HB 10 — AN ACT relating to maternal and child health.

Page 6 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA (a) Short-term"Health limited-durationbenefit coverage;plan" has the same meaning as in KRS 304.17A-005, except for purposes of this section, the term:

and1. (b) Student health insurance offered by a Kentucky-licensed insurer under written contract with a university or college whose students it proposes to insure.

Includes student health insurance offered by a Kentucky-licensed insurer under written contract with a university or college whose students it proposes to insure;

and 2.

Does not include a group health benefit plan that provides grandfathered health plan coverage as defined in 45 C.F.R.

sec.

147.140(a), as amended;

(b) "In-home program" means a program offered by a health care facility or health care professional for the treatment of substance use disorder which the insured accesses through telehealth or digital health services;

and (c) "Telehealth" or "digital health" has the same meaning as in KRS 211.332.

or[ and a minimum of ] Page 7 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA b.

and[ if ] (b) The attending physician, with the consent of the mother of the newly Page 7 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 born[newly-born] child, authorizes a shorter length of stay[ than that required of health benefit plans in subsection (1) of this section] upon the physician's determination that the mother and newborn meet the criteria for medical stability in the most current version of "Guidelines for Perinatal Care" prepared by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.

(4) A health benefit plan shall provide coverage:

(a) To pregnant and postpartum women for an in-home program;

and (b) For telehealth or digital health services that are related to maternity care associated with pregnancy, childbirth, and postpartum care.

KRS 304.17A-220 is amended to read as follows:

(1) All group health plans and insurers offering group health insurance coverage in the Commonwealth shall comply with Section 4 of this Act and the provisions of this section.

(2) Subject to subsection (8) of this section, a group health plan, and a health insurance insurer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a pre-existing condition exclusion only if:

(a) The exclusion relates to a condition, whether physical or mental, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the six (6) month period ending on the enrollment date.

For purposes of this paragraph:

1.

Medical advice, diagnosis, care, or treatment is taken into account only if it is recommended by, or received from, an individual licensed or similarly authorized to provide such services under state law and operating within the scope of practice authorized by state law;

and 2.

The six (6) month period ending on the enrollment date begins on the six (6) month anniversary date preceding the enrollment date;

(b) The exclusion extends for a period of not more than twelve (12) months, or eighteen (18) months in the case of a late enrollee, after the enrollment date;

(c) 1.

The period of any pre-existing condition exclusion that would otherwise apply to an individual is reduced by the number of days of creditable Page 8 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 coverage the individual has as of the enrollment date, as counted under subsection (3) of this section;

and 2.

Except for ineligible individuals who apply for coverage in the individual market, the period of any pre-existing condition exclusion that would otherwise apply to an individual may be reduced by the number of days of creditable coverage the individual has as of the effective date of coverage under the policy;

and (d) A written notice of the pre-existing condition exclusion is provided to participants under the plan, and the insurer cannot impose a pre-existing condition exclusion with respect to a participant or a dependent of the participant until such notice is provided.

(3) In reducing the pre-existing condition exclusion period that applies to an individual, the amount of creditable coverage is determined by counting all the days on which the individual has one (1) or more types of creditable coverage.

For purposes of counting creditable coverage:

(a) If on a particular day the individual has creditable coverage from more than one (1) source, all the creditable coverage on that day is counted as one (1) day;

(b) Any days in a waiting period for coverage are not creditable coverage;

(c) Days of creditable coverage that occur before a significant break in coverage are not required to be counted;

and (d) Days in a waiting period and days in an affiliation period are not taken into account in determining whether a significant break in coverage has occurred.

(4) An insurer may determine the amount of creditable coverage in another manner than established in subsection (3) of this section that is at least as favorable to the individual as the method established in subsection (3) of this section.

(5) If an insurer receives creditable coverage information, the insurer shall make a Page 9 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 determination regarding the amount of the individual's creditable coverage and the length of any pre-existing exclusion period that remains.

