# Kentucky HB 2: AN ACT relating to Medicaid, making an appropriation therefor, and declaring an emergency. Kentucky HB 2, AN ACT relating to Medicaid, making an appropriation therefor, and declaring an emergency., is a 2026 Regular Session House bill sponsored by Ken Fleming (Republican); status became law, last action 2026-04-14 (delivered to Secretary of State (Acts Ch. 179)); PRIA reads it as touching household money (as of 2026-11-01). - Canonical: https://policyrisk.com/state-bill/KY-HB2-2026RS - As of: 2026-11-01 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Kentucky HB 2 - State: Kentucky - Session: 2026 Regular Session - Title: AN ACT relating to Medicaid, making an appropriation therefor, and declaring an emergency. - Status: became law - Chamber: House - Introduced: 2026-01-21 - Last action: 2026-04-14, delivered to Secretary of State (Acts Ch. 179) - Sponsor: Ken Fleming (Republican) - Cosponsors: 4 - Subjects: Medicaid, Mental Disability, Reports Mandated, State Agencies, Fiscal Note, Administrative Regulations And Proceedings, Advisory Boards, Commissions, And Committees, Appropriations, Auditor Of Public Accounts, Boards And Commissions, Children And Minors, Contracts, Disabilities, Effective Dates, Emergency, Federal Laws And Regulations, Funds, General Assembly, Health And Medical Services, Health Care Professionals, Hospitals And Health Facilities, Legislative Research Commission, Studies Directed, Technology, Universities And Colleges, Workforce - Touches household money: yes - Roll calls: 5 (304 yes, 61 no in all) - Economic provisions PRIA read: 26 ## Summary No summary available. ## Bill overview: provisions PRIA read - Emergency slots reserved for waiver care: benefit, high. Kentucky must reserve capacity in every Medicaid waiver for people found to have emergency needs. The cabinet must develop emergency waitlist placement policies. By January 1, 2027, it must set emergency allocation criteria for waivers that lack them. The home and community based waiver must priori… - Faster decisions on Medicaid treatment requests: benefit, medium. Medicaid managed care plans must decide expedited treatment requests within 24 hours and standard requests within five calendar days. Substance-use-disorder treatment requests count as expedited. Expedited deadlines can extend up to 14 days when the enrollee requests it; standard deadlines can exte… - Medicaid covers more help quitting tobacco: benefit, medium. Medicaid covers all FDA-approved tobacco-cessation medicines and recommended individual, group, and telephone counseling, including combinations of services. Plans cannot require counseling before medication or limit treatment duration or quit attempts. Cost sharing is barred unless federal law req… - More Medicaid maternity and breastfeeding support: benefit, medium. Medicaid covers lactation visits, breast pumps, two pump kits and accessories, maternity digital care, and in-home substance-use treatment for pregnant and postpartum women. Breastfeeding coverage lasts for each birth throughout breastfeeding, as the beneficiary defines it. Beneficiaries can reques… - New tools guide Medicaid waiver care: benefit, medium. By July 1, 2026, Kentucky must select a nationally recognized, age-appropriate assessment tool for each Medicaid waiver. These tools guide all care-level assessments and yearly reviews, including recommended service frequency, duration, and intensity. Existing recipients age 18 or younger keep thei… - Coaching helps Medicaid adults meet work rules: benefit, low. Kentucky must provide Volunteers of America $5 million each fiscal year of the 2026–2028 budget period. The money funds a community engagement pilot run by that organization or its direct successor. Medicaid enrollees in pilot areas who face federal engagement requirements receive individual coachi… - Hospitals must help finish Medicaid applications: benefit, low. Qualified hospitals must help people they find temporarily eligible for Medicaid complete and submit a full application. That help must occur before the temporary presumptive eligibility period ends. Application assistance does not guarantee ongoing Medicaid eligibility. - Medicaid plan fines fund payment recommendations: benefit, low. Plans face at least $500 per prohibited claim-resubmission request or incentive, $1,000 per specified contact-penalty or death-reporting violation, and $5,000 per marketing