor shall make all initial appointments under 26
subsection (2)(a) of Section 5 of this Act within 90 days of the effective date of this Act. 27
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(2) Notwithstanding subsection (2)(d)2. of Section 5 of this Act, initial 1
appointments under subsection (2)(a) of Section 5 of this Act shall be staggered so that, 2
of the initial 13 appointments: 3
(a) Five of the appointments expire four years after the initial appointment; 4
(b) Four of the appointments expire three years after the initial appointment; and 5
(c) Four of the appointments expire two years after the initial appointment. 6
Section 12. If the Cabinet for Health and Family Services or the Department for 7
Medicaid Services determines that a state plan amendment, waiver, or any other form of 8
authorization or approval from any federal ag ency to implement Section 6 of this Act is 9
necessary to prevent the loss of federal funds or to comply with federal law, the cabinet 10
or department: 11
(1) Shall, within 90 days after the effective date of this section, request the 12
necessary federal authorization or approval to implement Section 6 of this Act; and 13
(2) May only delay implementation of the provisions of Section 6 of this Act for 14
which federal authorization or approval was deemed necessary until the federal 15
authorization or approval is granted. 16
Section 13. Sections 6 and 12 of this Act constitute the specific authorization 17
required under KRS 205.5372(1). 18