HB695: AN ACT relating to the Medicaid program and declaring an emergency.

Legislative 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 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; create various new sections of KRS Chapter 7A to establish the Medicaid Oversight and Advisory Board, the board's membership, and duties.