Create a new section of KRS Chapter 141 to provide taxpayers the option of having all or a portion of their individual income tax refund be contributed to the animal control and care fund created in KRS 258.119; establish requirements for administering the designation.

Amend KRS 61.510 to change the current definition of "membership date" in the Kentucky Employees Retirement System to remove date restrictions regarding educational contracts and allow any member who entered into an educational contract as a conditional employee of the state of Kentucky to have their system membership date, for purposes of retirement benefits determination, be based upon the earliest date of the contract.

Amend KRS 61.702, relating to the Kentucky Employees Retirement System and the State Police Retirement System, to increase the nonhazardous and hazardous duty under age 65 retiree health subsidy to $40 and $50 per month for each year of service, respectively, for those members who meet the "career threshold" who began participating in the system on or after July 1, 2003, and who are eligible for a fixed-dollar retiree health subsidy not tied to the premium; extend the employee contribution used to fund retiree health benefits to include members who began participating in the system on or after July 1, 2003, and increase the current hazardous employee contribution rate to 2% of pay for those eligible for the fixed-dollar retiree health subsidy; make technical amendments regarding the retiree health premium reimbursement program to conform to current policy; provide that the amendments to the employee contributions shall be effective July 1, 2027; for calculation of the retiree health subsidy increase, provide that the change shall apply to service earned prior to the effective date of this Act by eligible members, including retirees, and shall prospectively be adjusted annually by the 1.5% increase currently provided in statute; provide that subsidies payable to impacted retirees shall begin on or after January 1, 2027, to coincide with the next health plan year; direct the Public Pension Oversight Board to continue to review the retiree health fund actuarial data and evaluate potential legislative options to address any future continued improvements in the funds; RETROACTIVE.

Create new sections of KRS Chapter 311 to establish reproductive rights and define terms; amend KRS 18A.225 to remove the prohibition of insurance coverage for abortion; amend KRS 39A.180 to allow the Governor to suspend statutes related to abortion during a declared emergency; amend KRS 156.496 to allow a school district to operate a family resource center that provides abortion counseling; amend KRS 205.010 to permit financial aid for an abortion; amend KRS 205.510 to include abortions or induced miscarriages as medical care; amend KRS 205.560 to allow medical aid payments for abortion; amend KRS 211.603 to allow money in the rape crisis center trust fund to be used for abortion services or education; amend KRS 212.275 to allow health departments to dispense medication for an abortion; amend KRS 213.101 to remove various reporting requirements; amend various sections to remove penalties associated with performing abortions; amend various sections to conform; repeal, reenact, and amend or repeal and reenact KRS 311.783, 311.7710, 311.820, 311.780, 311.810, to conform; repeal KRS 15.241, 213.098, 213.172, 213.174, 213.176, 216B.0435, 216B.200, 216B.202, 216B.204, 216B.206, 216B.208, 216B.210, 304.5-160, 311.710, 311.715, 311.720, 311.723, 311.724, 311.725, 311.727, 311.728, 311.731, 311.732, 311.733, 311.735, 311.750, 311.760, 311.765, 311.770, 311.7701, 311.7702, 311.7703, 311.7704, 311.7705, 311.7706, 311.7707, 311.7708, 311.7709, 311.7711, 311.772, 311.7731, 311.7733, 311.7734, 311.7735, 311.7736, 311.7737, 311.7739, 311.774, 311.7741, 311.7743, 311.781, 311.7811, 311.782, 311.784, 311.7841, 311.785, 311.786, 311.787, 311.790, 311.800, 311.821, 311.822, 311.823, 311.824, 311.825, 311.826, 311.827, 311.830, 311.992, and 315.315; EFFECTIVE, in part, January 1, 2027.

Amend KRS 61.598, relating to pension spiking and the definition of "bona fide promotion or career advancement," to retroactively exempt pension spiking adjustments that were due to increases in rates of pay authorized or funded by the legislative or administrative body of an employer or mandated in a collective bargaining agreement approved by the legislative body of the employer for members of the Kentucky Employees Retirement System, County Employees Retirement System, or State Police Retirement System who retired on or after July 1, 2022; require the Kentucky Public Pension Authority to review and make necessary adjustments to benefits payable on or after July 1, 2022, to impacted members; RETROACTIVE.

