KRS § 205.5369 Report to the Legislative Research Commission on prior authorization. (Effective January 1, 2027)
AI-assisted research summary: The commissioner of the Department for Medicaid Services must file an annual written report, give a requested briefing, and adopt needed regulations to implement this section.
205.5369 Report to the Legislative Research Commission on prior authorization. (Effective January 1, 2027) The commissioner of the Department for Medicaid Services shall: (1) (a) Submit a written report not later than September 30 of each year to the Legislative Research Commission for referral to the Interim Joint Committees on Banking and Insurance and Health Services relating to prior authorization in the provision of Medicaid benefits in Kentucky. (b) The report required under paragraph (a) of this subsection shall include the following, categorized by Medicaid managed care organization and fee for service: 1. A list of all services, procedures, and other treatments, including prescription drugs, that require prior authorization; 2. The percentage of prior authorization requests for nonurgent health care services in aggregate and by specific service, procedure, prescription drug, and other treatment: a. That were approved without an extension; b. For which the review was extended and the request approved; and c. That were denied, which may include the reason or reasons for the denials; 3. The percentage of prior authorization requests for urgent health care services that were: a. Approved; and b. Denied, which may include the reason or reasons for the denials; and 4. The average and median time between submission of a prior authorization request and a prior authorization decision for: a. Nonurgent health care services; and b. Urgent health care services; (2) Provide the Interim Joint Committees on Banking and Insurance and Health Services with a detailed briefing, upon request, to discuss and explain any report submitted under subsection (1) of this section; and (3) Promulgate any administrative regulation, including an emergency administrative regulation, in accordance with KRS Chapter 13A that the commissioner deems necessary to implement this section. Effective: January 1, 2027 History: Created 2026 Ky. Acts ch. 102, sec. 5, effective January 1, 2027.