AN ACT relating to reimbursement for pharmacist services.
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HB 48 — AN ACT relating to reimbursement for pharmacist services.
Last action — signed by Governor (Acts Ch. 30)
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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✓In Committee
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✓Passed House
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✓Passed Senate
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced September 16, 2020. Enacted.
Prognosis
Where this bill stands today.
Odds of enactment
HighHow often bills like it became law.
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Enacted
Current position in the legislative process.
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59 sponsors
59 primary, 0 co-sponsors signed on.
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Bipartisan support
Sponsored across 2 parties (31 R · 6 D) — cross-party backing.
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Cleared a recorded vote
Passed 2 recorded votes so far.
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
Bill Text
What changed in the latest version
497 added · 667 removed497 line(s) added, 667 removed.
UNOFFICIALCHAPTER COPY30 211 RSCHAPTER 30 ( HB 48/GA48 ) AN ACT relating to reimbursement for pharmacist services.
Shall include any health maintenance organization, provider-provider-sponsored sponsored integrated health delivery network, or nonprofit hospital, medical-surgical, dental, and health service corporation;
Page 1 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA Section 2.
(c) The uniform health insurance claim form for all other health care providers shall consist of the HCFA 1500 data set or its successor submitted on the designated paper or electronic format as adopted by the National Uniform Claim[Claims] Committee;
and Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY 2.
Page 2 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (b) Modify the uniform claims form or its content;
(1) After a hearing or upon agreement by the self-insured employer-organized association group, the commissioner may suspend or revoke the certificate of filing of a self-insured employer-organized association group, impose a civil penalty of up to five thousand dollars ($5,000) per violation on a self-insured employer-organizedemployer- organized association group, or both, for:
(1) The Office of Health Data and Analytics shall select a third-party administrator, Page 3 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA through the state competitive bidding process, to administer Kentucky Access.
At least one (1) year prior to the expiration of the third-third-party party administrator's contract, the office may solicit third-party administrators, CHAPTER 30 3 including the current third-party administrator, to submit bids to serve as the third-third-party party administrator for the succeeding four (4) year period.
(3) In addition to any duties and obligations set forth in the contract with the third-party administrator, the third-partythird- party administrator shall:
(a) Develop and establish policies and procedures for enrollee enrollment, eligibility determination, provider enrollment and credentialing, utilization management, case management, disease management, quality improvement, Page 4 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA drug utilization review, premium billing and collection, data reporting, and other responsibilities determined by the office;
Page 5 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA 4.
or by any city, urban-county, charter county, county, or consolidated local government, whose legislative body has opted to participate in the state-state-sponsored sponsored health insurance program pursuant to KRS 79.080;
or, in the case of a public postsecondary education institution, is an individual participating in an optional retirement plan Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY authorized by KRS 161.567;
or is eligible to participate in a retirement plan established by an employer who ceases participating in the Kentucky Employees Retirement System pursuant to KRS 61.522 whose employees participated in the health insurance plans Page 6 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA administered by the Personnel Cabinet prior to the employer's effective cessation date in the Kentucky Employees Retirement System;
(2) (a) The secretary of the Finance and Administration Cabinet, upon the recommendation of the secretary of the Personnel Cabinet, shall procure, in compliance with the provisions of KRS 45A.080, 45A.085, and 45A.090, from one (1) or more insurers authorized to do business in this state, a group Page 7 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA health benefit plan that may include but not be limited to health maintenance organization (HMO), preferred provider organization (PPO), point of service (POS), and exclusive provider organization (EPO) benefit plans encompassing all or any class or classes of employees.
(c) Any carrier bidding to offer health care coverage to employees shall agree to Page 8 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA provide coverage to all members of the state group, including active employees and retirees and their eligible covered dependents and beneficiaries, within the county or counties specified in its bid.
