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Bill

HB 279

AN ACT relating to coverage for mental health or substance use disorders.

2026 Regular Session Introduced by Daniel Grossberg and 3 co-sponsors

Requires health plans in Kentucky to cover mental health and substance use services with parity to medical benefits, improving access and affordability.

to Banking & Insurance (H)
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Bill Summary · HB 279

Overview

HB 279 (2026 Regular Session, Kentucky) is an act relating to coverage for mental health or substance use disorders. The bill sets out requirements for health benefit coverage, access to services, and related responsibilities for insurers and health plans operating in Kentucky.

Purpose and Intent

  • To ensure that health benefit plans provide coverage for mental health and substance use disorder (MH/SUD) services.
  • Aims to align Kentucky’s coverage requirements with recognized standards for parity between physical health and behavioral health benefits.
  • Provisions may address access to care, affordability, and timely treatment for individuals with MH/SUD needs.

Key Provisions

While the specific legislative text is not provided here, typical elements in bills of this type often include:

  • Parity and non-discrimination: Require private health plans and state-regulated plans to cover MH/SUD services on terms no more restrictive than medical/surgical benefits, consistent with federal parity laws.
  • Covered services: Define or expand the range of MH/SUD services subject to coverage (e.g., inpatient, outpatient, emergency services, medication-assisted treatment, therapy, and crisis interventions).
  • Network adequacy and access: Provisions to ensure timely access to MH/SUD providers, including reasonable wait times and access standards.
  • Cost-sharing limits: Provisions to curb higher copays/coinsurance for MH/SUD services or to cap out-of-pocket costs to prevent barriers to care.
  • Prior authorization and utilization review: Rules governing prior authorizations, step therapies, and ongoing review to avoid unnecessary barriers.
  • Treatment duration and frequency: Standards for treatment plan requirements, recommended visit limits, or duration for certain services to ensure appropriate care.
  • Confidentiality and privacy: Protections for patient information related to MH/SUD treatment.
  • Compliance and enforcement: Roles for state agencies (e.g., Kentucky Department of Insurance) to enforce parity and coverage requirements, with potential penalties for noncompliance.
  • Reporting and oversight: Requirements for reporting on MH/SUD coverage practices, access metrics, or utilization data.

Affected Parties

  • Health insurers and health benefit plans operating in Kentucky (commercial, HMOs, PPOs, etc.).
  • State-regulated plans and possibly Medicaid managed care organizations, depending on the bill’s scope.
  • Employers sponsoring self-funded plans may be impacted if the bill applies to fully insured products or includes self-funded arrangements via state requirements.
  • Consumers and patients who use MH/SUD services, including individuals seeking therapy, medication-assisted treatment, crisis care, and inpatient services.
  • Healthcare providers delivering MH/SUD services (as network adequacy and authorization rules affect practice operations).

Procedural and Timeline Considerations

  • Introduction and referral: The bill was introduced on January 8, 2026, and assigned to the Banking & Insurance Committee (H) for consideration.
  • Committee process: The bill will undergo committee hearings, potential amendments, and votes before advancing to the full House for floor debate.
  • Potential implementation: If enacted, effective dates are typically specified within the bill (e.g., a date after enactment or phased compliance). Implementing regulations and guidance from the Kentucky Department of Insurance would follow.

Potential Impacts and Implications

  • Consumer access: Improved parity in MH/SUD coverage could reduce out-of-pocket costs and improve timely access to needed services.
  • Provider participation: Clear parity and network adequacy standards may influence provider networks and reimbursement practices.
  • Administrative burden: Insurers may need to adjust plan documents, coding, and utilization management processes to comply with parity and access requirements.
  • Budgetary considerations: Depending on cost-sharing and coverage requirements, there could be implications for premiums and plan costs.

If you have the full text or fiscal notes, I can refine this summary with exact provisions, definitions, timelines, and any specific numerical thresholds or reporting requirements.

Compiled from official sources — confirm details with the bill’s official record.

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