KY SB97

Requires all health benefit plans in Kentucky, including short-term and student health insurance, to provide coverage for prostheses and orthoses at a level at least equivalent to Medicare coverage for the aged and disabled

Mandates coverage for one or more prostheses/orthoses prescribed by a healthcare provider for daily living activities, job-related activities, physical activities (running, biking, swimming), whole-body health, and bathing needs

Requires coverage for all materials, components, instruction, repairs, and replacements of prostheses/orthoses, with replacement allowed when the device condition changes, becomes irreparable, or repair costs exceed 60% of replacement cost

Prohibits cost-sharing requirements that apply only to prostheses/orthoses coverage, and requires utilization review decisions to be nondiscriminatory and not deny coverage solely based on disability

Takes effect January 1, 2027, and requires insurers to submit annual reports by June 1 detailing claims received and paid for this coverage, with the Insurance Commissioner reporting aggregated data to the Legislative Research Commission by October 1