{"data":{"id":"us-ky/krs-205.5372","jurisdiction":"us-ky","citation":"KRS 205.5372","heading":"Specific authorization from General Assembly required to exercise state's","body":"option to develop basic health program under federal law or make changes\nrelated to eligibility, coverage, or benefits -- Fiscal impact assessment required\n-- Construction.\n(1) Notwithstanding any provision of law to the contrary, including but not limited to\nKRS 205.460 and 205.520, the cabinet shall not:\n(a) Unless required by federal law, exercise the state's option to develop a basic\nhealth program as permitted under 42 U.S.C. sec. 18051;\n(b) Make any change related to eligibility, coverage, or benefits in the Medicaid\nprogram, including by pursuing or applying for a waiver of federal Medicaid\nlaw under Title 42 of the United States Code, seeking to amend or renew an\nexisting waiver granted under Title 42 of the United States Code, or pursuing\na state plan amendment, without first obtaining specific authorization from the\nGeneral Assembly to do so; or\n(c) Provide any Medicaid benefit or expend general fund moneys on  any\nMedicaid benefit not expressly authorized by the General Assembly or\nrequired under federal law.\n(2) If the cabinet seeks authorization from the General Assembly to establish a basic\nhealth program, apply for a waiver under Title 42 of the United Stat es Code, amend\nan existing waiver granted under Title 42 of the United States Code, submit a state\nplan amendment, or make any other change to eligibility, coverage, or benefits in\nthe Medicaid program, the cabinet shall submit a detailed assessment of the\npotential fiscal impact of the change for which it is seeking authorization to the\nLegislative Research Commission for referral to the Medicaid Oversight and\nAdvisory Board, the Interim Joint Committee on Appropriations and Revenue, the\nInterim Joint Committee on Families and Children, the Interim Joint Committee on\nHealth Services, and the Office of Budget Review. The fiscal impact assessment\nrequired by this subsection shall include a review of any anticipated expenditures\nrelated to the change and any p rojected savings that may be generated by the\nchange for at least two (2) consecutive state fiscal years.\n(3) If the cabinet seeks authorization from the General Assembly to renew an existing\nwaiver granted under Title 42 of the United States Code, the cab inet shall be\nrequired to submit a fiscal impact assessment as described in subsection (2) of this\nsection and an assessment of the efficacy and necessity of the existing waiver. The\nassessments required by this subsection shall be submitted to the Legisla tive\nResearch Commission for referral to the Interim Joint Committee on Appropriations\nand Revenue, the Interim Joint Committee on Families and Children, the Interim\nJoint Committee on Health Services, and the Office of Budget Review at least\ntwelve (12) calendar months prior to the date on which the existing waiver is set to\nexpire.\n(4) (a) This section shall not be interpreted as limiting the General Assembly's ability\nto direct the cabinet to make changes to the Medicaid program, including but\nnot limited to changes to existing waivers, eligibility, coverage, or benefits.\n(b) Any act of the General Assembly directing the Cabinet for Health and Family\nServices or the Department for Medicaid Services to make a change to the\nMedicaid program shall constitute authorization for that change as required by\nsubsection (1) of this section.\n(5) (a) This section shall not be interpreted as limiting the cabinet's ability to make\nchanges to the Medicaid program that it determines are necessary:\n1. To comply with any requirements that may be imposed by federal law or\nby the federal Centers for Medicare and Medicaid Services;\n2. In response to a national emergency declaration issued by the President\nof the United States;\n3. In response to a federal disaster declaration issued by the President of\nthe United States; or\n4. In response to a state of emergency declared by the Governor of the\nCommonwealth.\n(b) If the cabinet determines that a change to the Medicaid program is necessary\nto comply with requirements imposed by federal law, the cabinet shall, at least\nninety (90) days prior to implementing the necess ary changes, submit an\nassessment of the potential fiscal impact, as described in subsection (2) of this\nsection, of those changes to the Legislative Research Commission for referral\nto the Medicaid Oversight and Advisory Board, the Interim Joint Committee\non Appropriations and Revenue, the Interim Joint Committee on Families and\nChildren, the Interim Joint Committee on Health Services, and the Office of\nBudget Review.\n(c) If the cabinet determines that a change to the Medicaid program is necessary\nto respond to a national emergency declaration or federal disaster declaration\nissued by the President of the United States or a state of emergency declared\nby the Governor of the Commonwealth, any such change shall be temporary\nin nature and shall only be in effe ct for the duration of the emergency or\ndisaster declaration.\n(6) Subsection (1) of this section shall not apply to:\n(a) Reimbursement rates or the fee-for-service fee schedules;\n(b) Medicaid directed or supplemental payment programs initially approved by\nthe federal Centers for Medicare and Medicaid Services prior to March 27,\n2025, including but not limited to:\n1. Those payment programs established in KRS 205.5601 to 205.5603,\n205.6405 to 205.6408, 205.6411, and 205.6412, and 907 KAR 10:015\nand 907 KAR 10:830; and\n2. Any other payment program for a university hospital as defined in KRS\n205.639; or\n(c) The Medicaid preferred drug list established by the Department for Medicaid\nServices as required under KRS 205.5514.\n(7) As used in this section, the term \" Medicaid program\" includes the Kentucky\nMedical Assistance Program established in KRS 205.510 to 205.5630 and the\nKentucky Children's Health Insurance Program established in KRS 205.6483.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57040","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"9e92c7c1952a4f1cf5dd912d1723f4888bdceb3eb34f62851862fbcc52cc5986","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.5371","next":"us-ky/krs-205.5373"},"notice":"GroundRules: Original legal text. Not legal advice."}