A written notice of the length of the pre-existing condition exclusion period that remains after offsetting for prior creditable coverage shall be issued by the insurer.

An insurer may not impose any limit on the amount of time that an individual has to present a certificate or evidence of creditable coverage.

(6) For purposes of this section:

(a) "Pre-existing condition exclusion" means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the effective date of coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before that day.

A pre-existing condition exclusion includes any exclusion applicable to an individual as a result of information relating to an individual's health status before the individual's effective date of coverage under a health benefit plan;

(b) "Enrollment date" means, with respect to an individual covered under a group health plan or health insurance coverage, the first day of coverage or, if there is a waiting period, the first day of the waiting period.

If an individual receiving benefits under a group health plan changes benefit packages, or if the employer changes its group health insurer, the individual's enrollment date does not change;

(c) "First day of coverage" means, in the case of an individual covered for benefits under a group health plan, the first day of coverage under the plan and, in the case of an individual covered by health insurance coverage in the individual market, the first day of coverage under the policy or contract;

(d) "Late enrollee" means an individual whose enrollment in a plan is a late enrollment;

Page 10 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 (e) "Late enrollment" means enrollment of an individual under a group health plan other than:

1.

On the earliest date on which coverage can become effective for the individual under the terms of the plan;

or 2.

Through special enrollment;

(f) "Significant break in coverage" means a period of sixty-three (63) consecutive days during each of which an individual does not have any creditable coverage;

and (g) "Waiting period" means the period that must pass before coverage for an employee or dependent who is otherwise eligible to enroll under the terms of a group health plan can become effective.

If an employee or dependent enrolls as a late enrollee or special enrollee, any period before such late or special enrollment is not a waiting period.

If an individual seeks coverage in the individual market, a waiting period begins on the date the individual submits a substantially complete application for coverage and ends on:

1.

If the application results in coverage, the date coverage begins;

or 2.

If the application does not result in coverage, the date on which the application is denied by the insurer or the date on which the offer of coverage lapses.

(7) (a) 1.

Except as otherwise provided under subsection (3) of this section, for purposes of applying subsection (2)(c) of this section, a group health plan, and a health insurance insurer offering group health insurance coverage, shall count a period of creditable coverage without regard to the specific benefits covered during the period.

2.

A group health plan, or a health insurance insurer offering group health insurance coverage, may elect to apply subsection (2)(c) of this section based on coverage of benefits within each of several classes or Page 11 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 categories of benefits specified in federal regulations.

This election shall be made on a uniform basis for all participants and beneficiaries.

Under this election, a group health plan or insurer shall count a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within this class or category.

3.

In the case of an election with respect to a group health plan under subparagraph 2.

of this paragraph, whether or not health insurance coverage is provided in connection with the plan, the plan shall:

a.

Prominently state in any disclosure statements concerning the plan, and state to each enrollee at the time of enrollment under the plan, that the plan has made this election;

and b.

Include in these statements a description of the effect of this election.

(b) Periods of creditable coverage with respect to an individual shall be established through presentation of certifications described in subsection (9) of this section or in such other manner as may be specified in administrative regulations.

(8) (a) Subject to paragraph (e) of this subsection, a group health plan, and a health insurance insurer offering group health insurance coverage, may not impose any pre-existing condition exclusion on a child who, within thirty (30) days after birth, is covered under any creditable coverage.

If a child is enrolled in a group health plan or other creditable coverage within thirty (30) days after birth and subsequently enrolls in another group health plan without a significant break in coverage, the other group health plan may not impose any pre-existing condition exclusion on the child.

(b) Subject to paragraph (e) of this subsection, a group health plan, and a health insurance insurer offering group health insurance coverage, may not impose Page 12 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 any pre-existing condition exclusion on a child who is adopted or placed for adoption before attaining eighteen (18) years of age and who, within thirty (30) days after the adoption or placement for adoption, is covered under any creditable coverage.