violation. Improperly counting an inactive provider in network analysis carries a $10,000 penalty per provider. Collections go… - More payment protections for Medicaid providers: benefit, low. Providers now have 120 days, up from 60, after confirmed receipt to appeal reduced or denied Medicaid claims. Plans must decide provider grievances and appeals within 30 days or face possible contract penalties. When an appeal finds money owed, plans must pay providers in full within 30 days. Provi… - Stronger safeguards for Medicaid health plans: benefit, low. New, renewed, or extended Medicaid contracts must require compliance with the law's listed rules, insurance laws, and contract duties. Plans and contractors cannot induce claim resubmissions to raise plan risk scores or punish providers for unsuccessful good-faith member contact. Marketing is limit… - Stronger tracking for Medicaid ride brokers: benefit, low. Regional ride brokers must pay for GPS devices that track vehicles while they provide covered Medicaid rides. Brokers have 2% of their payments withheld, earnable back through trip completion, delay, scheduling, and rider-satisfaction measures. Minimum medical loss ratios are 85% for the fiscal yea… - Medicaid stops covering weight-loss prescriptions: cost, high. Kentucky Medicaid and its managed care plans cannot cover drugs prescribed mainly for weight loss. The ban depends on the prescription’s main purpose, not just the drug’s name. The provision lists no exception or end date. - New work rules for Medicaid adults: cost, high. Starting no later than January 1, 2027, some Medicaid expansion adults ages 19–64 must meet community engagement rules. The rule also covers adults in waivers offering equivalent coverage. Qualifying activities include 80 monthly hours of work, service, or a work program; half-time approved educati… - Stricter applications for Medicaid waiver services: cost, high. Waiver applicants need a complete application with a provider's service recommendation and confirmation of their primary diagnosis. The provider must be a Kentucky-licensed physician, physician assistant, advanced practice registered nurse, or psychologist. Without those materials, the state cannot… - New copays for some Medicaid adults: cost, medium. Beginning October 1, 2028, Medicaid expansion enrollees with family income above 100% of the federal poverty line face copays. They pay $5 per covered care, item, or service and $1 per prescription, unless exempt. Primary care, mental health and substance-use services, and care at federally qualifi… - Residency notices can end Medicaid coverage: cost, medium. Where federal law allows, Kentucky checks federal matching records at least quarterly for possible dual-state enrollment or lost Kentucky residency. The state must notify identified people within 30 days and give them 30 days to prove Kentucky residency. Without a response, the state moves them fro… - Returned mail can end Medicaid enrollment: cost, medium. Returned first-class Medicaid mail triggers a search for the beneficiary's current address. The department must ask the health plan, check records, and try at least two of telephone, text, and email. It must continue those efforts for at least 30 days after asking the plan and resend mail when an a… - Tighter Medicaid and SNAP eligibility checks: cost, medium. Beginning January 1, 2027, Kentucky reviews Medicaid eligibility every six months for the federally specified groups, excluding federally exempt people. New information affecting eligibility triggers an additional full Medicaid review or a SNAP case review. Medicaid must use personal statements abo… - Lawmakers control more Medicaid benefit changes: cost, low. The cabinet generally needs specific legislative approval to establish a basic health program or change Medicaid eligibility, coverage, or benefits. The approval requirement also covers providing Medicaid benefits or spending state general funds on benefits. Exceptions cover federally required acti… - New duty to report Medicaid waiver violations: cost, low. People who know or have reasonable cause to suspect a Medicaid 1915(c) waiver law or policy violation must report it. Reports must go to the Office of Medicaid Fraud and Abuse Control or the Medicaid Fraud and Abuse hotline. The duty also covers suspected caregiver hiring, employment, or pay fraud… - Transportation brokers must certify Medicaid reports: