SB 140

Bill Subjects

Administrative Regulations And Proceedings Children And Minors Drugs And Medicines Education, Higher Effective Dates, Delayed Insurance, Health Medicaid Reports Mandated State Agencies State Employees

Abstract

Amend KRS 304.17A-163 to define terms; establish requirements for clinical review criteria and clinical practice guidelines used to establish step therapy protocols; require certain notices and disclosures relating to step therapy protocols; establish requirements for exception requests, internal appeals, and external reviews of step therapy protocols; create a new section of Subtitle 17A of KRS Chapter 304 to require the commissioner of insurance to promulgate administrative regulations; require insurers, health plans, pharmacy benefit managers, or private review agents to submit an annual report relating to step therapy exception requests; amend KRS 304.17A-168, 304.17A-535, 304.17A-600, 304.17A-607, 304.17A-617, and 304.17A-623 to conform; amend KRS 205.522, 205.6485, 164.2871, and 18A.225 to require Medicaid, the Kentucky Children's Health Insurance Program, self-insured employer group health plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the step therapy protocol requirements; apply to health plans delivered, issued for delivery, or renewed on or after the effective date of Sections 1 to 12 of the Act; require the Cabinet for Health and Family Services to seek a federal waiver of authorization if necessary; EFFECTIVE, in part, January 1, 2023.