Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696592726038.pdf (United States)
UNOFFICIAL COPY 23 RS BR 145 AN ACT relating to reproductive health services.

Be it enacted by the General Assembly of the Commonwealth of Kentucky: SECTION 1.
A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 IS CREATED TO READ AS FOLLOWS: (1) As used in this section: (a) "Health benefit plan" has the same meaning as in KRS 304.17A-005, except for purposes of this section, the term shall include student health insurance offered by a Kentucky-licensed insurer under written contract with a university or college whose students it proposes to insure; and (b) "Long-acting reversible contraception": 1.
Means a contraception method that requires administration less than once per month; and 2.

Shall include: a.

An intrauterine device; and b.

A contraceptive implant.

1 (2) A health benefit plan shall provide coverage for long-acting reversible 17 contraception administered during a postpartum hospital stay.

18 (3) The coverage required under this section shall not be subject to any cost-sharing 19 20 requirement, including a copayment, coinsurance, or deductible.
SECTION 2.

A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 21 READ AS FOLLOWS: 22 (1) As used in this section: 23 24 25 26 27 (a) "Family planning services": 1.

Means family planning services that are provided under the Medicaid program; 2.

Shall include: a.

Sexual health education and family planning counseling; and BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 1 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 b.
Other medical diagnosis, treatment, or preventive care routinely provided as part of a family planning service visit; and 3.

Shall not include an elective abortion, as defined in KRS 304.5-160; and (b) "Low-income individual" means an individual who: 1.

Has an income level that is equal to or below ninety-five percent (95%) of the federal poverty level; and 2.

Does not qualify for full coverage under the Medicaid program.
(2) Within ninety (90) days of the effective date of this section, the Cabinet for Health and Family Services shall apply for a waiver or a state plan amendment with the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services to: (a) Offer a program that provides family planning services to low-income individuals; and (b) Receive a federal match rate of ninety percent (90%) of state expenditures for family planning services provided under the waiver or state plan amendment.
18 (3) If the waiver or state plan amendment described in subsection (2) of this section 26 27 is approved, the Cabinet for Health and Family Services shall report to the Legislative Research Commission, while the waiver or state plan amendment is in effect, annually before November 30, the following: (a) The number of qualified individuals served under the program; (b) The cost of the program; and (c) The effectiveness of the program, including any: 1.
Savings to the Medicaid program from reduction in enrollment; 2.

Reduction in the number of abortions; 3.

Reduction in the number of unintended pregnancies; BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 2 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 4.

Reduction in the number of individuals requiring services from the program for women, infants, and children established in 42 U.S.C.

sec.

1786; and 5.

Other costs and benefits as a result of the program.

Section 3.
Section 3.

KRS 205.522 (Effective January 1, 2023) is amended to read as follows: (1) The Department for Medicaid Services and any managed care organization contracted to provide Medicaid benefits pursuant to this chapter shall comply with the provisions of Section 1 of this Act and KRS 304.17A-163, 304.17A-1631, 304.17A-167, 304.17A-235, 304.17A-257, 304.17A-259, 304.17A-515, 304.17A- 580, 304.17A-600, 304.17A-603, 304.17A-607, and 304.17A-740 to 304.17A-743, as applicable.
13 (2) A managed care organization contracted to provide Medicaid benefits pursuant to 14 15 this chapter shall comply with the reporting requirements of KRS 304.17A-732.

Section 4.
Section 4.

KRS 205.6485 (Effective January 1, 2023) is amended to read as 16 follows: 17 (1) The Cabinet for Health and Family Services shall prepare a state child health plan 26 27 meeting the requirements of Title XXI of the Federal Social Security Act, for submission to the Secretary of the United States Department of Health and Human Services within such time as will permit the state to receive the maximum amounts of federal matching funds available under Title XXI.
The cabinet shall, by administrative regulation promulgated in accordance with KRS Chapter 13A, establish the following: (a) The eligibility criteria for children covered by the Kentucky Children's Health Insurance Program.

However, no person eligible for services under Title XIX of the Social Security Act, 42 U.S.C.

secs.
1396 to 1396v, as amended, shall be eligible for services under the Kentucky Children's Health Insurance BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 3 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 26 27 Program except to the extent that Title XIX coverage is expanded by KRS 205.6481 to 205.6495 and KRS 304.17A-340; (b) The schedule of benefits to be covered by the Kentucky Children's Health Insurance Program, which shall include preventive services, vision services including glasses, and dental services including at least sealants, extractions, and fillings, and which shall be at least equivalent to one (1) of the following: 1.
The standard Blue Cross/Blue Shield preferred provider option under the Federal Employees Health Benefit Plan established by 5 U.S.C.

sec.

