Posted April 13, 2021
Thanks to the advocacy of engaged physicians from across the state, the Kentucky Medical Association (KMA) completed one of its most successful legislative sessions in recent history. Despite challenges related to the COVID-19 pandemic and several inclement weather delays, five KMA priority issues were sent to the Governor’s desk and became law. These include:
Telehealth Expansion: Expands the definition of telehealth to include remote patient monitoring, allows telehealth services to continue through audio-only encounters, and removes the face-to-face restriction for certain behavioral health services. Also prohibits commercial health plans and Medicaid MCOs from requiring prior authorization for a telehealth service that would not be required if that service were provided in person.
Mental Health Parity: Requires insurers to demonstrate compliance with federal law in how they design and apply managed care techniques for behavioral and mental health treatment to ensure coverage is no more restrictive than for any other medical condition. Insurers will be required to file annual reports to the Kentucky Department of Insurance (DOI).
Co-Pay Accumulator: Requires health insurers to count ALL payments for prescription drugs made by patients directly or on their behalf toward their deductibles and overall out-of-pocket maximums.
Prior Authorization for MAT: Removes prior authorization requirements by commercial health plans and Medicaid MCOs for FDA-approved medications used to treat alcohol and opioid use disorder. Also requires commercial insurers and Medicaid MCOs to file annual reports to the state showing whether providers have prescribed medication for addiction treatment in conjunction with behavioral therapy.
COVID-19 Liability Protections: Provides liability protections for “essential service” providers, including physicians and hospitals, from claims “arising from COVID-19” on or after the public health emergency was declared on March 6, 2020 until the emergency is withdrawn or lapses.
Members are encouraged to review the full KMA 2021 Advocacy in Action Achievement Report, available here, which outlines each of the bills that passed, along with additional healthcare-related legislation.
KMA thanks the hundreds of engaged members across the state who contacted their legislators in support of the Association’s priority issues. Thank you for advocating on behalf of Kentucky’s physicians and patients and for improving the practice of medicine and the health of the Commonwealth!