If a child is enrolled in a group health plan or other creditable coverage within thirty (30) days after adoption or placement for adoption and subsequently enrolls in another group health plan without a significant break in coverage, the other group health plan may not impose any pre-existing condition exclusion on the child.

This shall not apply to coverage before the date of the adoption or placement for adoption.

(c) A group health plan may not impose any pre-existing condition exclusion relating to pregnancy.

(d) A group health plan may not impose a pre-existing condition exclusion relating to a condition based solely on genetic information.

If an individual is diagnosed with a condition, even if the condition relates to genetic information, the insurer may impose a pre-existing condition exclusion with respect to the condition, subject to other requirements of this section.

(e) Paragraphs (a) and (b) of this subsection shall no longer apply to an individual after the end of the first sixty-three (63) day period during all of which the individual was not covered under any creditable coverage.

(9) (a) 1.

A group health plan, and a health insurance insurer offering group health insurance coverage, shall provide a certificate of creditable coverage as described in subparagraph 2.

of this subsection.

A certificate of creditable coverage shall be provided, without charge, for participants or dependents who are or were covered under a group health plan upon the occurrence of any of the following events:

a.

At the time an individual ceases to be covered under a health benefit plan or otherwise becomes eligible under a COBRA Page 13 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 continuation provision;

b.

In the case of an individual becoming covered under a COBRA continuation provision, at the time the individual ceases to be covered under the COBRA continuation provision;

and c.

On request on behalf of an individual made not later than twenty- four (24) months after the date of cessation of the coverage described in subdivision a.

or b.

of this subparagraph, whichever is later.

The certificate of creditable coverage as described under subdivision a.

of this subparagraph may be provided, to the extent practicable, at a time consistent with notices required under any applicable COBRA continuation provision.

2.

The certification described in this subparagraph is a written certification of:

a.

The period of creditable coverage of the individual under the health benefit plan and the coverage, if any, under the COBRA continuation provision;

and b.

The waiting period, if any, and affiliation period, if applicable, imposed with respect to the individual for any coverage under the plan.

3.

To the extent that medical care under a group health plan consists of group health insurance coverage, the plan is deemed to have satisfied the certification requirement under this paragraph if the health insurance insurer offering the coverage provides for the certification in accordance with this paragraph.

(b) In the case of an election described in subsection (7)(a)2.

of this section by a group health plan or health insurance insurer, if the plan or insurer enrolls an Page 14 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 individual for coverage under the plan and the individual provides a certification of coverage of the individual under paragraph (a) of this subsection:

1.

Upon request of that plan or insurer, the entity that issued the certification provided by the individual shall promptly disclose to the requesting plan or insurer information on coverage of classes and categories of health benefits available under the entity's plan or coverage;

and 2.

The entity may charge the requesting plan or insurer for the reasonable cost of disclosing this information.

(10) (a) A group health plan, and a health insurance insurer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible but not enrolled for coverage under the terms of the plan, or a dependent of that employee if the dependent is eligible but not enrolled for coverage under these terms, to enroll for coverage under the terms of the plan if each of the following conditions is met:

1.

The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or dependent;

2.

The employee stated in writing at that time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor or insurer, if applicable, required that statement at that time and provided the employee with notice of the requirement, and the consequences of the requirement, at that time;

3.

The employee's or dependent's coverage described in subparagraph 1.

of this paragraph:

Page 15 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 a.

Was under a COBRA continuation provision and the coverage under that provision was exhausted;

or b.

Was not under such a provision and either the coverage was terminated as a result of loss of eligibility for the coverage, including as a result of legal separation, divorce, cessation of dependent status, such as obtaining the maximum age to be eligible as a dependent child, death of the employee, termination of employment, reduction in the number of hours of employment, employer contributions toward the coverage were terminated, a situation in which an individual incurs a claim that would meet or exceed a lifetime limit on all benefits, or a situation in which a plan no longer offers any benefits to the class of similarly situated individuals that includes the individual;

or c.

