Summary of Original VersionAmend KRS 304.17A-132 to modify coverage requirements for hearing aids and related services; amend KRS 304.17A-131 to modify coverage requirements for cochlear implants; amend KRS 205.522, 205.6485, 164.2871, and 18A.225 to require Medicaid, KCHIP, self-insured employer group plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the coverage requirements for hearing aids and related services and cochlear implants; provide that various sections apply to health benefit plans issued or renewed on or after January 1, 2026; establish construction of certain provisions for purposes of federal law and require state officials to comply; require the Department of Insurance to determine whether the coverage requirements for hearing aids and related services or cochlear implants would be in addition to essential health benefits required under federal law; require the Department of Insurance and the Cabinet for Health and Family Services to obtain federal waivers or approval, if necessary; EFFECTIVE, January 1, 2026.
Summary of Amendment: Senate Committee Substitute 1Summary
Retain original provisions, except delete coverage requirement for hearing aids and related services for adults; require the minimum coverage amount per hearing aid to be at least $2,500; require the commissioner to consult with the Kentucky Commission on the Deaf and Hard of Hearing when establishing a minimum coverage amount per hearing aid; modify the amount that an insured may pay for a higher priced hearing aid; establish network adequacy requirements relating to pediatric audiologists.
Summary of Amendment: House Committee Substitute 1Summary
Retain original provisions, except limit the definition of "hearing aid" to prescription hearing aids; define "pediatric audiologist"; make technical corrections; create a new section of Subtitle 17A of KRS Chapter 304 to define terms; require health plans to provide coverage for eating or feeding disorder treatment; prohibit health plans from using certain standards, including body mass index, when determining medical necessity or the appropriate level of care for an individual diagnosed with a feeding or eating disorder; amend KRS 304.17C-125, 205.522, 205.6485, 164.2871, and 18A.225 to require limited health services benefit plans, Medicaid, KCHIP, self-insured employer group plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the prohibition from using certain standards when determining medical necessity and the coverage requirement for eating or feeding disorder treatment; provide that various sections apply to health plans issued or renewed on or after January 1, 2026; require the Department for Medicaid Services or the Cabinet for Health and Family Services to obtain federal approval, if necessary, and comply with notice requirements; EFFECTIVE, in part, January 1, 2026.
Summary of Amendment: House Committee Amendment 1 -- K. MoserSummary
Make title amendment.
Statutes affected: Senate Committee Substitute 1: 205.522, 205.6485, 164.2871, 18A.225
House Committee Substitute 1: 205.522, 205.6485, 164.2871, 18A.225
Current: 205.522, 205.6485, 164.2871, 18A.225