Kentucky requires annual reviews of Medicaid and children’s coverage

Kentucky’s Department for Medicaid Services must submit plan documents and answer questions at two annual legislative reviews. Reviews cover Medicaid and the Kentucky Children’s Health Insurance Program, known as KCHIP, including changes submitted for federal approval. Annual reports cover federal approvals, rejections, and pending submissions since July 1 of the previous year. For each plan change, officials must provide federal submission materials, explain its purpose and expected benefits, assess whether authorization was required, and estimate costs over one, two, and five years. The health services committee also reviews officials’ responses to the Medicaid oversight board’s recommendations. The initial 2026 reviews cover both entire plans. Reviewers may request detailed summaries of any part of the Medicaid plan by June 1, 2026. Reports are due July 1 each year. The Medicaid oversight board reviews them by August 31, and the health services committee by October 31. Initial plans are due within five calendar days of the law taking effect.

The Medicaid Oversight and Advisory Board may recommend changes, and the Interim Joint Committee on Health Services may formally find problems with a plan. These powers cover Medicaid and KCHIP plans and changes to those plans. Recommendations need a majority of the board’s appointed voting members. Formal findings need a majority of the committee’s appointed members. The committee may flag apparent legal conflicts, excessive agency authority, unreasonable burdens, incomplete reports, failure to fully follow board recommendations, or other problems. The committee cannot find a plan deficient based on a federally rejected or pending change, but it may recommend action on those changes. A formal finding about the Medicaid plan requires a request for the Governor to decide whether to amend the Medicaid or KCHIP plan or leave it in effect. The board must send recommendations to state leaders within 30 calendar days of its review. The Governor must send a decision to legislative reviewers within 30 calendar days of the committee’s finding.

The Department for Medicaid Services must publish plan documents on its website in an easily accessible way. Publication covers current Medicaid and KCHIP plans and plan changes submitted to both federal officials and the Legislative Research Commission. Current plans must show the date of their most recent federally approved change. Posted plan changes must include the required summaries and statements explaining their benefits. The posting deadline is 30 days after the law’s effective date. Its emergency clause makes it effective upon becoming law.