Was offered through a health maintenance organization or other arrangement in the group market that does not provide benefits to individuals who no longer reside, live, or work in a service area and, loss of coverage in the group market occurred because an individual no longer resides, lives, or works in the service area, whether or not within the choice of the individual, and no other benefit package is available to the individual;

and 4.

An insurer shall allow an employee and dependent a period of at least thirty (30) days after an event described in this paragraph has occurred to request enrollment for the employee or the employee's dependent.

Coverage shall begin no later than the first day of the first calendar month beginning after the date the insurer receives the request for special enrollment.

(b) A dependent of a current employee, including the employee's spouse, and the Page 16 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 employee each are eligible for enrollment in the group health plan subject to plan eligibility rules conditioning dependent enrollment on enrollment of the employee if the requirements of paragraph (a) of this subsection are satisfied.

(c) 1.

If:

a.

A group health plan makes coverage available with respect to a dependent of an individual;

b.

The individual is a participant under the plan, or has met any waiting period applicable to becoming a participant under the plan and is eligible to be enrolled under the plan but for a failure to enroll during a previous enrollment period;

and c.

A person becomes such a dependent of the individual through marriage, birth, or adoption or placement for adoption;

the group health plan shall provide for a dependent special enrollment period described in subparagraph 2.

of this paragraph during which the person or, if not otherwise enrolled, the individual, may be enrolled under the plan as a dependent of the individual, and in the case of the birth or adoption of a child, the spouse of the individual may be enrolled as a dependent of the individual if the spouse is otherwise eligible for coverage.

2.

A dependent special enrollment period under this subparagraph shall be a period of at least thirty (30) days and shall begin on the later of:

a.

The date dependent coverage is made available;

or b.

The date of the marriage, birth, or adoption or placement for adoption, as the case may be, described in subparagraph 1.c.

of this paragraph.

3.

If an individual seeks to enroll a dependent during the first thirty (30) days of the dependent special enrollment period, the coverage of the Page 17 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 dependent shall become effective:

a.

In the case of marriage, not later than the first day of the first month beginning after the date the completed request for enrollment is received;

b.

In the case of a dependent's birth, as of the date of the birth;

or c.

In the case of a dependent's adoption or placement for adoption, the date of the adoption or placement for adoption.

(d) At or before the time an employee is initially offered the opportunity to enroll in a group health plan, the employer shall provide the employee with a notice of special enrollment rights.

(11) (a) In the case of a group health plan that offers medical care through health insurance coverage offered by a health maintenance organization, the plan may provide for an affiliation period with respect to coverage through the organization only if:

1.

No pre-existing condition exclusion is imposed with respect to coverage through the organization;

2.

The period is applied uniformly without regard to any health status- related factors;

and 3.

The period does not exceed two (2) months, or three (3) months in the case of a late enrollee.

(b) 1.

For purposes of this section, the term "affiliation period" means a period which, under the terms of the health insurance coverage offered by the health maintenance organization, must expire before the health insurance coverage becomes effective.

The organization is not required to provide health care services or benefits during this period and no premium shall be charged to the participant or beneficiary for any coverage during the period.

Page 18 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 2.

This period shall begin on the enrollment date.

3.

An affiliation period under a plan shall run concurrently with any waiting period under the plan.

(c) A health maintenance organization described in paragraph (a) of this subsection may use alternative methods other than those described in that paragraph to address adverse selection as approved by the commissioner.

Section 7.

and who is either a contributing member to any one (1) of the retirement systems Page 8 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA administered by the state, including but not limited to the Kentucky Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement System, the Legislators' Retirement Plan, or the Judicial Retirement Plan;

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 administered by the Personnel Cabinet prior to the employer's effective Page 19 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 cessation date in the Kentucky Employees Retirement System;

Any eligible dependents and beneficiaries of participating employees and retirees who are entitled to participate in the state-sponsored health Page 9 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA insurance program;

(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 20 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 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.