8903(1); 2.

A mid-range health benefit coverage plan that is offered and generally available to state employees; or 3.
Health insurance coverage offered by a health maintenance organization that has the largest insured commercial, non-Medicaid enrollment of covered lives in the state; (c) The premium contribution per family of health insurance coverage available under the Kentucky Children's Health Insurance Program with provisions for the payment of premium contributions by families of children eligible for coverage by the program based upon a sliding scale relating to family income.
Premium contributions shall be based on a six (6) month period not to exceed: 1.

Ten dollars ($10), to be paid by a family with income between one hundred percent (100%) to one hundred thirty-three percent (133%) of the federal poverty level; 2.

Twenty dollars ($20), to be paid by a family with income between one hundred thirty-four percent (134%) to one hundred forty-nine percent (149%) of the federal poverty level; and 3.
One hundred twenty dollars ($120), to be paid by a family with income between one hundred fifty percent (150%) to two hundred percent BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 4 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 (200%) of the federal poverty level, and which may be made on a partial payment plan of twenty dollars ($20) per month or sixty dollars ($60) per quarter; (d) There shall be no copayments for services provided under the Kentucky Children's Health Insurance Program; and (e) The criteria for health services providers and insurers wishing to contract with the Commonwealth to provide the children's health insurance coverage.
However, the cabinet shall provide, in any contracting process for the preventive health insurance program, the opportunity for a public health department to bid on preventive health services to eligible children within the public health department's service area.

A public health department shall not be disqualified from bidding because the department does not currently offer all the services required by paragraph (b) of this subsection.
The criteria shall be set forth in administrative regulations under KRS Chapter 13A and shall maximize competition among the providers and insurers.

The Cabinet for Finance and Administration shall provide oversight over contracting policies and procedures to assure that the number of applicants for contracts is maximized.
19 (2) Within twelve (12) months of federal approval of the state's Title XXI child health 20 21 22 plan, the Cabinet for Health and Family Services shall assure that a KCHIP program is available to all eligible children in all regions of the state.

If necessary, in order to meet this assurance, the cabinet shall institute its own program.
23 (3) KCHIP recipients shall have direct access without a referral from any gatekeeper 24 25 26 27 primary care provider to dentists for covered primary dental services and to optometrists and ophthalmologists for covered primary eye and vision services.
(4) The Kentucky Children's Health Insurance Program[Plan] shall comply with: (a) Section 1 of this Act; and BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 5 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 (b) KRS 304.17A-163 and 304.17A-1631.

Section 5.
Section 5.

KRS 164.2871 (Effective January 1, 2023) is amended to read as follows: (1) The governing board of each state postsecondary educational institution is authorized to purchase liability insurance for the protection of the individual members of the governing board, faculty, and staff of such institutions from liability for acts and omissions committed in the course and scope of the individual's employment or service.
Each institution may purchase the type and amount of liability coverage deemed to best serve the interest of such institution.
10 (2) All retirement annuity allowances accrued or accruing to any employee of a state postsecondary educational institution through a retirement program sponsored by 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.
Except retirement benefits accrued or accruing to any employee of a state postsecondary educational institution through a retirement program sponsored by the state postsecondary educational institution on or after January 1, 1998, shall be subject to the tax imposed by KRS 141.020, to the extent provided in KRS 141.010 and 141.0215.
20 (3) Except as provided in KRS Chapter 44, the purchase of liability insurance for 21 22 23 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.
24 (4) The governing board of each state postsecondary education institution is authorized 25 26 27 to provide a self-insured employer group health plan to its employees, which plan shall: (a) Conform to the requirements of Subtitle 32 of KRS Chapter 304; and BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 6 of 19 Jacketed 26 27 UNOFFICIAL COPY 23 RS BR 145 (b) Except as provided in subsection (5) of this section, be exempt from conformity with Subtitle 17A of KRS Chapter 304.
(5) A self-insured employer group health plan provided by the governing board of a state postsecondary education institution to its employees shall comply with: (a) Section 1 of this Act; and (b) KRS 304.17A-163 and 304.17A-1631.

Section 6.

