Kentucky
General Assembly

02/19/25	introduced in House to Committee on Committees (H)
02/21/25	to Appropriations & Revenue (H)
02/25/25	taken from Appropriations & Revenue (H) 1st reading returned to Appropriations & Revenue (H)
02/26/25	taken from Appropriations & Revenue (H) 2nd reading returned to Appropriations & Revenue (H)
03/04/25	reported favorably, to Rules with Committee Substitute (1) taken from Rules placed in the Orders of the Day for Tuesday, March 04, 2025 3rd reading, passed 80-19 with Committee Substitute (1)
03/05/25	received in Senate to Committee on Committees (S)
03/11/25	to Appropriations & Revenue (S)
03/12/25	reported favorably, 1st reading, to Calendar with Committee Substitute (1)
03/13/25	2nd reading, to Rules posted for passage in the Regular Orders of the Day for Friday, March 14, 2025
03/14/25	passed over and retained in the Orders of the Day taken from the Regular Orders of the Day recommitted to Appropriations & Revenue (S) reported favorably, to Rules with Committee Substitute (2) posted for passage in the Regular Orders of the Day for Friday, March 14, 2025 3rd reading, passed 29-7 with Committee Substitute (2) received in House to Rules (H) posted for passage for concurrence in Senate Committee Substitute (2) House concurred in Senate Committee Substitute (2) passed 72-19 enrolled, signed by Speaker of the House enrolled, signed by President of the Senate delivered to Governor

Amendment	House Committee Substitute 1
Fiscal Impact Statement	Fiscal Note to House Committee Substitute 1
Summary	Retain original provisions, except delete requirement for the Cabinet for Health and Family Services to obtain authorization from the General Assembly prior to making changes to Medicaid reimbursement rates and provisions designating funds deposited into the Kentucky Medicaid pharmaceutical rebate fund as unappropriated; and establish that the requirement for the Cabinet for Health and Family Services to obtain authorization from the General Assembly prior to making changes to the Medicaid program shall not apply to directed or supplemental Medicaid payment programs approved by the Centers for Medicare and Medicaid Services prior to the effective date of this Act or to the Medicaid preferred drug list established by the Department for Medicaid Services; direct the Cabinet for Health and Family Services to submit a waiver application to establish a community engagement program for certain Medicaid beneficiaries within 90 days after the effective date of this Act; require the Cabinet for Health and Family Services to provide a copy of the community engagement waiver application to the Legislative Research Commission and to update the Legislative Research Commission on the status of the application at least quarterly; establish that moneys in the Kentucky Medicaid pharmaceutical rebate fund at the close of state fiscal years 2024-2025 and 2025-2026 shall not lapse and shall carry forward; include KRS 142.361 in the list of providers taxes and assessments to be reported to the Legislative Research Commissions; increase the number of units of psychoeducational services that the Department for Medicaid Services and managed care organizations are required to cover and provide reimbursement for from 100 to 400; increase the number of units of psychoeducational services allowed per day from one to four; establish that the Cabinet for Health and Family Services is authorized to make any change to eligibility, coverage, or benefits in the Medicaid program provided for in 2024 Ky. Acts ch. 173, sec. 1(186) and 2024 Ky. Acts ch. 175, Part I, G., 3., b.; make technical corrections; EMERGENCY.
Index Headings	Reports Mandated - Medicaid managed care organizations, reports mandated Fiscal Note - Medicaid, program changes, General Assembly authorization requirement, pharmaceutical rebates Effective Dates, Emergency - Medicaid program, administration General Assembly - Medicaid, program changes, General Assembly authorization requirement Health and Medical Services - Medicaid, program changes, General Assembly authorization requirement Mental Health - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Mental Health - Medicaid, prior authorizations Mental Health - Psychoeducational services, Medicaid coverage, requirement Public Assistance - Medicaid, pharmaceutical rebates, sequestration of funds Public Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Pharmaceutical rebates, sequestration of funds Public Medical Assistance - Psychoeducational services, coverage, requirement Public Medical Assistance - Record retention, requirements State Agencies - Department for Medicaid Services, pharmaceutical rebates, sequestration of funds State Agencies - Department for Medicaid Services, procurement of managed care contracts, requirement State Agencies - Department for Medicaid Services, program changes, General Assembly authorization requirement State Agencies - Department for Medicaid Services, record retention, requirements Substance Abuse - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Substance Abuse - Medicaid, prior authorizations Substance Abuse - Psychoeducational services, Medicaid coverage, requirement Medicaid - Managed care organizations, behavioral health and substance use scorecard, requirement Medicaid - Medicaid, program changes, General Assembly authorization requirement Medicaid - Pharmaceutical rebates, sequestration of funds Medicaid - Psychoeducational services, coverage, requirement Medicaid - Record retention, requirements Reports Mandated - Cabinet for Health and Family Services, reports mandated Reports Mandated - Department for Medicaid Services, reports mandated