Health insurance coverage provided to state employees under this section shall, at a minimum, contain the same benefits as provided under Kentucky Kare Standard as of January 1, 1994, and shall include a mail-order drug option as provided in subsection Page 10 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA (13) of this section.

(c) Any carrier bidding to offer health care coverage to employees shall agree to Page 21 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 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.

however, Page 11 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA confidentiality assertions shall not relieve a carrier from the requirement of providing stipulated data to 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 Page 22 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 financial stability of the program, which shall include but not be limited to loss ratios, methods of risk adjustment, measurements of carrier quality of service, prescription coverage and cost management, and statutorily required mandates.

(h) Each entity participating in the state-sponsored health insurance program shall Page 12 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA provide an amount at least equal to the state contribution rate for the employer portion of the health insurance premium.

or (c) Partly from each, except that any premium due for health care coverage or Page 23 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 dental coverage, if any, in excess of the premium amount contributed by any 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.

Any premium or other expense incurred by any department, board, agency, public postsecondary educational institution, or branch Page 13 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA of state, city, urban-county, charter county, county, or consolidated local government shall be considered a proper cost of administration.

(8) The health care contract or contracts for employees shall be entered into for a Page 24 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 period of not less than one (1) year.

The secretary shall also appoint two (2) members from a list of five (5) names submitted by the Kentucky Education Association, two (2) members from a list of five (5) names submitted by the largest state employee organization of nonschool state employees, two (2) members from a list of five (5) names submitted by the Kentucky Association of Counties, two (2) members from a list of five (5) names submitted by the Kentucky League of Cities, and two (2) members from a Page 14 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA list of names consisting of five (5) names submitted by each state employee organization that has two thousand (2,000) or more members on state payroll deduction.

(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 Page 25 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 procedures approved by the Department of Insurance, if the physician supervising the treatment certifies that the change is not in the best interests of the patient.

(b) A health insurer shall not discriminate against any retail pharmacy located within the geographic coverage area of the health benefit plan and that meets Page 15 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA the terms and conditions for participation established by the insurer, including price, dispensing fee, and copay requirements of a mail-order option.

(15) Any policy provided to state employees or their dependents pursuant to this section Page 26 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 shall provide coverage for the diagnosis and treatment of autism spectrum disorders consistent with KRS 304.17A-142.

(18) If a state employee's residence and place of employment are each located in counties in which the hospitals do not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the employee Page 16 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA may select a plan available in a county contiguous to the county of residence 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.

(20) Notwithstanding any other provision of this section, the bid for proposals for health insurance coverage for calendar year 2004 shall include a bid scenario that reflects the statewide rating structure provided in calendar year 2003 and a bid scenario that allows for a regional rating structure that allows carriers to submit bids that may Page 27 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 vary by region for a given product offering as described in this subsection:

and (e) Nothing in this subsection shall prohibit the Personnel Cabinet from including Page 17 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA other requirements or criteria in the request for proposal.

Page 28 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 (b) KRS 304.17A-270 and 304.17A-525;

(n) KRS 304.17A-262;[ and] (o) Section 45 of this Act;

(p)_and Section(p) 5Administrative ofregulations promulgated pursuant to statutes listed in this Act;subsection.

andPage (q)18 Administrativeof regulations30 promulgatedHB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA (23) (a) Any fully insured health benefit plan or self-insured plan issued or renewed to public employees pursuant to statutesthis listedsection shall provide a special enrollment period to pregnant women who are eligible for coverage in accordance with the requirements set forth in Section 4 of this subsection.Act.

Section(b) 8.The Department of Employee Insurance shall, at or before the time a public employee is initially offered the opportunity to enroll in the plan or coverage, provide the employee a notice of the special enrollment rights under this subsection.