KRS 18A.225 (Effective January 1, 2023) is amended to read as follows: (1) (a) The term "employee" for purposes of this section means: 1.
Any person, including an elected public official, who is regularly employed by any department, office, board, agency, or branch of state government; or by a public postsecondary educational institution; or by any city, urban-county, charter county, county, or consolidated local government, whose legislative body has opted to participate in the state- sponsored health insurance program pursuant to KRS 79.080; and who is either a contributing member to any one (1) of the retirement systems 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 receiving a contractual contribution from the state toward a retirement plan; or, in the case of a public postsecondary education institution, is an individual participating in an optional retirement plan 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 administered by the Personnel Cabinet prior to the employer's effective BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 7 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 cessation date in the Kentucky Employees Retirement System; 2.
Any certified or classified employee of a local board of education or a public charter school as defined in KRS 160.1590; 3.

Any elected member of a local board of education; 4.
Any person who is a present or future recipient of a retirement allowance from the Kentucky Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement System, the Legislators' Retirement Plan, the Judicial Retirement Plan, or the Kentucky Community and Technical College System's optional retirement plan authorized by KRS 161.567, except that a person who is receiving a retirement allowance and who is age sixty-five (65) or older shall not be included, with the exception of persons covered under KRS 61.702(2)(b)3. and 78.5536(2)(b)3., unless he or she is actively employed pursuant to subparagraph 1. of this paragraph; and 5.
Any eligible dependents and beneficiaries of participating employees and retirees who are entitled to participate in the state-sponsored health insurance program; (b) The term "health benefit plan" for the purposes of this section means a health benefit plan as defined in KRS 304.17A-005; (c) The term "insurer" for the purposes of this section means an insurer as defined in KRS 304.17A-005; and (d) The term "managed care plan" for the purposes of this section means a managed care plan as defined in KRS 304.17A-500.
24 (2) (a) The secretary of the Finance and Administration Cabinet, upon the 25 26 27 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 BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 8 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 26 27 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.
With the exception of employers governed by the provisions of KRS Chapters 16, 18A, and 151B, all employers of any class of employees or former employees shall enter into a contract with the Personnel Cabinet prior to including that group in the state health insurance group.
The contracts shall include but not be limited to designating the entity responsible for filing any federal forms, adoption of policies required for proper plan administration, acceptance of the contractual provisions with health insurance carriers or third-party administrators, and adoption of the payment and reimbursement methods necessary for efficient administration of the health insurance program.
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 (13) of this section.
All employees and other persons for whom the health care coverage is provided or made available shall annually be given an option to elect health care coverage through a self-funded plan offered by the Commonwealth or, if a self-funded plan is not available, from a list of coverage options determined by the competitive bid process under the provisions of KRS 45A.080, 45A.085, and 45A.090 and made available during annual open enrollment.
(b) The policy or policies shall be approved by the commissioner of insurance and may contain the provisions the commissioner of insurance approves, whether or not otherwise permitted by the insurance laws.
(c) Any carrier bidding to offer health care coverage to employees shall agree to BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 9 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 26 27 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.
Except as provided in subsection (20) of this section, any carrier bidding to offer health care coverage to employees shall also agree to rate all employees as a single entity, except for those retirees whose former employers insure their active employees outside the state-sponsored health insurance program and as otherwise provided in KRS 61.702(2)(b)3.b.

and 78.5536(2)(b)3.b.


(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; to provide data in an electronic form and within a time frame specified by the Personnel Cabinet; and to be subject to penalties for noncompliance with data reporting requirements as specified by the Personnel Cabinet.
The Personnel Cabinet shall take strict precautions to protect the confidentiality of each individual employee; however, confidentiality assertions shall not relieve a carrier from the requirement of providing stipulated data to the Commonwealth.
(e) The Personnel Cabinet shall develop the necessary techniques and capabilities for timely analysis of data received from carriers and, to the extent possible, provide in the request-for-proposal specifics relating to data requirements, electronic reporting, and penalties for noncompliance.

The Commonwealth shall own the enrollment, claims, and utilization data provided by each carrier and shall develop methods to protect the confidentiality of the individual.
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 BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 10 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 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.
If state self-insurance was available as a carrier option, the report also shall provide a detailed financial analysis of the self-insurance fund including but not limited to loss ratios, reserves, and reinsurance agreements.
(f) If any agency participating in the state-sponsored employee health insurance program for its active employees terminates participation and there is a state appropriation for the employer's contribution for active employees' health insurance coverage, then neither the agency nor the employees shall receive the state-funded contribution after termination from the state-sponsored employee health insurance program.
(g) Any funds in flexible spending accounts that remain after all reimbursements have been processed shall be transferred to the credit of the state-sponsored health insurance plan's appropriation account.