Create new sections of KRS Chapter 262 to establish the Healthy Soils Program and the Healthy Soils Program fund in the Department for Natural Resources, Division of Conservation; require the department to provide technical advice and assistance and to assist with soil health assessments and soil health plans; require the commissioner to approve applications for grants and other types of financial assistance under the Healthy Soils Program; authorize the department to promulgate administrative regulations to implement the Healthy Soils Program and the Healthy Soils Program fund; amend KRS 146.100 to require the director of the Division of Conservation to have experience in healthy soil practices; amend KRS 224.71-110 to require the Agriculture Water Quality Authority to promote soil restoration and include an organic agriculture organization among appointments to the authority and add healthy soil practices as a committee; amend KRS 262.010 to define "healthy soil practices," "soil health," "soil health assessment," and "watershed health"; amend KRS 262.020 to add restoration, biological diversity, watershed health, and healthy soil practices to the purpose of soil and water conservation districts; amend KRS 262.748 and 262.778 to conform.

Create a new section of KRS Chapter 218A to make possession of a personal use quantity of cannabis exempt from civil or criminal penalty; amend KRS 218A.010 to define "cannabis," "personal use quantity of cannabis," and "cannabis accessory"; redefine "marijuana"; amend KRS 218A.1422, regarding cannabis possession, to conform; amend KRS 218A.1423, regarding cannabis cultivation, to conform; amend KRS 218A.500, regarding drug paraphernalia, to exempt personal use cannabis accessories; amend KRS 218A.1421, regarding cannabis trafficking, to exempt personal use quantities; amend KRS 138.872 to exclude personal use quantities from the cannabis stamp tax; amend KRS 218A.276, 218A.410, and 533.030 to conform; create a new section of KRS Chapter 431 to allow expungement of certain convictions relating to cannabis and to apply expungement retroactively; RETROACTIVE, in part.

Propose to create a new section of the Constitution of Kentucky to guarantee the right of an individual 21 years of age or older to possess, use, buy, or sell 1 ounce or less of cannabis and to cultivate, harvest, and store up to 5 cannabis plants for personal use; grant the General Assembly control over the production, processing, and sale of cannabis and cannabis-derived products; designate the ballot question; direct the Secretary of State to publish the proposed amendment in a newspaper of general circulation; direct the Secretary of State to certify the proposed amendment to the county clerk of each county.

Create a new section of Subtitle 17A of KRS Chapter 304 to require health benefit plans to provide coverage for in vitro fertilization, intrauterine insemination, and any other assisted reproductive technology; establish minimum requirements for the coverage; suspend the coverage requirement's application to qualified health plans if the state would be required to make cost defrayal payments; amend KRS 304.17A-099 to conform; amend KRS 164.2871 and 18A.225 to require self-insured employer plans provided by the governing board of a state postsecondary education institution and the state employee health plan to comply with the assisted reproductive technology coverage requirement; direct that certain provisions apply to health benefit plans issued or renewed on or after January 1, 2027; EFFECTIVE January 1, 2027.

