{"data":{"id":"us-ky/krs-7a.286","jurisdiction":"us-ky","citation":"KRS 7A.286","heading":"Board duties and permitted activities.","body":"(1) The board, consistent with its purpose as established in KRS 7A.273, shall:\n(a) On an ongoing basis, conduct an impartial review of all state laws and\nregulations governing the Medicaid program and recommend to the General\nAssembly any changes it finds des irable with respect to program\nadministration, including delivery system models, program financing, benefits\nand coverage policies, reimbursement rates, payment methodologies, provider\nparticipation, or any other aspect of the program;\n(b) On an ongoing ba sis, review any change or proposed change in federal laws\nand regulations governing the Medicaid program and report to the\nCommission on the probable costs, possible budgetary implications, potential\neffect on healthcare outcomes, and the overall desirabil ity of any change or\nproposed change in federal laws or regulations governing the Medicaid\nprogram;\n(c) At the request of the Speaker of the House of Representatives or the President\nof the Senate, evaluate proposed changes to state laws affecting the Medi caid\nprogram and report to the Speaker or the President on the probable costs,\npossible budgetary implications, potential effect on healthcare outcomes, and\noverall desirability as a matter of public policy;\n(d) At the request of the Commission, research i ssues related to the Medicaid\nprogram;\n(e) Beginning in 2027 and at least once every five (5) years thereafter, cause:\n1. A review to be made of the administrative expenses and operational cost\nof the Medicaid program. The review shall include but not be l imited to\nevaluating the level and growth of administrative costs, the potential for\nlegislative changes to reduce administrative costs, and administrative\nchanges the department may make to reduce administrative costs or\nstaffing needs. At the discretion of the Commission, the review may be\nconducted by a consultant retained by the board;\n2. A program evaluation to be conducted of the Medicaid program. In any\ninstance in which a program evaluation indicates inadequate operating\nor administrative system con trols or procedures, inaccuracies,\ninefficiencies, waste, extravagance, unauthorized or unintended\nactivities, or other deficiencies, the board shall report its findings to the\nCommission. The program evaluation shall be performed by a\nconsultant retained by the board; and\n3. An actuarial analysis to be performed of the Medicaid program, to\nevaluate the sufficiency and appropriateness of Medicaid reimbursement\nrates established by the department and those paid by any managed care\norganization contracted by the department for th e delivery of Medicaid\nservices. The actuarial analysis shall be performed by an actuary\nretained by the board;\n(f) Beginning in 2029 and at least once every five (5) years thereafter, cause the\noverall health of the Medicaid population to be assessed. The assessment shall\ninclude but not be limited to a review of health outcomes, healthcare\ndisparities among program beneficiaries and as compared to the general\npopulation, and the effect of the overall health of the Medicaid population on\nprogram expenses. The assessment shall be performed by a consultant\nretained by the board; and\n(g) Beginning in 2026 and annually thereafter, publish a report covering the\nboard's evaluations and recommendations with respect to the Medicaid\nprogram. The report shall be subm itted to the Commission no later than\nDecember 1 of each year, and shall include at a minimum a summary of the\nboard's current evaluation of the program and any legislative\nrecommendations made by the board.\n(2) The board, consistent with its purpose as established in KRS 7A.273, may:\n(a) Review all new or amended administrative regulations related to the Medicaid\nprogram and provide comments to the Administrative Regulation Review\nSubcommittee established in KRS 13A.020;\n(b) Make recommendations to the General Assembly, the Governor, the secretary\nof the cabinet, and the commissioner of the department regarding program\nadministration, including benefits and coverage policies, access to services\nand provider network adequacy, healthcare outcomes and disparit ies,\nreimbursement rates, payment methodologies, delivery system models,\nfunding, and administrative regulations. Recommendations made pursuant to\nthis section shall be nonbinding and shall not have the force of law; and\n(c) On or before December 1 of each  calendar year, adopt an annual research\nagenda. The annual research agenda may include studies, research, and\ninvestigations considered by the board to be significant. Board staff shall\nprepare a list of study and research topics related to the Medicaid p rogram for\nconsideration by the board in the adoption of the annual research agenda. An\nannual research agenda adopted by the board may be amended by the\nCommission to include any studies or reports mandated by the General\nAssembly during the next succeeding regular session.\n(3) At the discretion of the Commission, studies and research projects included in an\nannual research agenda adopted by the board pursuant to subsection (2)(c) of this\nsection may be conducted by outside consultants, analysts, or resear chers to ensure\nthe timely completion of the research agenda.","path":["KRS Chapter 7A"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=57039","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:48:27Z","sha256":"1286409a4b4fc64d4a8067fc0700ae2f2dcf623338e973d03201336a7cd6bf59","source_id":"us-ky","stale":false,"prev":"us-ky/krs-7a.285","next":"us-ky/krs-7a.287"},"notice":"GroundRules: Original legal text. Not legal advice."}