(h) Each entity participating in the state-sponsored health insurance program shall provide an amount at least equal to the state contribution rate for the employer portion of the health insurance premium.
For any participating entity that used the state payroll system, the employer contribution amount shall be equal to but not greater than the state contribution rate.
21 (3) The premiums may be paid by the policyholder: 22 23 24 25 26 27 (a) Wholly from funds contributed by the employee, by payroll deduction or otherwise; (b) Wholly from funds contributed by any department, board, agency, public postsecondary education institution, or branch of state, city, urban-county, charter county, county, or consolidated local government; or (c) Partly from each, except that any premium due for health care coverage or BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 11 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 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.
(4) If an employee moves his or her place of residence or employment out of the service area of an insurer offering a managed health care plan, under which he or she has elected coverage, into either the service area of another managed health care plan or into an area of the Commonwealth not within a managed health care plan service area, the employee shall be given an option, at the time of the move or 10 transfer, to change his or her coverage to another health benefit plan.
11 (5) No payment of premium by any department, board, agency, public postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall constitute compensation to an insured employee for the purposes of any statute fixing or limiting the compensation of such an employee.
Any premium or other expense incurred by any department, board, agency, public postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall be considered a proper cost of administration.
19 (6) The policy or policies may contain the provisions with respect to the class or classes 20 21 22 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.
23 (7) Group rates under this section shall be made available to the disabled child of an 24 25 26 employee regardless of the child's age if the entire premium for the disabled child's coverage is paid by the state employee.

A child shall be considered disabled if he or she has been determined to be eligible for federal Social Security disability benefits.
27 (8) The health care contract or contracts for employees shall be entered into for a BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 12 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 period of not less than one (1) year.

(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.
The secretary shall appoint, from a list of names submitted by appointing authorities, members representing school districts from each of the seven (7) Supreme Court districts, members representing state government from each of the seven (7) Supreme Court districts, two (2) members representing retirees under age sixty-five (65), one (1) member representing local health departments, two (2) members representing the Kentucky Teachers' Retirement System, and three (3) members at large.
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 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.
The advisory committee shall be appointed in January of each year and shall meet quarterly.

1 (10) Notwithstanding any other provision of law to the contrary, the policy or policies 22 23 24 25 26 27 provided to employees pursuant to this section shall not provide coverage for obtaining or performing an abortion, nor shall any state funds be used for the purpose of obtaining or performing an abortion on behalf of employees or their dependents.
(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 BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 13 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 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.
(12) Any employee who is eligible for and elects to participate in the state health insurance program as a retiree, or the spouse or beneficiary of a retiree, under any one (1) of the state-sponsored retirement systems shall not be eligible to receive the state health insurance contribution toward health care coverage as a result of any other employment for which there is a public employer contribution.
This does not preclude a retiree and an active employee spouse from using both contributions to the extent needed for purchase of one (1) state sponsored health insurance policy 10 for that plan year.

11 (13) (a) The policies of health insurance coverage procured under subsection (2) of this section shall include a mail-order drug option for maintenance drugs for state employees.

Maintenance drugs may be dispensed by mail order in accordance with Kentucky law.
(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 the terms and conditions for participation established by the insurer, including price, dispensing fee, and copay requirements of a mail-order option.

The retail pharmacy shall not be required to dispense by mail.

