Summary of Original Version

Amend KRS 304.17A-660 to specify classifications to be included in the term "classification of benefits"; specify requirements, standards, and methodologies to be included in the term "nonquantitative treatment limitation"; change the definition of "mental health condition" to the definition of "mental health or substance use disorder condition"; amend KRS 304.17A-661 to require an insurer's mental health parity analysis to include an evaluation of standards relating to network composition, out-of-network utilization rates, and medical management techniques; require insurers to submit a remediation plan for the commissioner's approval if its mental health parity analysis indicates noncompliance; require insurer's annual mental health parity report to be submitted to the Legislative Research Commission; delete language applying remedies under Subtitle 12 of KRS Chapter 304 to violations; authorize the Attorney General to enforce the mental health parity law; establish duties, remedies, and penalties for enforcement by the Attorney General; authorize a private cause of action by any person directly injured by a violation or likely violation of the mental health parity law; establish duties, remedies, and penalties for a private right of action under the mental health parity law; establish construction clauses; authorize the Attorney General to promulgate administrative regulations for proper enforcement of mental health parity law; create new sections of KRS 304.17A-660 to 304.17A-669 to define "health care professional"; require insurers to comply with KRS 304.17A-700 to 304.17A-730 for claims submitted by health care professionals for the diagnosis or treatment of mental health or substance use disorder conditions; authorize the Attorney General to enforce the requirement to comply with KRS 304.17A-700 to 304.17A-730; create the Advisory Council on Mental Health and Substance Use Disorder Parity; establish duties and membership; amend KRS 304.17A-665 to require the commissioner of insurance to publish a summary of each insurer's mental health parity report and report findings to specified legislative committees; amend KRS 304.17A-669 to conform; amend KRS 18A.225 to require the state employee health plan to comply with KRS 304.17A-660 to 304.17A-669; provide terms for initial appointment of members of the Advisory Council on Mental Health and Substance Use Disorder Parity; provide that certain sections apply to contracts issued or renewed on or after January 1, 2027; EFFECTIVE, January 1, 2027.

Statutes affected:
Introduced: 18A.225