KY HB2

Requires mandatory community engagement (80 hours/month of work, education, or community service) for Medicaid enrollees ages 19-64 by January 1, 2027, with exemptions for pregnant women, disabled individuals, caregivers of children under 13, those in substance abuse recovery programs, and others with special circumstances

Establishes new cost-sharing requirements including copayments for Medicaid enrollees with income above 100% of the federal poverty level: $8 for non-emergency ER use, $35 for inpatient hospital services, and $20 flat copay for most services beginning October 2028, capped at 5% of family income

Implements six-month eligibility redeterminations and enhanced verification procedures prohibiting self-attestation of income, residency, or age, while requiring data cross-checks with lottery, gaming, unemployment, corrections, transportation, and revenue agencies to identify ineligible enrollees

Transitions Medicaid dental services from managed care to an administrative services organization (ASO) model by January 1, 2028, with the ASO receiving no more than 2% of claims paid as administrative compensation and required to maintain a 90% medical loss ratio

Strengthens legislative oversight through expanded Medicaid Oversight and Advisory Board authority, mandatory five-year Auditor examinations of the Medicaid program, direct legislative access to Medicaid data systems, and required Medicaid impact statements for legislation affecting the program