Amendment	Senate Committee Substitute 1
Fiscal Impact Statement	Fiscal Note to Senate Committee Substitute 1
Summary	Retain original provisions, except delete Medicaid coverage limitations for psychoeducational services; establish that changes to the Medicaid program necessitated by requirements imposed by the federal Centers for Medicare and Medicaid Services or related to payment programs for university hospitals shall be exempt from the requirement that the change be authorized by the General Assembly; locate the Kentucky Medicaid pharmaceutical rebate fund in the Cabinet for Health and Family Services instead of the Finance and Administration Cabinet; establish that moneys in the Kentucky Medicaid pharmaceutical rebate fund shall be expended in accordance with federal law for the purpose of providing Medicaid-covered services; create new sections of KRS Chapter 205 to require the Department for Medicaid Services to monitor utilization rates and expenditures for behavioral health and substance use disorder services and to report to the Legislative Research Commission on any service for which the utilization rate or expenditures increase by more than 10 percent over the previous calendar year and to limit the number of managed care organizations contracted by the Department for Medicaid Services to no more than three; establish that Medicaid beneficiaries receiving behavioral health services prior to the effective date of this Act for which prior authorization requirements are reinstated shall be permitted to continue to receive those services for 180 days without a prior authorization; establish that any managed care organization that failed during state fiscal year 2025-2026 to comply with 2024 Ky Acts ch. 175, Part I, G., 3., a., (2) and b., (7) be ineligible to for a new Medicaid managed care contract; require the Cabinet for Health and Family Services to develop a behavioral health and substance use disorder treatment services scorecard to be used by all contracted Medicaid managed care organizations; require the Cabinet for Health and Family Services to conduct a feasibility study for managed long-term services and supports.
Index Headings	General Assembly - Medicaid, program changes, General Assembly authorization requirement Health and Medical Services - Medicaid, program changes, General Assembly authorization requirement Mental Health - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Mental Health - Medicaid, prior authorizations Public Assistance - Medicaid managed care contracts, limit on number awarded Public Assistance - Medicaid, pharmaceutical rebates, sequestration of funds Public Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Medicaid managed care contracts, limit on number awarded Public Medical Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Pharmaceutical rebates, sequestration of funds Public Medical Assistance - Record retention, requirements State Agencies - Department for Medicaid Services, procurement of managed care contracts, requirement State Agencies - Department for Medicaid Services, program changes, General Assembly authorization requirement State Agencies - Department for Medicaid Services, record retention, requirements State Agencies - Department for Medicaid Services, pharmaceutical rebates, sequestration of funds Substance Abuse - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Substance Abuse - Medicaid, prior authorizations Medicaid - Managed care organizations, behavioral health and substance use scorecard, requirement Medicaid - Medicaid, program changes, General Assembly authorization requirement Medicaid - Pharmaceutical rebates, sequestration of funds Medicaid - Record retention, requirements Contracts - Medicaid managed care contracts, limit on number awarded Reports Mandated - Cabinet for Health and Family Services, reports mandated Reports Mandated - Department for Medicaid Services, reports mandated Reports Mandated - Medicaid managed care organizations, reports mandated Fiscal Note - Department for Medicaid Services, pharmaceutical rebates, sequestration of funds

Amendment	Senate Committee Substitute 2
Summary	Retain original provisions, except delete Medicaid coverage limitations for psychoeducational services; establish that changes to the Medicaid program necessitated by requirements imposed by the federal Centers for Medicare and Medicaid Services or related to payment programs for university hospitals shall be exempt from the requirement that the change be authorized by the General Assembly; amend KRS 205.5371 to establish that the community engagement program shall be a mandatory waiver program; locate the Kentucky Medicaid pharmaceutical rebate fund in the Cabinet for Health and Family Services instead of the Finance and Administration Cabinet; establish that moneys in the Kentucky Medicaid pharmaceutical rebate fund shall be expended in accordance with federal law; create new sections of KRS Chapter 205 to require the Department for Medicaid Services to monitor utilization rates and expenditures for behavioral health and substance use disorder services and to report to the Legislative Research Commission on any service for which the utilization rate or expenditures increase by more than 10 percent over the previous calendar year; establish that any managed care organization that failed during state fiscal year 2025-2026 to comply with 2024 Ky Acts ch. 175, Part I, G., 3., a., (2) and b., (7) be ineligible for a new Medicaid managed care contract; require the Cabinet for Health and Family Services to develop a behavioral health and substance use disorder treatment services scorecard to be used by all contracted Medicaid managed care organizations; create various new sections of KRS Chapter 7A to establish the Medicaid Oversight and Advisory Board, the board's membership, and duties.
Index Headings	General Assembly - Medicaid, program changes, General Assembly authorization requirement Health and Medical Services - Medicaid, program changes, General Assembly authorization requirement Mental Health - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Mental Health - Medicaid, prior authorizations Public Assistance - Medicaid managed care contracts, limit on number awarded Public Assistance - Medicaid, pharmaceutical rebates, sequestration of funds Public Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Medicaid managed care contracts, limit on number awarded Public Medical Assistance - Medicaid, program changes, General Assembly authorization requirement Public Medical Assistance - Pharmaceutical rebates, sequestration of funds Public Medical Assistance - Record retention, requirements State Agencies - Cabinet for Health and Family Services, Medicaid Oversight and Advisory Board, establishment State Agencies - Department for Medicaid Services, pharmaceutical rebates, sequestration of funds State Agencies - Department for Medicaid Services, procurement of managed care contracts, requirement State Agencies - Department for Medicaid Services, program changes, General Assembly authorization requirement State Agencies - Department for Medicaid Services, record retention, requirements State Agencies - Office of the State Budget Director, Medicaid Oversight and Advisory Board, establishment Substance Abuse - Medicaid managed care organizations, behavioral health and substance use scorecard, requirement Substance Abuse - Medicaid, prior authorizations Medicaid - Managed care organizations, behavioral health and substance use scorecard, requirement Medicaid - Medicaid Oversight and Advisory Board, establishment Medicaid - Medicaid, program changes, General Assembly authorization requirement Medicaid - Pharmaceutical rebates, sequestration of funds Medicaid - Record retention, requirements Auditor of Public Accounts - Medicaid Oversight and Advisory Board, establishment Reports Mandated - Cabinet for Health and Family Services, reports mandated Reports Mandated - Department for Medicaid Services, reports mandated Reports Mandated - Medicaid managed care organizations, reports mandated Advisory Boards, Commissions, and Committees - Medicaid Oversight and Advisory Board, establishment