CHAPTER 30 5 (d) Any carrier bidding to offer health care coverage to employees shall agree to provide enrollment, claims, and utilization data to the Commonwealth in a format specified by the Personnel Cabinet with the understanding that the data shall be owned by the Commonwealth;
The Personnel Cabinet shall include in the October annual report submitted pursuant to the provisions of KRS 18A.226 to the Governor, the General Assembly, and the Chief Justice of the Supreme Court, an analysis of the financial stability of the program, which shall include but not be limited to Page 9 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA loss ratios, methods of risk adjustment, measurements of carrier quality of service, prescription coverage and cost management, and statutorily required mandates.
or (c) Partly from each, except that any premium due for health care coverage or dental coverage, if any, in excess of the premium amount contributed by any Page 10 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA department, board, agency, postsecondary education institution, or branch of state, city, urban-county, charter county, county, or consolidated local government for any other health care coverage shall be paid by the employee.
Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY (6) The policy or policies may contain the provisions with respect to the class or classes of employees covered, amounts of insurance or coverage for designated classes or groups of employees, policy options, terms of eligibility, and continuation of insurance or coverage after retirement.
Page 11 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (9) The secretary shall appoint thirty-two (32) persons to an Advisory Committee of State Health Insurance Subscribers to advise the secretary or the secretary's designee regarding the state-sponsored health insurance program for employees.
(11) Interruption of an established treatment regime with maintenance drugs shall be grounds for an insured to appeal a formulary change through the established appeal procedures approved by the Department of Insurance, if the physician supervising Page 12 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA the treatment certifies that the change is not in the best interests of the patient.
(15) Any policy provided to state employees or their dependents pursuant to this section shall provide coverage for the diagnosis and treatment of autism spectrum disorders Page 13 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA consistent with KRS 304.17A-142.
CHAPTER 30 7 (17) If a state employee's residence and place of employment are in the same county, and if the hospital located within that county does not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the employee may select a plan available in a contiguous county that does provide those services, and the state contribution for the plan shall be the amount available in the county where the plan selected is located.
Page 14 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (a) The regional rating bid scenario shall not include a request for bid on a statewide option;
Page 15 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (b) [the provisions of ]KRS 304.17A-270 and 304.17A-525;
Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY [(23) Any fully insured health benefit plan or self -insured plan issued or renewed on or after July 12, 2006, to public employees shall comply with KRS 304.17A-600 to 304.17A-633 pertaining to utilization review, KRS 205.593 and 304.17A-700 to 304.17A-730 pertaining to payment of claims, KRS 304.14-135 pertaining to uniform health insurance claim forms, KRS 304.17A-580 and 304.17A-641 pertaining to emergency medical care, KRS 304.99-123, and any administrative regulations promulgated thereunder.
Page 16 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (2) In claims resulting in an award of permanent total disability or resulting from an injury described in subsection (9) of this section, the employer's obligation to pay the benefits specified in this section shall continue for so long as the employee is disabled regardless of the duration of the employee's income benefits.
Page 17 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (d) If the administrative law judge determines that medical benefits are not reasonably necessary or not related to the work injury or occupational disease, or if an employee fails to make proper application for continued benefits within the time period provided in paragraph (c) of this subsection, any future medical treatment shall be deemed to be unrelated to the work injury and the employer's obligation to pay medical benefits shall cease permanently.
The provider of medical services shall submit the statement for services within forty-fiveforty- five (45) days of the day treatment is initiated and every forty-five (45) days thereafter, if appropriate, as long as medical services are rendered.
CHAPTER 30 9 (5) Notwithstanding any provision of the Kentucky Revised Statutes to the contrary, medical services and treatment provided under this chapter shall not be subject to copayments or deductibles.
Page 18 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA (6) Employers may provide medical services through a managed health care system.
(h) A schedule of fees for all medical services to be provided under this chapter Page 19 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA which shall not be subject to the limitations on medical fees contained in this chapter.
then the administrative law judge may allow the Page 20 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA employer to select a physician to treat the employee and the hospital or hospitals in which the employee is treated for the injury or disease.
Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY (11) An employee who reports an injury alleged to be work-related or files an application for adjustment of a claim shall execute a waiver and consent of any physician-physician-patient, patient, psychiatrist-patient, or chiropractor-patient privilege with respect to any condition or complaint reasonably related to the condition for which the employee claims compensation.
and Page 21 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA 3.
Page 22 of 23 HB004810.100 - 328 - XXXX GA UNOFFICIAL COPY 21 RS HB 48/GA b.