cost, low. Regional Medicaid transportation brokers must have an officer certify data and reports sent to state transportation oversight or administration agencies. The officer must confirm that submissions are truthful, accurate, and complete to the best of their knowledge. This applies to nonemergency medic… - Medicaid plans must earn withheld payments: cost, low. Medicaid plans must work with the department on a payment model that withholds 2% of each plan's capitation payment. Plans can earn back some or all of that amount by meeting care measures. Measures include readmissions, screenings, well-care visits, maternity care, emergency visits, behavioral hea… - Tighter checks on Medicaid enrollment records: cost, low. Kentucky Medicaid plans must make reasonable efforts at least monthly to find members also covered in another state. This check covers the same plan, its parent company, or a subsidiary; plans must promptly notify the cabinet about matches. Plans must report their efforts monthly and face $1,000 pe… - State takes over Medicaid dental claims: mixed, medium. Beginning January 1, 2029, an administrative services organization must manage all covered Medicaid dental services instead of managed care plans. Kentucky remains responsible for dental claims; the administrator cannot take financial or insurance risk for them. The department must hire a full-time… - New arrangements for Medicaid medical rides: mixed, low. Kentucky must decide eligibility for covered nonemergency rides during Medicaid applications and eligibility reviews. It must also check transportation records, including vehicle registrations, at least quarterly when they may show eligibility changes. Regional brokers arrange rides not covered by… - Current Medicaid contracts extended through 2028: mixed, low. Kentucky must extend Medicaid managed care contracts in effect when the law takes effect through December 31, 2028. The department cannot begin seeking new managed care contracts before January 1, 2028. The extension and procurement restriction expire after March 15, 2029, unless lawmakers extend t… ## Sponsors and cosponsors - Sponsor: Ken Fleming (Republican), House - Cosponsor: David W. Osborne (Republican), House - Cosponsor: John Hodgson (Republican), House - Cosponsor: Tony Hampton (Republican), House - Cosponsor: Vanessa Grossl (Republican), House ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2026-04-14 | Senate | passed | pass | 32 | 6 | | | 2026-04-14 | House | passed | pass | 80 | 18 | | | 2026-04-01 | House | passed | pass | 83 | 11 | | | 2026-04-01 | Senate | passed | pass | 32 | 5 | | | 2026-02-27 | House | passed | pass | 77 | 21 | | ## Actions (69) - 2026-04-14: delivered to Secretary of State (Acts Ch. 179) - 2026-04-14: enrolled, signed by President of the Senate (House) - 2026-04-14: enrolled, signed by Speaker of the House (House) - 2026-04-14: received in House (House) - 2026-04-14: passed 32-6 (Senate) - 2026-04-14: vetoes overridden (Senate) - 2026-04-14: posted for passage for consideration of Governor's line vetoes - 2026-04-14: to Rules (S) (Senate) - 2026-04-14: received in Senate (Senate) - 2026-04-14: passed 80-18 (House) - 2026-04-14: vetoes overridden (House) - 2026-04-14: posted for consideration of Governor's line vetoes - 2026-04-14: taken from Rules (House) - 2026-04-14: to Rules (H) (House) - 2026-04-14: received in House (House) - 2026-04-13: line items vetoed - 2026-04-01: delivered to Governor - 2026-04-01: enrolled, signed by President of the Senate (House) - 2026-04-01: enrolled, signed by Speaker of the House (House) - 2026-04-01: passed 83-11 (House) - 2026-04-01: Free Conference Committee report adopted in House (House) - 2026-04-01: posted for passage for consideration of Free Conference Committee Report (House) - 2026-04-01: taken from Rules (House) - 2026-04-01: to Rules (H) (House) - 2026-04-01: received in House (House) - 2026-04-01: passed 32-5 (Senate) - 2026-04-01: Free Conference Committee report adopted in Senate (Senate) - 2026-04-01: posted for passage for consideration of Free Conference Committee Report (House) - 2026-04-01: Free Conference Committee report filed in House and Senate (House) - 2026-04-01: Free Conference Committee appointed in House and Senate (House) - 2026-04-01: Conference Committee report (1) filed in House and Senate (House) - 2026-04-01: Conference Committee report adopted in House and Senate (House) - 