Section 7.

(2) All retirement annuity allowances accrued or accruing to any employee of a state postsecondary educational institution through a retirement program sponsored by Page 29 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 the state postsecondary educational institution are hereby exempt from any state, county, or municipal tax, and shall not be subject to execution, attachment, garnishment, or any other process whatsoever, nor shall any assignment thereof be enforceable in any court.

(3) Except as provided in KRS Chapter 44, the purchase of liability insurance for Page 19 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA members of governing boards, faculty and staff of institutions of higher education in this state shall not be construed to be a waiver of sovereign immunity or any other immunity or privilege.

and (e) Section 45 of this Act;Act.

and(6) (f)(a) A self-insured employer group health plan provided by the governing board of a state postsecondary education institution to its employees shall provide a special enrollment period to pregnant women who are eligible for coverage in accordance with the requirements set forth in Section 54 of this Act.

Section(b) 9.The governing board of a state postsecondary education institution shall, at or before the time an employee is initially offered the opportunity to enroll in the plan or coverage, provide the employee a notice of the special enrollment rights under this subsection.

Section 8.

Page(1) 30The Division of 40Health XXXXBenefit 1/12/2024Exchange 11:24within AMthe JacketedOffice UNOFFICIALof COPYData 24Analytics RSshall BRPage 44220 (1)of The30 DivisionHB001010.100 of- Health442 Benefit- ExchangeXXXX within3/5/2024 the4:21 OfficePM ofGA DataUNOFFICIAL AnalyticsCOPY shall24 RS HB 10/GA administer the provisions of the Patient Protection and Affordable Care Act of 2010, Pub.

155.110, to the extent necessary to carry out the duties and responsibilities of the office if[, provided that] the agreements incorporate adequate protections with respect to the confidentiality of any information to be shared;[.] (b)[(4)] [The office ]Shall pursue all available federal funding for the further development and operation of the Division of Health Benefit Exchange;[.] Page(c)[(5)] 31[The Office of 40Health XXXXData 1/12/2024and 11:24Analytics AM]Shall Jacketedpromulgate UNOFFICIALPage COPY21 24of RS30 BRHB001010.100 - 442 (c)[(5)]- [TheXXXX Office3/5/2024 of4:21 HealthPM DataGA andUNOFFICIAL AnalyticsCOPY ]Shall24 promulgateRS HB 10/GA administrative regulations in accordance with KRS Chapter 13A to implement this section;

Section 10.9.

Section 11.10.

Page(1) 32Except ofas 40provided XXXXin 1/12/2024subsection 11:24(2) AMof Jacketedthis UNOFFICIALsection, COPYpregnant 24women, RSnew BRmothers 442Page (1)22 Exceptof as30 providedHB001010.100 in- subsection442 (2)- ofXXXX this3/5/2024 section,4:21 pregnantPM women,GA newUNOFFICIAL mothersCOPY 24 RS HB 10/GA up to twelve (12) months postpartum, and children up to age one (1) shall be eligible for participation in the Kentucky Medical Assistance Program if:

Section 12.11.

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The[ Cabinet for] PageFinance 35and ofAdministration 40Cabinet XXXXshall 1/12/2024provide 11:24oversight AMover JacketedPage UNOFFICIAL25 COPYof 2430 RSHB001010.100 BR- 442 Finance- andXXXX Administration3/5/2024 Cabinet4:21 shallPM provideGA oversightUNOFFICIAL overCOPY 24 RS HB 10/GA contracting policies and procedures to assure that the number of applicants for contracts is maximized.

SECTION 13.12.