Amend KRS 205.5371 to require the Cabinet for Health and Family Services to condition eligibility for enrollment or continued enrollment in the Medicaid program on demonstrated community engagement as required under federal law; require the cabinet to continue to condition eligibility on demonstrated community engagement if federal requirements are abolished, repealed, or otherwise diminished; amend KRS 205.6312 to require the cabinet and any contracted Medicaid managed care organization to impose cost-sharing requirements for Medicaid enrollees as required under federal law no later than January 1, 2027; establish minimum cost-sharing amounts; amend KRS 205.556 and 205.618 to conform; create new sections of KRS Chapter 205 to require the cabinet to, no later than July 1, 2026, begin conducting Medicaid eligibility redeterminations once every 6 months as required under federal law; require the cabinet to access and review certain data when conducting eligibility redeterminations; establish a process for identifying and, when appropriate, disenrolling individuals who are concurrently enrolled in the Kentucky Medicaid program and a Medicaid program administered by another state or states; amend KRS 205.178 to require the cabinet to receive and review information from the Kentucky Lottery Corporation, Department of Corrections, and the Kentucky Horse Racing and Gaming Corporation on at least a monthly basis, the Kentucky Department of Revenue on at least an annual basis, and the Kentucky Transportation Cabinet on a quarterly basis; require the Department for Medicaid Services to enter into a data sharing agreement with the Social Security Administration to receive the full file of death information on at least a quarterly basis; prohibit the cabinet from seeking or requesting an exemption or waiver from federal community engagement requirements related to county unemployment rates unless specifically authorized by the General Assembly to do so; amend KRS 205.5375 to require hospitals to assist presumptively eligible individuals in submitting a full Medicaid application; amend KRS 205.200 to prohibit the cabinet from accepting self-attestation of income, residency, or age for the purpose of determining eligibility for Medicaid or compliance with community engagement requirements; create new sections of KRS Chapter 205 to establish Medicaid managed care organization contracting requirements and penalties; establish the Medicaid managed care organization compliance fund within the State Treasury; establish that amounts in the fund not appropriated at the close of a fiscal year shall not lapse and shall be carried forward; prohibit the expenditure of funds in the account unless expressly appropriated by the General Assembly; require the Department for Medicaid Services to submit recommendations for use of monies in the fund to the Legislative Research Commission by November 1, 2027, and November 1, of each following odd-numbered year; amend KRS 205.533 to require Medicaid managed care organizations to include certain information for providers on their websites; amend KRS 205.534 to require managed care organizations to allow providers 120 days to file an appeal or grievance related to a reduction of denial of a claim; establish penalties for a managed care organization's failure to ensure the timely disposition of any appeal or grievance; require payment of any amount owed to a provider following an appeal to be paid within 30 days; require payments made following an appeal to include interest and reasonable attorney's fees; establish standards and requirements for provider audits; require the inclusion of additional information in the monthly report filed by managed care organizations; require the Department for Medicaid Services to submit an annual report to the Legislative Research Commission related to Medicaid claims, appeals, and grievances; authorize the Department for Medicaid Services to promulgate administrative regulations; create new sections of KRS Chapter 205 to establish requirements for administration of the Medicaid-covered nonemergency medical transportation services; establish requirements for the administration of 1915(c) Medicaid waiver programs; require the Department for Medicaid Services to develop and implement a tiered priority system for assigning 1915(c) Medicaid waiver program slots by January 1, 2027; require administration of Medicaid-covered dental services by an administrative service organization; establish that the administrative service organization shall not assume any financial or insurance risk; limit compensation paid to the administrative service organization to no more than 2% of the actual Medicaid-covered dental service claims paid on an annual basis; require the Department for Medicaid Services to establish a Dental Program Advisory Panel; require the Department for Medicaid Services to employ a dental director; require the Department for Medicaid Services to submit an annual report on the Medicaid dental program to the Legislative Research Commission; create new sections of KRS 7A.270 to 7A.290 to establish legislative findings; require the cabinet to provide the Legislative Research Commission with access to all databases, datasets, electronic records, and files pertaining to any aspect of the Medicaid program determined by the director of the Legislative Research Commission to be necessary for the meaningful and effective discharge of the General Assembly's legislative duties; require the Legislative Research Commission, the University of Kentucky, and the University of Louisville to enter into a partnership to design and develop a web-based healthcare transparency dashboard; require the dashboard be overseen by a subcommittee of the Medicaid Oversight and Advisory Board; require the dashboard be maintained and operated by the Legislative Research Commission; amend KRS 7A.283 to allow the appointment of individuals who are not members of the board to advisory committees or subcommittees upon approval of the Legislative Research Commission; create a new section of KRS Chapter 43 to require the Auditor of Public Accounts to conduct an examination of the state's Medicaid program and Kentucky Children's Health Insurance Program; establish audit reporting requirements; require the Auditor to conduct a review of the Medicaid program and Kentucky Children's Health Insurance Program to assess progress in addressing issues identified in previous examinations; establish that the Office of Program Performance in the Commonwealth Office of the Ombudsman shall conduct all quality control reviews of the Department for Community Based Services for the Medicaid program, Supplemental Nutrition Assistance Program, and Temporary Assistance for Needy Families to comply with federal law and regulations; establish that no other state agency shall conduct these quality control reviews unless otherwise authorized by the General Assembly; amend KRS 7A.286 to establish that examinations conducted by the Auditor may constitute fulfillment of certain duties assigned to the Medicaid Oversight and Advisory Board at the discretion of the Legislative Review Commission; repeal KRS 205.515 related to administration of the Medicaid program; repeal KRS 311A.172 related to nonemergency medical transportation services; appropriate $500,000 in General Fund moneys in fiscal year 2025-2026 for staffing and technology needs in the Office of the Auditor of Public Accounts; create a new section of KRS Chapter 6 to establish a Medicaid impact statement; require any legislation that makes or directs a change to the Medicaid program to be accompanied by a Medicaid impact statement; require certain factors to be analyzed and included in a Medicaid impact statement; require Medicaid impact statements to be completed by an economic consulting firm retained by the Legislative Research Commission; create a new section of KRS Chapter 13A to require the cabinet to provide a draft copy of certain administrative regulations related to the Medicaid program to the Medicaid Oversight and Advisory Board for comment at least 30 days before filing the administrative regulation with the regulations compiler; direct the Medicaid Oversight and Advisory Board to establish a Dental Services Transition Subcommittee; establish membership and duties of the Dental Services Subcommittee; require any contract between the Department for Medicaid Services and a Medicaid managed care organization entered into, renewed, or extended after the effective date of this Act to include notice to the managed care organization of the department's intent to transition to an administrative service organization delivery model for Medicaid-covered dental services; require the cabinet or the Department for Medicaid Services to seek federal approval if it is determined that such approval is necessary; provide authorization from the General Assembly to make changes in the Medicaid program as required under KRS 205.5372(1); direct the Medicaid Oversight and Advisory Board to evaluate the nonemergency medical transportation program and submit findings and recommendations to the Legislative Research Commission by December 31, 2026; APPROPRIATION; EMERGENCY.

