{"data":{"id":"us-ky/krs-205.5369","jurisdiction":"us-ky","citation":"KRS 205.5369","heading":"Report to the Legislative Research Commission on prior authorization.","body":"(Effective January 1, 2027)\nThe commissioner of the Department for Medicaid Services shall:\n(1) (a) Submit a written report not later than September 30 of each year to the\nLegislative Research Commission for referral to the Interim Joint Committees\non Banking and Insurance and Health Services relating to prior authorization\nin the provision of Medicaid benefits in Kentucky.\n(b) The report required under paragraph (a) of this s ubsection shall include the\nfollowing, categorized by Medicaid managed care organization and fee for\nservice:\n1. A list of all services, procedures, and other treatments, including\nprescription drugs, that require prior authorization;\n2. The percentage of prior authorization requests for nonurgent health care\nservices in aggregate and by specific service, procedure, prescription\ndrug, and other treatment:\na. That were approved without an extension;\nb. For which the review was extended and the request approved; and\nc. That were denied, which may include the reason or reasons for the\ndenials;\n3. The percentage of prior authorization requests for urgent health care\nservices that were:\na. Approved; and\nb. Denied, which may include the reason or reasons for the denials;\nand\n4. The average and median time between submission of a prior\nauthorization request and a prior authorization decision for:\na. Nonurgent health care services; and\nb. Urgent health care services;\n(2) Provide the Interim Joint Committees on Banking and Insurance and Health\nServices with a detailed briefing, upon request, to discuss and explain any report\nsubmitted under subsection (1) of this section; and\n(3) Promulgate any administrative regu lation, including an emergency administrative\nregulation, in accordance with KRS Chapter 13A that the commissioner deems\nnecessary to implement this section.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=58257","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"1b67b8d51b6d9a7f244e1776d97560780eaedcbff0b56b71f53a1a39643070e4","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.5367","next":"us-ky/krs-205.5370"},"notice":"GroundRules: Original legal text. Not legal advice."}