Brandon Smith

Amend KRS 304.17A-660 to define "health professional"; amend KRS 304.17A-661 to require that annual mental health parity reports be submitted to the Legislative Research Commission on or before June 1 of each year for referral to certain committees and be published by the insurance commissioner on the Department of Insurance's website; require insurers to have an independent audit conducted to evaluate mental health parity compliance upon request of the commissioner or Attorney General; require the commissioner to establish and operate a hotline that allows health professionals and insureds to submit complaints regarding mental health parity compliance; prohibit insurers from retaliating against a health professional for submitting a complaint; authorize the Attorney General to enforce the mental health parity law; establish duties, remedies, and penalties for enforcement by the Attorney General; authorize a private cause of action by any person directly injured by a violation or likely violation of the mental health parity law; establish duties, remedies, and penalties for a private right of action under the mental health parity law; establish construction clauses; authorize the Attorney General to promulgate administrative regulations for proper enforcement of mental health parity law; create a new section of KRS 304.17A-660 to 304.17A-669 to establish requirements for review criteria used by insurers to determine the medical necessity and appropriateness of a claim submitted for the diagnosis or treatment of a mental health condition; require that the review criteria be publicly available on the insurer's website; require insurers to comply with KRS 304.17A-600  to 304.17A-633 with respect to claims submitted by health professionals for the diagnosis of treatment of mental health conditions except as provided in the section; amend KRS 304.17A-617 and 304.17A-623 to conform; amend KRS 205.522 to require the Department for Medicaid Services, Medicaid managed care organizations, and the state' medical assistance program to comply with mental health parity law; require the Department for Medicaid Services or the Cabinet for Health and Family Services to obtain federal approval, if necessary, and comply with notice requirements; provide authorization from the General Assembly to make changes as required under KRS 205.5372(1); EFFECTIVE, in part, January 1, 2027; EMERGENCY.