Amend KRS 341.370 to prohibit disqualification from benefits for workers unemployed as a result of domestic violence and abuse, dating violence and abuse, sexual assault, or stalking; create a new section of KRS Chapter 341 to direct the secretary of the Education and Labor Cabinet to promulgate administrative regulations; amend KRS 341.125 to require the secretary to provide training to personnel who process claims related to domestic or dating violence and abuse, sexual assault, or stalking and to report to the Legislative Research Commission annually the number of claims paid involving domestic or dating violence and abuse, sexual assault, or stalking; amend KRS 341.360 to conform; amend KRS 341.530 to charge benefits to pooled account for workers displaced from employment through domestic or dating violence and abuse, sexual assault, or stalking; amend KRS 341.550 to prevent benefit payments from pooled account from impacting an employer's experience rating.

Create new sections of KRS 304.17A-600 to 304.17A-633 to define terms; prohibit insurers of health benefit plans from requiring prior authorization for a health care service for which the provider has an exemption; require insurers of health benefit plans to establish a program under which participating providers may qualify for exemptions from prior authorization; establish mandatory and permitted provisions of an insurer's prior authorization exemption program; establish requirements for sending forms and notices; require the commissioner of the Department of Insurance to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 304.17A-605 to conform; amend KRS 304.17A-611 to prohibit conducting a retrospective review that is based solely on a participating provider having a prior authorization exemption; provide that certain utilization review time frames do not apply to retrospective reviews conducted for the purposes of determining eligibility for a prior authorization exemption; create a new section of KRS Chapter 205 to require the commissioner of the Department for Medicaid Services to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 205.536 to conform; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028; EFFECTIVE, in part, January 1, 2027, and January 1, 2028.

Amend KRS 314.041, relating to registered nurse licensure, and KRS 314.051, relating to licensed practical nurse licensure, to add credential requirements; amend KRS 314.042 to require physicians collaborating with an advanced practice registered nurse to have an active and unrestricted license in Kentucky; amend KRS 314.109 to reduce the time from 90 to 30 days for a person under the jurisdiction of the board to notify the board of a conviction of certain misdemeanors or felonies; amend KRS 209.032, relating to employees of vulnerable adult service providers, to permit a state licensing board to query the cabinet for a validated substantiated finding of adult abuse, neglect, or exploitation against an individual under the licensing board's jurisdiction; create a new section of KRS 158.830 to 158.838 to define terms; permit health care practitioners to prescribe and dispense undesignated glucagon in the name of a school or to a trained individual; permit trained individuals to receive, possess, and administer undesignated glucagon during diabetic medical emergencies; permit schools to stock undesignated glucagon; provide for immunity from civil liability for any personal injury resulting from good-faith actions to use undesignated glucagon to treat diabetic medical emergencies; amend KRS 158.832 to add definition of "documented medical conditions" and medications to the definition of "medications"; amend KRS 158.834 to add medical conditions and medications that may be self-administered in schools with parental authorization and a prescription; amend KRS 158.836 to require students to permit bronchodilator rescue inhalers, nebulizers, glucagon, Solu-Cortef, or other prescribed medications in their possession or in the possession of school personnel; encourage schools to stock undesignated glucagon; and require policies and Good Samaritan protection for the good-faith administration of glucagon, Solu-Cortef, or other prescribed medications for authorized school employees.

Create a new section of KRS 304.17A-660 to 304.17A-669 to define "psychiatric collaborative care model"; require the commissioner of insurance to promulgate and maintain an administrative regulation to list alterations and additions to relevant billing codes; require health benefit plans that provide coverage for treatment of a mental health condition to provide reimbursement for those benefits that are delivered through the psychiatric collaborative care model; authorize insurers to deny any benefit billed under a covered billing code on grounds of medical necessity if certain conditions are met; apply requirement to health benefit plans issued, delivered, or renewed on or after January 1, 2027; require the Department of Insurance to seek a federal waiver if cost defrayal is determined.

Create a new section of KRS Chapter 6 to establish a children's health and welfare fiscal impact statement to evaluate the potential costs that would be incurred by the state or a local government by passing certain legislation; specify the requirements and components of the statement; require state agencies and local governments to respond to requests for information relating to the statements; require the Attorney General to certify, upon request, if a proposal constitutes a state mandate; authorize the director of the Legislative Research Commission to implement policies and procedures necessary to produce the statements.