PageSigned 23by ofGovernor 23March HB004810.10017, -2021. 328 - XXXX GA
Action History
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signed by Governor (Acts Ch. 30)
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delivered to Governor
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enrolled, signed by President of the Senate
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enrolled, signed by Speaker of the House
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received in House
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3rd reading, passed 35-0
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posted for passage in the Consent Orders of the Day for Thursday, March 11, 2021
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reported favorably, to Rules as a consent bill
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returned to Health & Welfare (S)
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2nd reading
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taken from Health & Welfare (S)
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returned to Health & Welfare (S)
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1st reading
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taken from Health & Welfare (S)
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to Health & Welfare (S)
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to Committee on Committees (S)
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received in Senate
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3rd reading, passed 96-0
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posted for passage in the Regular Orders of the Day for Tuesday, March 2, 2021
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2nd reading, to Rules
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reported favorably, 1st reading, to Calendar
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posted in committee
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to Banking & Insurance (H)
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to Committee on Committees (H)
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introduced in House
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Prefiled by the sponsor(s).
Sponsors
- D. Bentley · Primary
- Kim Banta · Primary
- L. Bechler · Primary
- John Blanton · Primary
- Tina Bojanowski · Primary
- Adam Bowling · Primary
- Josh Branscum · Primary
- Josh Bray · Primary
- Randy Bridges · Primary
- Josh Calloway · Primary
- Ryan Dotson · Primary
- J. DuPlessis · Primary
- J. Fischer · Primary
- Patrick Flannery · Primary
- Deanna Gordon · Primary
- Chris Freeland · Primary
- R. Goforth · Primary
- D. Graham · Primary
- David Hale · Primary
- Mark Hart · Primary
- A. Hatton · Primary
- R. Heath · Primary
- Samara Heavrin · Primary
- Thomas Huff · Primary
- DJ Johnson · Primary
- Nima Kulkarni · Primary
- Derek Lewis · Primary
- Scott Lewis · Primary
- Mary Lou Marzian · Primary
- C. Massey · Primary
- Bobby McCool · Primary
- C. McCoy · Primary
- P. Minter · Primary
- Jason Nemes · Primary
- David W. Osborne · Primary
- R. Palumbo · Primary
- P. Pratt · Primary
- M. Prunty · Primary
- B. Reed · Primary
- Steve Riley · Primary
- Steven Rudy · Primary
- S. Santoro · Primary
- A. Scott · Primary
- Scott Sharp · Primary
- S. Sheldon · Primary
- Tom Smith · Primary
- Ashley Tackett Laferty · Primary
- Nancy Tate · Primary
- Walker Thomas · Primary
- K. Timoney · Primary
- James Tipton · Primary
- R. Webber · Primary
- S. Westrom · Primary
- B. Wheatley · Primary
- Lisa Willner · Primary
- Pamela Stevenson · Primary
- Thomas Huff · Primary
- Ken Fleming · Primary
- Steve Bratcher · Primary
Sponsorship breakdown
Export CSV (upgrade) →59 sponsors · 0 co-sponsors · 79 not signed on
Sponsors (59)
- D. Bentley
- Kim Banta Republican
- L. Bechler
- John Blanton Republican
- Tina Bojanowski Democrat
- Adam Bowling Republican
- Josh Branscum Republican
- Josh Bray Republican
- Randy Bridges Republican
- Josh Calloway Republican
- Ryan Dotson Republican
- J. DuPlessis
- J. Fischer
- Patrick Flannery Republican
- Deanna Gordon Republican
- Chris Freeland Republican
- R. Goforth
- D. Graham
- David Hale Republican
- Mark Hart Republican
- A. Hatton
- R. Heath
- Samara Heavrin Republican
- Thomas Huff Republican
- DJ Johnson Republican
- Nima Kulkarni Democrat
- Derek Lewis Republican
- Scott Lewis Republican
- Mary Lou Marzian Democrat
- C. Massey
- Bobby McCool Republican
- C. McCoy
- P. Minter
- Jason Nemes Republican
- David W. Osborne Republican
- R. Palumbo
- P. Pratt
- M. Prunty
- B. Reed
- Steve Riley Republican
- Steven Rudy Republican
- S. Santoro
- A. Scott
- Scott Sharp Republican
- S. Sheldon
- Tom Smith Republican
- Ashley Tackett Laferty Democrat
- Nancy Tate Republican
- Walker Thomas Republican
- K. Timoney
- James Tipton Republican
- R. Webber
- S. Westrom
- B. Wheatley
- Lisa Willner Democrat
- Pamela Stevenson Democrat
- Thomas Huff Republican
- Ken Fleming Republican
- Steve Bratcher Republican
Co-sponsors (0)
None.
