# Kentucky HB 689: AN ACT relating to the establishment of a Medicaid state-directed payment program. Kentucky HB 689, AN ACT relating to the establishment of a Medicaid state-directed payment program., is a 2026 Regular Session House bill sponsored by Amy Neighbors (Republican); status signed, last action 2026-04-13 (signed by Governor (Acts Ch. 117)) (as of 2026-11-01). - Canonical: https://policyrisk.com/state-bill/KY-HB689-2026RS - 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 689 - State: Kentucky - Session: 2026 Regular Session - Title: AN ACT relating to the establishment of a Medicaid state-directed payment program. - Status: signed - Chamber: House - Introduced: 2026-02-20 - Last action: 2026-04-13, signed by Governor (Acts Ch. 117) - Sponsor: Amy Neighbors (Republican) - Cosponsors: 14 - Subjects: Health Care Professionals, Hospitals And Health Facilities, Medicaid, Physicians, Retroactive Legislation - Touches household money: no - Roll calls: 3 (222 yes, 1 no in all) - Economic provisions PRIA read: 4 ## Summary No summary available. ## Bill overview: provisions PRIA read - New Medicaid add-on payments to hospitals: benefit, medium. The law creates a new, separate Medicaid hospital payment program. It uses add-on payments from Medicaid managed care plans to raise what qualifying hospitals get paid. If CMS approves the preprint, hospitals that train providers with a state-owned university program get extra payments. These add-o… - Start date and retroactive hospital payments: benefit, low. Within 60 days after the law takes effect, the Department must send CMS a preprint asking for a January 1, 2026 start date. If CMS approves a retroactive January 1, 2026 date, the Department directs Medicaid managed care plans to make back payments to qualifying hospitals. These retroactive add-ons… - Funding rules and hospital repayment risk: cost, medium. The nonfederal share must come from a source that follows CMS rules, is not the KRS 205.6406 assessment, and is not the state general fund. If that nonfederal or state match funding goes away, the Department must end the program. If a federal agency later seeks repayment for this program, the state… - Which hospitals get Medicaid add-ons: mixed, low. To qualify, a hospital must be in the state’s hospital rate improvement program. It also must meet one of these: Level II–IV trauma center; in a county with Medicaid enrollment above the statewide median (per the Cabinet’s December report for the prior year); has clinical rotations with a universit… ## Sponsors and cosponsors - Sponsor: Amy Neighbors (Republican), House - Cosponsor: Beverly Chester-Burton (Democrat), House - Cosponsor: DJ Johnson (Republican), House - Cosponsor: George Brown Jr. (Democrat), House - Cosponsor: Kim Banta (Republican), House - Cosponsor: Kevin Jackson (Republican), House - Cosponsor: Kim King (Republican), House - Cosponsor: Kimberly Poore Moser (Republican), House - Cosponsor: Mike Clines (Republican), House - Cosponsor: Michael Meredith (Republican), House - Cosponsor: Robert Duvall (Republican), House - Cosponsor: Stephanie Dietz (Republican), House - Cosponsor: Scott Lewis (Republican), House - Cosponsor: Shawn McPherson (Republican), House - Cosponsor: Steve Riley (Republican), House ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2026-03-31 | House | passed | pass | 90 | 1 | | | 2026-03-31 | Senate | 3rd reading, passed | pass | 38 | 0 | | | 2026-03-18 | House | 3rd reading, passed | pass | 94 | 0 | | ## Actions (24) - 2026-04-13: signed by Governor (Acts Ch. 117) - 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) - 2026-03-31: passed 90-1 (House) - 2026-03-31: House concurred in Committee Substitute (1) (House) - 2026-03-31: posted for passage for concurrence in Senate Committee Substitute (1) (Senate) - 2026-03-31: to Rules (H) (House) - 2026-03-31: received in House (House) - 2026-03-31: 3rd reading, passed 38-0 with Committee Substitute (1) (Senate) - 2026-03-26: posted for passage in the Consent Orders of the Day for Friday, March 27 2026 (Senate) - 2026-03-26: 2nd reading, to Rules as a consent bill (Senate) - 2026-03-25: reported favorably, 1st reading, to Consent Calendar with Committee Substitute (1) (Senate) - 2026-03-24: to Health Services (S) (Senate) - 2026-03-19: to Committee on Committees (S) (Senate) - 2026-03-19: received in Senate (Senate) - 2026-03-18: 3rd reading, passed 94-0 with Floor Amendment (1) (House) - 2026-03-17: posted for passage in the Regular Orders of the Day for Wednesday, March 18 2026 (House) - 2026-03-16: floor amendment (1) filed (House) - 2026-03-06: 2nd reading, to Rules (House) - 2026-03-05: reported favorably, 1st reading, to Calendar (House) - 2026-02-27: to Health Services (H) (House) - 2026-02-20: to Committee on Committees (H) (House) - 2026-02-20: introduced in House (House) ## Bill text - Current, 2026-03-31: [PDF](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb689/bill.pdf) - Introduced, 2026-03-18: [PDF](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb689/orig_bill.pdf) ## Related bills - HB 869: AN ACT relating to fiscal matters and declaring an emergency. (signed) - 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 826: AN ACT relating to education. (signed) - HB 727: AN ACT relating to education and declaring an emergency. (signed) - SB 324: AN ACT relating to the entertainment industry. (signed) ## Sources - [Current (PDF)](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb689/bill.pdf) - [Introduced (PDF)](https://apps.legislature.ky.gov/recorddocuments/bill/26RS/hb689/orig_bill.pdf) ## Related - [HB 869: AN ACT relating to fiscal matters and declaring an emergency.](https://policyrisk.com/state-bill/KY-HB869-2026RS) - [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 826: AN ACT relating to education.](https://policyrisk.com/state-bill/KY-HB826-2026RS) - [HB 727: AN ACT relating to education and declaring an emergency.](https://policyrisk.com/state-bill/KY-HB727-2026RS) - [SB 324: AN ACT relating to the entertainment industry.](https://policyrisk.com/state-bill/KY-SB324-2026RS) - [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-HB689-2026RS (as of 2026-11-01).