2026-04-01: Conference Committee appointed in House and Senate (House) - 2026-04-01: Senate refused to recede from Senate Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-04-01: posted for passage for receding from Senate Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-04-01: to Rules (S) (Senate) - 2026-04-01: received in Senate (Senate) - 2026-04-01: House refused to concur in Senate Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-04-01: posted for passage for concurrence in Senate Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-04-01: to Rules (H) (House) - 2026-04-01: received in House (House) - 2026-04-01: passed 32-5 with Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-04-01: floor amendment (1) withdrawn (Senate) - 2026-04-01: 3rd reading (Senate) - 2026-03-31: floor amendment (1) filed to Committee Substitute (Senate) - 2026-03-31: passed over and retained in the Orders of the Day (Senate) - 2026-03-31: posted for passage in the Regular Orders of the Day for Tuesday, March 31 2026 (Senate) - 2026-03-31: reported favorably, to Rules with Committee Substitute (1) and Committee Amendment (1-title) (Senate) - 2026-03-26: reassigned to Health Services (S) (Senate) - 2026-03-25: returned to Appropriations & Revenue (S) (Senate) - 2026-03-25: 2nd reading (Senate) - 2026-03-25: taken from Appropriations & Revenue (S) (Senate) - 2026-03-24: returned to Appropriations & Revenue (S) (Senate) - 2026-03-24: 1st reading (Senate) - 2026-03-24: taken from Appropriations & Revenue (S) (Senate) - 2026-03-13: to Appropriations & Revenue (S) (Senate) - 2026-03-02: to Committee on Committees (S) (Senate) - 2026-03-02: received in Senate (Senate) - 2026-02-27: passed 77-21 with Committee Substitute (1) and Floor Amendment (18) (House) - 2026-02-27: Floor Amendments (1), (4), (6), (7), (10) and (16) defeated (House) - 2026-02-27: 3rd reading (House) - 2026-02-26: floor amendments (18) and (19) filed to Committee Substitute (House) - 2026-02-25: posted for passage in the Regular Orders of the Day for Thursday, February 26 2026 (House) - 2026-02-25: 2nd reading, to Rules (House) - 2026-02-24: floor amendments (1), (4), (6), (7), (10), (11), (12), (13) and (16) filed to Committee Substitute, floor amendments (2), (3), (5), (8), (9), (14), (15) and (17) filed to bill (House) - 2026-02-24: reported favorably, 1st reading, to Calendar with Committee Substitute (1) (House) - 2026-01-29: to Appropriations & Revenue (H) (House) - 2026-01-21: to Committee on Committees (H) (House) - 2026-01-21: introduced in House (House) ## Bill text - Current, 2026-04-14: [PDF](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb2/bill.pdf) - Introduced, 2026-02-27: [PDF](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb2/orig_bill.pdf) ## Related bills - SB 197: AN ACT providing funding and establishing conditions for state government agencies and institutions, making an appropriation therefor, and declaring an emergen… (became law) - SB 133: AN ACT relating to the fiscal reporting of local entities. (signed) - HB 869: AN ACT relating to fiscal matters and declaring an emergency. (signed) - SB 324: AN ACT relating to the entertainment industry. (signed) - SB 66: AN ACT relating to the operation of a motor vehicle. (signed) - HB 826: AN ACT relating to education. (signed) ## Sources - [Current (PDF)](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb2/bill.pdf) - [Introduced (PDF)](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb2/orig_bill.pdf) ## Related - [SB 197: AN ACT providing funding and establishing conditions for state government agenc…](https://policyrisk.com/state-bill/KY-SB197-2026RS) - [SB 133: AN ACT relating to the fiscal reporting of local entities.](https://policyrisk.com/state-bill/KY-SB133-2026RS) - [HB 869: AN ACT relating to fiscal matters and declaring an emergency.](https://policyrisk.com/state-bill/KY-HB869-2026RS) - [SB 324: AN ACT relating to the entertainment industry.](https://policyrisk.com/state-bill/KY-SB324-2026RS) - [SB 66: AN ACT relating to the operation of a motor vehicle.](https://policyrisk.com/state-bill/KY-SB66-2026RS) - [HB 826: AN ACT relating to education.](https://policyrisk.com/state-bill/KY-HB826-2026RS) - [Kentucky bills](https://policyrisk.com/states/kentucky/bills) - [Kentucky state hub](https://policyrisk.com/states/kentucky) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/KY-HB2-2026RS (as of 2026-11-01).