Kentucky legislation · 2026 Regular Session
Kentucky SB97: AN ACT relating to coverage for prostheses and orthoses.
Status: Signed into law, April 7, 2026
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.
What the bill says
An act relating to coverage for prostheses and orthoses.
From the committee substitute text:
AN ACT relating to coverage for prostheses and orthoses. Be it enacted by the General Assembly of the Commonwealth of Kentucky: SECTION 1. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER IS CREATED TO READ AS FOLLOWS: (1) As used in this section, "health benefit plan" has the same meaning as in KRS 304.17A-005, except for purposes of this section, the term includes student health insurance offered by a Kentucky-licensed insurer under written contract with a university or college whose students it proposes to insure. (2) All health benefit plans shall provide coverage for prostheses and orthoses. (3) The coverage required under this section: (a) Shall, at a minimum, be equivalent to the coverage of, and payment for, prostheses and orthoses provided for the aged and disabled under the following, as 2. 42 U.S.C. sec. 1395l; 3. 42 U.S.C. sec. 1395m; 4. 42 C.F.R. sec. 410.100; 5. 42 C.F.R. sec. 414.202; 6. 42 C.F.R. sec. 414.210; and 7. 42 C.F.R. sec. 414.228; (b) To the extent not covered under paragraph (a) of this subsection, shall include: 1. Subject to paragraph (e) of this subsection, coverage for any one (1) or more prostheses and orthoses prescribed by an insured's health care provider and determined by a licensed prosthetist or orthotist to be the most appropriate model or models that adequately …
Sponsors
- Rick Girdler (R, SD-015) · primary sponsor
- Julie Raque Adams (R, SD-036)
- Matthew Deneen (R, SD-010)
- Greg Elkins (R, SD-028)
- Scott Madon (R, SD-029)
- Amanda Mays Bledsoe (R, SD-012)
- Matt Nunn (R, SD-017)
- Steve Rawlings (R, SD-011)
- Aaron Reed (R, SD-007)
- Brandon Storm (R, SD-021)
- Phillip Wheeler (R, SD-031)
Latest actions
- : signed by Governor (Acts Ch. 51)
- : delivered to Governor
- : enrolled, signed by Speaker of the House
- : enrolled, signed by President of the Senate
- : passed 38-0
- : Senate concurred in Committee Substitute (1) and Floor Amendment (1)
- : posted for passage for concurrence in House Floor Amendment (1) and Committee Substitute (1)
- : to Rules (S)
- : received in Senate
- : 3rd reading, passed 95-0 with Committee Substitute (1) and Floor Amendment (1)
Votes
- Senate: FINAL PASSAGE OF SB 97 w/ HCS 1, HFA 1 (HCS 1) RSN# 4079 (March 31, 2026): 38 yea, 0 nay, passed
- House: Pass RCS# 343 (March 27, 2026): 95 yea, 0 nay, passed
- Senate: PASS SB 97 w/ SCS 1 (SCS 1) RSN# 3918 (March 12, 2026): 38 yea, 0 nay, passed
Subjects: Education, Higher, Reports Mandated, Insurance, Health, Health Care Professionals, State Employee Health Plan Mandate, State Employees, Health And Medical Services, Local Mandate
Common questions
- What is SB97?
- SB97 is a bill in the Kentucky Legislature (2026 Regular Session): AN ACT relating to coverage for prostheses and orthoses.
- What does SB97 do?
- In its own words: An act relating to coverage for prostheses and orthoses.
- What is the status of SB97?
- Signed into law as of April 7, 2026. Latest action: signed by Governor (Acts Ch. 51) (April 7, 2026).
- Who sponsored SB97?
- Rick Girdler (R, SD-015), with 10 co-sponsors.
- Where is the official record for SB97?
- On the Kentucky Legislature website: https://apps.legislature.ky.gov/record/26rs/sb97.html
Source: official Kentucky record. Tracked by Delilah, AI for legislation across all 50 states and Congress.