26RS SB 97

Senate Bill 97

Actions

Last Action	01/15/26: to Committee on Committees (S)
Title	AN ACT relating to coverage for prostheses and orthoses.
Bill Documents	Introduced
Fiscal Impact Statements	Actuarial Analysis Health Mandate Local Mandate State Employee Health Plan Impact
Bill Request Number	1263
Sponsors	R. Girdler, J. Adams
Summary of Original Version	Create a new section of Subtitle 17A of KRS Chapter 304 to require health benefit plans to provide coverage for prostheses and orthoses; establish minimum requirements for the required coverage; require utilizations review decisions to be made in a nondiscriminatory manner; require an insurer or its private review agent to provide notice of certain rights of the insured; establish notice requirements for denials; establish network adequacy requirements for the provision of a prosthesis or orthosis that is required to be covered; establish reporting requirements for insurers and the commissioner of the Department of Insurance relating to the required coverage; amend KRS 164.2871 and 18A.225 to require self-insured group health plans offering by the governing board of state postsecondary education institutions and the state employee health plan to comply with the requirements relating to coverage for prostheses and orthoses; provide that the Act applies to health benefit plans issued or renewed on or after January 1, 2027; EFFECTIVE January 1, 2027.
Index Headings of Original Version	Health Benefit Plan Mandate - Prostheses and orthoses, coverage requirement, network adequacy Local Mandate - Prostheses and orthoses, coverage requirement, network adequacy State Employee Health Plan Mandate - Prostheses and orthoses, coverage requirement, network adequacy Disabilities - Prostheses and orthoses, coverage requirement Education, Higher - Self-insured group health plans, prostheses and orthoses, coverage, requirements Effective Dates, Delayed - Prostheses and orthoses, coverage requirement, January 1, 2027 Health And Medical Services - Prostheses and orthoses, coverage requirement Health Care Professionals - Prostheses and orthoses, insurance, network adequacy Insurance, Health - Prostheses and orthoses, coverage requirement, network adequacy Reports Mandated - Department of Insurance, prostheses and orthoses coverage Reports Mandated - Insurers, prostheses and orthoses coverage State Employees - Health plan, prostheses and orthoses, coverage requirement Actuarial Analysis - Prostheses and orthoses, coverage requirement, network adequacy