(b) "Lactation"In-home consultation"program" means thea clinicalprogram applicationoffered ofby scientifica principleshealth andcare afacility multidisciplinaryor bodyhealth ofcare evidenceprofessional for evaluation,the problemtreatment identification, treatment, education, and consultation to families regarding Page 36 of 40substance XXXXuse 1/12/2024disorder 11:24which AM Jacketed UNOFFICIAL COPY 24 RS BR 442 the courseinsured ofaccesses lactationthrough andtelehealth feedingor bydigital ahealth qualifiedservice; clinical lactation care practitioner, including but not be limited to:

(c) "Lactation consultation" means the clinical application of scientific Page 26 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA principles and a multidisciplinary body of evidence for evaluation, problem identification, treatment, education, and consultation to families regarding the course of lactation and feeding by a qualified clinical lactation care practitioner, including but not be limited to:

and(d) (c) "Qualified clinical lactation care practitioner" means a licensed health care practitioner wherein lactation consultation is within their legal scope of practice.practice;

(2) The Department for Medicaid Services and any(e) managed"Telehealth" careor organization"digital withhealth" whichhas the departmentsame contractsmeaning foras thein deliveryKRS of211.332. Medicaid services shall provide coverage for lactation consultation and breastfeeding equipment.

(2) The Department for Medicaid Services and any managed care organization with which the department contracts for the delivery of Medicaid services shall provide coverage:

(a) For lactation consultation;

(b) For breastfeeding equipment;

(c) To pregnant and postpartum women for an in-home program;

and (d) For telehealth or digital health services that are related to maternity care Page 27 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA associated with pregnancy, childbirth, and postpartum care.

Page 37 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 (b) Be provided in conjunction with each birth for the duration of breastfeeding, as defined by the beneficiary;

Page 28 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA (4) (a) The breastfeeding equipment described in subsection (3)(d) of this section shall be furnished within forty-eight (48) hours of notification of need, if requested after the birth of the child, or by the later of two (2) weeks before the beneficiary's expected due date or seventy-two (72) hours after notification of need, if requested prior to the birth of the child.

(b) If the department cannot ensure delivery of breastfeeding equipment in accordance with paragraph (a) of this subsection, an individual may purchase equipment and the department or a managed care organization Page 38 of 40 XXXX 1/12/2024 11:24 AM Jacketed UNOFFICIAL COPY 24 RS BR 442 with whom the department contracts for the delivery of Medicaid services shall reimburse the individual for all out-of-pocket expenses incurred by the individual, including any balance billing amounts.

Section 14.13.

Section 14.

If the Cabinet for Health and Family Services determines that a waiver or other authorization from a federal agency is necessary to implement Section 8, 9, 10, 11, or 12 of this Act for any reason, including the loss of federal funds, the cabinet shall, within 90 days of the effective date of this section, request the waiver or authorization, and may only delay implementation of those provisions for which a waiver or authorization was deemed necessary until the waiver or authorization is granted.

If the Cabinet for Health and Family Services determines that a waiver or other authorization from a federal agency is necessary to implement Section 9, 10, 11, 12, or 13 of this Act for any reason, including the loss of federal funds, the cabinet shall, within 90 days of the effective date of this section, request the waiver or authorization, and may only delay implementation of those provisions for which a waiver or authorization was deemed necessary until the waiver or authorization is granted.

Section 16.

The study shall review the training and quality requirements of doula certifications and consider potential recommendations regarding Page 29 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA UNOFFICIAL COPY 24 RS HB 10/GA doula services for populations most at risk for poor perinatal outcomes.

Section 16.

Sections 4 to 8 of this Act apply to plans issued or renewed on or after January 1, 2025.

Sections 44, to5, 96, of7, this8, Actand apply16 to plans issued or renewed on or Page 39 of 40this XXXXAct 1/12/2024take 11:24effect AM Jacketed UNOFFICIAL COPY 24 RS BR 442 after January 1, 2025.

SectionPage 18.30 of 30 HB001010.100 - 442 - XXXX 3/5/2024 4:21 PM GA

Sections 4, 5, 6, 7, 8, 9, and 17 of this Act take effect on January 1, 2025.

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