(c) The mail-order option shall not permit the dispensing of a controlled substance classified in Schedule II.
22 (14) The policy or policies provided to state employees or their dependents pursuant to 23 24 25 26 this section shall provide coverage for obtaining a hearing aid and acquiring hearing aid-related services for insured individuals under eighteen (18) years of age, subject to a cap of one thousand four hundred dollars ($1,400) every thirty-six (36) months pursuant to KRS 304.17A-132.
27 (15) Any policy provided to state employees or their dependents pursuant to this section BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 14 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 shall provide coverage for the diagnosis and treatment of autism spectrum disorders consistent with KRS 304.17A-142.
(16) Any policy provided to state employees or their dependents pursuant to this section shall provide coverage for obtaining amino acid-based elemental formula pursuant to KRS 304.17A-258.
(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.
13 (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 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 (19) The Personnel Cabinet is encouraged to study whether it is fair and reasonable and 21 22 23 in the best interests of the state group to allow any carrier bidding to offer health care coverage under this section to submit bids that may vary county by county or by larger geographic areas.
24 (20) Notwithstanding any other provision of this section, the bid for proposals for health 25 26 27 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 BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 15 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 vary by region for a given product offering as described in this subsection: (a) The regional rating bid scenario shall not include a request for bid on a statewide option; (b) The Personnel Cabinet shall divide the state into geographical regions which shall be the same as the partnership regions designated by the Department for Medicaid Services for purposes of the Kentucky Health Care Partnership Program established pursuant to 907 KAR 1:705; (c) The request for proposal shall require a carrier's bid to include every county within the region or regions for which the bid is submitted and include but not be restricted to a preferred provider organization (PPO) option; (d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the carrier all of the counties included in its bid within the region.
If the Personnel Cabinet deems the bids submitted in accordance with this subsection to be in the best interests of state employees in a region, the cabinet may award the contract for that region to no more than two (2) carriers; and (e) Nothing in this subsection shall prohibit the Personnel Cabinet from including other requirements or criteria in the request for proposal.
18 (21) Any fully insured health benefit plan or self-insured plan issued or renewed on or 26 27 after July 12, 2006, to public employees pursuant to this section which provides coverage for services rendered by a physician or osteopath duly licensed under KRS Chapter 311 that are within the scope of practice of an optometrist duly licensed under the provisions of KRS Chapter 320 shall provide the same payment of coverage to optometrists as allowed for those services rendered by physicians or osteopaths.
(22) Any fully insured health benefit plan or self-insured plan issued or renewed to public employees pursuant to this section shall comply with: (a) KRS 304.12-237; BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 16 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 (b) KRS 304.17A-270 and 304.17A-525; (c) KRS 304.17A-600 to 304.17A-633; (d) KRS 205.593; (e) KRS 304.17A-700 to 304.17A-730; (f) KRS 304.14-135; (g) KRS 304.17A-580 and 304.17A-641; (h) KRS 304.99-123; (i) KRS 304.17A-138; (j) KRS 304.17A-148; (k) KRS 304.17A-163 and 304.17A-1631;[ and] (l) Section 1 of this Act; and (m) Administrative regulations promulgated pursuant to statutes listed in this subsection.
Section 7.

KRS 446.350 is amended to read as follows: 15 (1) Government shall not substantially burden a person's freedom of religion.

The right to act or refuse to act in a manner motivated by a sincerely held religious belief may not be substantially burdened unless the government proves by clear and convincing evidence that it has a compelling governmental interest in infringing the specific act or refusal to act and has used the least restrictive means to further that interest.
A "burden" shall include indirect burdens such as withholding benefits, assessing penalties, or an exclusion from programs or access to facilities.

22 (2) Nothing in Section 1 of this Act shall be construed to be in violation of this 23 24 25 26 section.

Section 8.
(1) Each insurer of a health benefit plan, as defined in Section 1 of this Act, shall, in consultation with its pharmacy benefit manager, if any, submit to the commissioner of the Department of Insurance, at a time and in a manner prescribed by 27 the commissioner, a report that: BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 17 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 (a) Explains how the insurer may provide coverage for over-the-counter oral contraceptives and over-the-counter emergency contraceptives in its health benefit plans without requiring a prescription and without imposing cost-sharing; and (b) Indicates whether the insurer provides the coverage referenced in paragraph (a) of this subsection, and if the insurer does not provide the coverage, whether they would, or are likely to, add the coverage to one or more of the insurer's health benefit plans.
(2) The commissioner of the Department of Insurance shall utilize the information received under subsection (1) of this section, in addition to any other 10 information available to the commissioner, to submit a written report to the Legislative 11 Research Commission, on or before July 1, 2025, that shall include: 12 (a) Recommendations on how insurers of health benefit plans could provide 13 coverage for over-the-counter oral contraceptives and over-the-counter emergency 14 contraceptives in health benefit plans without a prescription or cost sharing; 15 (b) The estimated impact of the coverage referred to in paragraph (a) of this 16 subsection on health insurance premiums, and 17 (c) Statistics on how many insurers intend to add the benefit to any or all of its 18 health insurance plans.
19 Section 9.

Sections 1, 5, and 6 of this Act apply to health benefit plans issued or 20 renewed on or after January 1, 2024.

21 Section 10.
If the Cabinet for Health and Family Services determines that a 22 waiver or any other authorization from a federal agency is necessary to implement 23 Section 3 or 4 of this Act for any reason, including the loss of federal funds, the Cabinet 24 shall, within 90 days after the effective date of this section, request the waiver or 25 26 27 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 11.

Sections 1 and Sections 3 to 9 of this Act take effect January 1, BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 18 of 19 Jacketed UNOFFICIAL COPY 23 RS BR 145 1 2024.

BR014500.100 - 145 - XXXX 2/14/2023 3:58 PM Page 19 of 19 Jacketed