Not signed on (79)
79 members have not signed on to this bill.
Show all 79 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 16 | 0 | 0 | 0 |
| Republican | 17 | 0 | 0 | 0 |
| Democrat | 2 | 0 | 0 | 0 |
| Total | 35 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (35)
| Member | Party | Vote |
|---|---|---|
| Alvarado | — | Yea |
| Turner | — | Yea |
| Hornback | — | Yea |
| Schickel | — | Yea |
| Buford | — | Yea |
| Schroder | — | Yea |
| Smith | — | Yea |
| Westerfield | — | Yea |
| McGarvey | — | Yea |
| Southworth | — | Yea |
| Castlen | — | Yea |
| Meredith | — | Yea |
| Embry | — | Yea |
| Thayer | — | Yea |
| Yates | — | Yea |
| Thomas | — | Yea |
| Gerald A. Neal | Democrat | Yea |
| Karen Berg | Democrat | Yea |
| Brandon J. Storm | Republican | Yea |
| Christian McDaniel | Republican | Yea |
| Danny Carroll | Republican | Yea |
| David P. Givens | Republican | Yea |
| Jared Carpenter | Republican | Yea |
| Jason Howell | Republican | Yea |
| Jason Nemes | Republican | Yea |
| Jimmy Higdon | Republican | Yea |
| Julie Raque Adams | Republican | Yea |
| Max Wise | Republican | Yea |
| Mike Wilson | Republican | Yea |
| Phillip Wheeler | Republican | Yea |
| Rick Girdler | Republican | Yea |
| Robby Mills | Republican | Yea |
| Robert Stivers | Republican | Yea |
| Robin L. Webb | Republican | Yea |
| Stephen West | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 52 | 0 | 0 | 0 |
| Unaffiliated | 37 | 0 | 0 | 0 |
| Democrat | 7 | 0 | 0 | 0 |
| Total | 96 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (96)
| Member | Party | Vote |
|---|---|---|
| Meredith | — | Yea |
| Santoro | — | Yea |
| Fischer | — | Yea |
| Scott | — | Yea |
| Bechler | — | Yea |
| Jenkins | — | Yea |
| Bentley | — | Yea |
| Sheldon | — | Yea |
| Minter | — | Yea |
| Smith | — | Yea |
| Flood | — | Yea |
| Palumbo | — | Yea |
| Thomas | — | Yea |
| Goforth | — | Yea |
| Pratt | — | Yea |
| Timoney | — | Yea |
| Burch | — | Yea |
| Prunty | — | Yea |
| Graham | — | Yea |
| Cantrell | — | Yea |
| Raymond | — | Yea |
| Webber | — | Yea |
| Massey | — | Yea |
| Dixon | — | Yea |
| Hatton | — | Yea |
| Westrom | — | Yea |
| Donohue | — | Yea |
| Heath | — | Yea |
| McCoy | — | Yea |
| Wheatley | — | Yea |
| Rowland | — | Yea |
| DuPlessis | — | Yea |
| Huff R | — | Yea |
| Kirk McCormick | — | Yea |
| Miller C | — | Yea |
| Miller J | — | Yea |
| Stevenson C | — | Yea |
| Al Gentry | Democrat | Yea |
| Ashley Tackett Laferty | Democrat | Yea |
| Lisa Willner | Democrat | Yea |
| Mary Lou Marzian | Democrat | Yea |
| Nima Kulkarni | Democrat | Yea |
| Pamela Stevenson | Democrat | Yea |
| Tina Bojanowski | Democrat | Yea |
| Aaron Reed | Republican | Yea |
| Adam Bowling | Republican | Yea |
| Bill Wesley | Republican | Yea |
| Bobby McCool | Republican | Yea |
| Chris Freeland | Republican | Yea |
| Chris Fugate | Republican | Yea |
| DJ Johnson | Republican | Yea |
| Daniel Elliott | Republican | Yea |
| Daniel Fister | Republican | Yea |
| David Hale | Republican | Yea |
| David Meade | Republican | Yea |
