Title 806 | Chapter 017 | Regulation 590
SUPERSEDED
This document is no longer current.
PREVIOUS VERSION
The previous document that this document is based upon is available.
PUBLIC PROTECTION CABINET
Department of Insurance
Health Life and Managed Care Division
(Amendment)
806 KAR 17:590.Annual report on providers prescribing medication for addiction treatment.
Section 1.
Definitions.(1)
"Commissioner" is defined by KRS 304.1-050(1).(2)
"Department" is defined by(3)
"Insurer" is defined by KRS 304.17A-005(29).(4)
"Medication for addiction treatment" means a prescription drug that:(a)
1.
Is prescribed for use in the treatment of alcohol or opioid addiction; and2.
Contains methadone, buprenorphine, or naltrexone; or(b)
Was approved before January 1, 2022, by the United States Food and Drug Administration for the mitigation of opioid withdrawal symptoms.(5)
Section 2.
Data Reporting Requirements.(1)
(a)
An insurer authorized to write health insurance in this state shall submit the data required by the Annual Report on Providers Prescribing Medication for Addiction Treatment Form(2)(b)
The data required by the Annual Report on Providers Prescribing Medication for Addiction Treatment Form1.
2.
3.
(2)
(a)
(b)
(c)
1.
2.
3.
Section 3.
Material Incorporated by Reference.(1)
(a)
(b)
(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Department of Insurance, Mayo-Underwood Building, 500 Mero Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 pm. This material is also available on the department's Web site at https://insurance.ky.gov/ppc/CHAPTER.aspx.SHARON P. CLARK, Commissioner
RAY A. PERRY, Secretary
APPROVED BY AGENCY: September 12, 2023
FILED WITH LRC: September 13, 2023 at noon
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held at 9:00 a.m. on November 28, 2023 at 500 Mero Street, Frankfort, Kentucky 40602. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through 11:59 p.m. on November 30, 2023. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person below.
CONTACT PERSON: Abigail Gall, Executive Advisor, 500 Mero Street, Frankfort, Kentucky 40601, phone +1 (502) 564-6026, fax +1 (502) 564-1453, email abigail.gall@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Abigail Gall
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation sets forth the format and submission time frame for the data reporting requirements in KRS 304.17A-732.
(b) The necessity of this administrative regulation:
The necessity of this administrative regulation is to adhere to the reporting requirements set forth in KRS 304.17A-732 which requires insurers to annually report to the commissioner the number and type of providers that have prescribed medication for addiction treatment to its insureds in conjunction with behavioral therapy and not in conjunction with behavioral therapy.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 304.2-110 authorizes that the Commissioner may promulgate administrative regulations relative to the Kentucky Insurance Code, as well as KRS 304.17A-732.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation assists in the effectuation of KRS 304.17A-732, which was Senate Bill 51 of this 2021 Regular Session.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The amendments change the reporting form process.
(b) The necessity of the amendment to this administrative regulation:
These amendments are necessary to make the process more efficient and accessible for reporting insurers and the department.
(c) How the amendment conforms to the content of the authorizing statutes:
These amendments conform to the statutes by requesting the exact data for the department to submit its annual report.
(d) How the amendment will assist in the effective administration of the statutes:
These amendments streamline the reporting process and ensure the department can meet the statutory reporting requirements.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
All insurers offering/transacting in health insurance in the state of Kentucky.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Health Insurers will need to provide the Commissioner with a listing of provider types that are prescribing medicated assistant treatment in conjunction with behavioral therapy and not.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no associated cost with this administrative regulation.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Insurers and PBMs will be in compliance with statutory reporting requirements.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Implementation of this amendment is not anticipated to have an initial cost on the Department of Insurance.
(b) On a continuing basis:
Implementation of this amendment is not anticipated to have an on-going cost on the Department of Insurance.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Department will use funds from its current operational budget to perform the tasks necessary.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
There will be no increase in fees or funding to implement this new administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
There a no fees that will be established.
(9) TIERING: Is tiering applied?
Tiering is not applied because this administrative regulation requires all insurers licensed to transact health insurance to report the same information to the department.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Department as the implementer of this administrative regulation.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
No revenue is expected to be generated.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
No revenue is expected to be generated.
(c) How much will it cost to administer this program for the first year?
No cost is expected.
(d) How much will it cost to administer this program for subsequent years?
No cost is expected.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Neutral
Expenditures (+/-):
Neutral
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
(c) How much will it cost the regulated entities for the first year?
(d) How much will it cost the regulated entities for subsequent years?
