AN ACT relating to legislative oversight of the Medicaid state plan and declaring an emergency.

Kentucky Medicaid plans get public legislative review

Kentucky requires yearly reviews of Medicaid and its Children's Health Insurance Program plans. The law does not directly change eligibility, benefits, or household costs. By July 1 each year, the Medicaid department must send current plans and amendment records to the Legislative Research Commission. Records cover amendments approved, denied, rejected, or still pending since July 1 of the previous year. Each amendment needs federal submission materials, a change summary, expected benefits, reasons for the change, and an explanation of authorization requirements. It also needs cost and budget projections for 1, 2, and 5 years. The Medicaid Oversight and Advisory Board reviews these records by August 31; the legislative health committee reviews them by October 31. Department officials must answer questions, and the committee reviews department responses to board recommendations. Board recommendations require a majority vote and must be sent in writing within 30 calendar days after review. Committee findings that a plan is deficient also require a majority vote. Denied, rejected, or pending amendments cannot support those findings, but the committee can recommend changes concerning them. The Governor must send a determination on amending or keeping the plan within 30 calendar days of a deficiency finding. For the initial 2026 review, officials review the full plans and may request summaries by June 1, 2026. Review grounds include legal conflicts, actions beyond agency authority, unreasonable burdens, missed review requirements, and failure to include board recommendations. The law took effect immediately upon passage and the Governor's approval. Within five calendar days, the department must send current plans to the commission. Within 30 days, it must post current plans and submitted amendments on an easily accessible website. Posted plans must show their latest federally approved amendment date; amendments must include summaries and statements of benefits.