SB 154/HM (BR 1626) - D. Harper Angel
AN ACT relating to health benefit plan coverage for acquired brain injuries.
Create new sections of Subtitle 17A of KRS Chapter 304 to require insurers issuing large group health benefit plans in the state to provide specified coverage for acquired brain injuries; prohibit a lifetime limit on benefits; subject coverage to deductibles, copayments, and coinsurance for treatment, include periodic reevaluation coverage; require an expedited utilization review or an internal appeal based on an allegation of medical necessity for individuals with an acquired brain injury; Prohibit denial of coverage for services provided at a skilled nursing facility for treatment for an acquired brain injury; require the executive director of the Office of Insurance to promulgate administrative regulations in consultation with the Kentucky Traumatic Brain Injury Trust Fund Board to implement the new sections, including training requirements and notice requirements which shall be promulgated; require adequate training for an insurer's personnel responsible for preauthorization of coverage or utilization review to prevent denial of coverage and avoid confusion of medical benefits with mental health benefits; require an annual notification by the plan to an employee of the covered benefits, including a statement, that hospitalization is not required for treatment of an acquired brain injury, and that treatment may be provided by a hospital or skilled nursing facility.
Feb 11-introduced in Senate
Feb 16-to Banking & Insurance (S)