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)]
PUBLIC PROTECTION CABINET
Department of Insurance
Health Life and Managed Care Division
(Amendment)
806 KAR 17:590.Annual report on providers prescribing medication for addiction treatment.
Section 1.
Definitions.(1)
"Commissioner" is defined by KRS 304.1-050(1).(2)
"Department" is defined by KRS 304.1-050(2).(3)
"Insurer" is defined by KRS 304.17A-005(29).(4)
"Medication for addiction treatment" means a prescription drug that:(a)
1.
Is prescribed for use in the treatment of alcohol or opioid addiction; and2.
Contains methadone, buprenorphine, or naltrexone; or(b)
Was approved before January 1, 2022, by the United States Food and Drug Administration for the mitigation of opioid withdrawal symptoms.Section 2.
Data Reporting Requirements.(1)
An insurer authorized to write health insurance in this state shall submit the data required by the Annual Report on Providers Prescribing Medication for Addiction Treatment Form to the commissioner by March 31st of each year.(2)
The data required by the Annual Report on Providers Prescribing Medication for Addiction Treatment Form shall be submitted via electronic mail to DOI.Healthreporting@ky.gov:Section 3.
Material Incorporated by Reference.(1)
Annual Report on Providers Prescribing Medication for Addiction Treatment Form, 7/2023, is incorporated by reference.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Department of Insurance, Mayo-Underwood Building, 500 Mero Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 pm. This material is also available on the department's Web site at https://insurance.ky.gov/ppc/CHAPTER.aspx.SHARON P. CLARK, Commissioner
RAY A. PERRY, Secretary
APPROVED BY AGENCY: September 12, 2023
FILED WITH LRC: September 13, 2023 at noon
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held at 9:00 a.m. on November 28, 2023 at 500 Mero Street, Frankfort, Kentucky 40602. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through 11:59 p.m. on November 30, 2023. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person below.
CONTACT PERSON: Abigail Gall, Executive Advisor, 500 Mero Street, Frankfort, Kentucky 40601, phone +1 (502) 564-6026, fax +1 (502) 564-1453, email abigail.gall@ky.gov
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Abigail Gall
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation sets forth the format and submission time frame for the data reporting requirements in KRS 304.17A-732.
(b) The necessity of this administrative regulation:
The necessity of this administrative regulation is to adhere to the reporting requirements set forth in KRS 304.17A-732 which requires insurers to annually report to the commissioner the number and type of providers that have prescribed medication for addiction treatment to its insureds in conjunction with behavioral therapy and not in conjunction with behavioral therapy.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 304.2-110 authorizes that the Commissioner may promulgate administrative regulations relative to the Kentucky Insurance Code, as well as KRS 304.17A-732.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation assists in the effectuation of KRS 304.17A-732, which was Senate Bill 51 of this 2021 Regular Session.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The amendments change the reporting form process.
(b) The necessity of the amendment to this administrative regulation:
These amendments are necessary to make the process more efficient and accessible for reporting insurers and the department.
(c) How the amendment conforms to the content of the authorizing statutes:
These amendments conform to the statutes by requesting the exact data for the department to submit its annual report.
(d) How the amendment will assist in the effective administration of the statutes:
These amendments streamline the reporting process and ensure the department can meet the statutory reporting requirements.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
All insurers offering/transacting in health insurance in the state of Kentucky.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Health Insurers will need to provide the Commissioner with a listing of provider types that are prescribing medicated assistant treatment in conjunction with behavioral therapy and not.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no associated cost with this administrative regulation.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Insurers and PBMs will be in compliance with statutory reporting requirements.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Implementation of this amendment is not anticipated to have an initial cost on the Department of Insurance.
(b) On a continuing basis:
Implementation of this amendment is not anticipated to have an on-going cost on the Department of Insurance.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Department will use funds from its current operational budget to perform the tasks necessary.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
There will be no increase in fees or funding to implement this new administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
There a no fees that will be established.
(9) TIERING: Is tiering applied?
Tiering is not applied because this administrative regulation requires all insurers licensed to transact health insurance to report the same information to the department.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Department as the implementer of this administrative regulation.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
No revenue is expected to be generated.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
No revenue is expected to be generated.
(c) How much will it cost to administer this program for the first year?
No cost is expected.
(d) How much will it cost to administer this program for subsequent years?
No cost is expected.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Neutral
Expenditures (+/-):
Neutral
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
(c) How much will it cost the regulated entities for the first year?
(d) How much will it cost the regulated entities for subsequent years?
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)]