KRS 304.17A-129: Coverage for stuttering.

(1) As used in this section:

(a) "Habilitative services" means health care services that help a person keep,

learn, or improve skills and functioning for daily living;

(b) "Habilitative speech therapy" means speech therapy that helps a person keep,

learn, or improve skills and functioning for daily living;

(c) "Rehabilitative services" means health care services that help a person restore

or improve skills and functioning for daily living that have been lost or

impaired; and

(d) "Rehabilitative speech therapy" means speech therapy that hel ps a person

restore or improve skills and functioning for daily living that have been lost or

impaired.

(2) Except as provided in subsection (4) of this section, any health insurance policy,

certificate, plan, or contract, including but not limited to a he alth benefit plan, that

provides coverage for:

(a) Habilitative services, shall provide coverage for habilitative speech therapy as

a treatment for stuttering, regardless of whether the stuttering is classified as

developmental;

(b) Rehabilitative services , shall provide coverage for rehabilitative speech

therapy as a treatment for stuttering; or

(c) Both habilitative services and rehabilitative services, shall provide the

coverage required under paragraphs (a) and (b) of this subsection.

(3) The coverage required under subsection (2) of this section shall:

(a) Not be:

1. Subject to any maximum annual benefit limit, including any limits on

the number of visits an insured may make to a speech -language

pathologist;

2. Limited based on the type of disease, injury, disorder, or other medical

condition that resulted in the stuttering; or

3. Subject to utilization review or utilization management requirements,

including prior authorization or a determination that the speech therapy

services are medically necessary; and

(b) 1. Include coverage for speech therapy provided in person and via

telehealth.

2. The telehealth coverage required under this paragraph shall:

a. Not be less than the coverage required for health benefit plans

under KRS 304.17A-138; and

b. Include the use of any communication technology, application, or

platform t o deliver telehealth services, except coverage may be

restricted to technology, applications, or platforms that are

compliant with any applicable privacy provisions of the federal

Health Insurance Portability and Accountability Act of 1996, 42

U.S.C. sec. 1320d et seq., as amended.

(4) If the application of any requirement of this section to a qualified health plan as

defined in 42 U.S.C. sec. 18021(a)(1), as amended, would result in a determination

that the state must make payments to defray the cost of th e requirement under 42

U.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the

requirement shall not apply to the qualified health plan until the cost defrayal

requirement is no longer applicable.