SB 97
AN ACT relating to coverage for prostheses and orthoses.
In Plain Language
This bill requires health insurance plans to cover prostheses and orthoses (artificial limbs and braces) starting in 2027. Insurance companies must make fair decisions about coverage requests, tell you if they deny your claim, and maintain a network of providers who can supply these devices. State employee and university health plans must follow the same rules.
Official summary
Create a new section of Subtitle 17A of KRS Chapter 304 to require health benefit plans to provide coverage for prostheses and orthoses; establish minimum requirements for the required coverage; require utilizations review decisions to be made in a nondiscriminatory manner; require an insurer or its private review agent to provide notice of certain rights of the insured; establish notice requirements for denials; establish network adequacy requirements for the provision of a prosthesis or orthosis that is required to be covered; establish reporting requirements for insurers and the commissioner of the Department of Insurance relating to the required coverage; amend KRS 164.2871 and 18A.225 to require self-insured group health plans offering by the governing board of state postsecondary education institutions and the state employee health plan to comply with the requirements relating to coverage for prostheses and orthoses; provide that the Act applies to health benefit plans issued or renewed on or after January 1, 2027; EFFECTIVE January 1, 2027.
Sponsor
R. Girdler (Republican-15)
Cosponsors
10 listed
Latest action
signed by Governor (Acts Ch. 51)
Apr 7, 2026
Official source
Action history
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