| David W. Osborne | Republican | Yea |
| Deanna Gordon | Republican | Yea |
| Derek Lewis | Republican | Yea |
| Felicia Rabourn | Republican | Yea |
| James Tipton | Republican | Yea |
| Jason Nemes | Republican | Yea |
| Jason Petrie | Republican | Yea |
| Jennifer Decker | Republican | Yea |
| Jim Gooch Jr. | Republican | Yea |
| John Blanton | Republican | Yea |
| Josh Branscum | Republican | Yea |
| Josh Bray | Republican | Yea |
| Josh Calloway | Republican | Yea |
| Ken Fleming | Republican | Yea |
| Ken Upchurch | Republican | Yea |
| Kim Banta | Republican | Yea |
| Kim King | Republican | Yea |
| Kimberly Poore Moser | Republican | Yea |
| Mark Hart | Republican | Yea |
| Mary Beth Imes | Republican | Yea |
| Matt Lockett | Republican | Yea |
| Matthew Koch | Republican | Yea |
| Myron Dossett | Republican | Yea |
| Nancy Tate | Republican | Yea |
| Patrick Flannery | Republican | Yea |
| Randy Bridges | Republican | Yea |
| Richard White | Republican | Yea |
| Ryan Dotson | Republican | Yea |
| Samara Heavrin | Republican | Yea |
| Savannah Maddox | Republican | Yea |
| Scott Lewis | Republican | Yea |
| Scott Sharp | Republican | Yea |
| Shane Baker | Republican | Yea |
| Shawn McPherson | Republican | Yea |
| Steve Bratcher | Republican | Yea |
| Steve Riley | Republican | Yea |
| Steven Rudy | Republican | Yea |
| Suzanne Miles | Republican | Yea |
| T.J. Roberts | Republican | Yea |
| Thomas Huff | Republican | Yea |
| William Lawrence | Republican | Yea |
Subjects
Frequently asked questions
- Who sponsors HB 48?
- HB 48 is sponsored by D. Bentley, Kim Banta (Republican), L. Bechler, John Blanton (Republican), Tina Bojanowski (Democrat), Adam Bowling (Republican), Josh Branscum (Republican), Josh Bray (Republican), Randy Bridges (Republican), Josh Calloway (Republican), Ryan Dotson (Republican), J. DuPlessis, J. Fischer, Patrick Flannery (Republican), Deanna Gordon (Republican), Chris Freeland (Republican), R. Goforth, D. Graham, David Hale (Republican), Mark Hart (Republican), A. Hatton, R. Heath, Samara Heavrin (Republican), Thomas Huff (Republican), DJ Johnson (Republican), Nima Kulkarni (Democrat), Derek Lewis (Republican), Scott Lewis (Republican), Mary Lou Marzian (Democrat), C. Massey, Bobby McCool (Republican), C. McCoy, P. Minter, Jason Nemes (Republican), David W. Osborne (Republican), R. Palumbo, P. Pratt, M. Prunty, B. Reed, Steve Riley (Republican), Steven Rudy (Republican), S. Santoro, A. Scott, Scott Sharp (Republican), S. Sheldon, Tom Smith (Republican), Ashley Tackett Laferty (Democrat), Nancy Tate (Republican), Walker Thomas (Republican), K. Timoney, James Tipton (Republican), R. Webber, S. Westrom, B. Wheatley, Lisa Willner (Democrat), Pamela Stevenson (Democrat), Ken Fleming (Republican), and Steve Bratcher (Republican).
- What is the current status of HB 48?
- This bill has been enacted into law. Introduced September 16, 2020. Enacted.
- Where can I track HB 48?
- Track HB 48 free on One Click Politics — get push/email alerts when it moves.
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