Reducing Barriers to Behavioral Care
What Medical Providers Need to Know About Kentucky House Bills 169 and 178
Kentucky’s 2026 legislative session brought two significant developments for practitioners providing behavioral health care. First, House Bill 169 addresses insurance coverage for the diagnosis and treatment of feeding and eating disorders. Second, House Bill 178 establishes a new framework for psychiatric collaborative care. Governor Andy Beshear signed both bills into law on April 13, 2026, with key insurance coverage provisions applying to health plans issued, delivered, or renewed on or after January 1, 2027.
Although the bills address different aspects of care, they share a common objective: reducing barriers between patients who need behavioral health services and the clinicians equipped to provide them. For medical providers, the practical implications for expanded insurance coverage may impact service models and care coordination because reimbursement realities may increase patient access to care.
As implementation approaches, physicians, advanced practice clinicians, behavioral health professionals, health system administrators, and medical practice leaders should understand what each law changes, and what it does not.
“Primary care clinicians routinely encounter patients whose depression, anxiety, or other mental health concerns complicate the management of chronic medical conditions. The collaborative care model offers a structured way to address these needs without requiring every patient to obtain a separate appointment with a psychiatrist. Kentucky’s HB 169 and HB 178 represent two complementary developments in behavioral health policy.”
HB 169: Changing the Coverage Landscape for Eating Disorders
House Bill 169 establishes new requirements for insurers to offer coverage of the diagnosis and treatment of feeding or eating disorders. It also restricts the use of standards such as body mass index (BMI), ideal body weight, or weight goals as grounds for denying, limiting, or restricting coverage. The law permits insurers to consider specific factors when determining medical necessity of a treatment or the appropriate level of care, such as:
Eating behaviors
The need for supervised meals;
Recovery environments; and
Co-occurring disorders.
For clinicians, the significance is straightforward: coverage decisions for eating disorder treatment must account for the requirements established by the new law rather than rely on prohibited criteria. BMI and weight goals are no longer an appropriate standard for insurers to use when determining coverage for care. By restricting the use of BMI and certain other standards in coverage determinations, HB 169 will hopefully reduce one source of friction between clinical assessments and insurance authorization decisions.
But the law does not eliminate medical necessity review or guarantee coverage for every requested service. Instead, it changes the framework within which covered services must be evaluated.
Because front-line providers such as primary care clinicians, pediatricians, and family physicians are often positioned to identify eating disorder symptoms before a patient realizes the need for specialty care, an increase in coverage should help patients obtain diagnostic evaluations and treatment. And BMI no longer provides insurers with a sole basis for a coverage restriction, so greater clinical documentation will be necessary.
Greater attention to clinical documentation. This new law makes it particularly important for practices to document the rationale for diagnosis, treatment recommendations, referrals, and level-of-care decisions. Clinicians should record relevant symptoms, medical and psychiatric risks, treatment response, functional limitations, and the clinical reasons for recommending outpatient, intensive outpatient, residential, or inpatient services when applicable.
Which plans are affected? HB 169 extends its requirements across several categories of coverage, including specified commercial and limited-benefit plans, Medicaid, the Kentucky Children’s Health Insurance Program (KCHIP), the state employee health plan, and certain self-insured higher-education employee plans. Providers should avoid assuming that every plan will implement the requirements identically or simultaneously.
HB 178: Bringing Behavioral Health Into Primary Care
House Bill 178 establishes a statutory definition of the psychiatric collaborative care model and requires health benefit plans that cover treatment for mental health conditions to reimburse covered benefits delivered through this model. The requirements apply to health benefit plans issued, delivered, or renewed on or after January 1, 2027.
The psychiatric collaborative care model is a structured approach to integrating mental health services into primary care. Rather than relying exclusively on referrals to outside specialists, the model brings together treating primary care clinicians, behavioral care managers, and consulting psychiatrists into a collaborative team.
This arrangement allows patients to receive mental health support through a familiar medical setting while drawing on psychiatric expertise that may otherwise be difficult to access. HB 178 establishes a reimbursement framework for this approach in Kentucky.
Why this matters?
Primary care clinicians routinely encounter patients whose depression, anxiety, or other mental health concerns complicate the management of chronic medical conditions. The collaborative care model offers a structured way to address these needs without requiring every patient to obtain a separate appointment with a psychiatrist.
For rural and underserved communities, where access to psychiatric specialists may be limited, the model could provide an additional avenue for integrating behavioral health expertise into routine care.
HB 178 should create a financial framework that may help practices compensate consulting psychiatrists for their participation in collaborative care and change qualified personnel to behavioral care managers.
Kentucky’s HB 169 and HB 178 represent two complementary developments in behavioral health policy. One addresses insurance coverage for feeding and eating disorder diagnosis and treatment; the other establishes a reimbursement framework for psychiatric collaborative care.
Clinicians should understand the laws’ scope and work with their administrative teams to ensure that coverage and billing practices reflect these changes and take advantage of new opportunities to improve care.
Andy M. Yocum is a civil litigation and healthcare law member attorney at Sturgill Turner. He can be reached at ayocum@sturgillturner.com or 859.255.8581. This article is intended as a summary of state and/or federal law and does not constitute legal advice.
This article originally appeared in the Lexington Medical Society November 2026 Newsletter.
