Kentucky legislation · 2026 Regular Session
Kentucky SB307: AN ACT relating to step therapy protocols.
Status: In committee, February 27, 2026
Amend KRS 304.17A-163 to modify the definition of "health plan"; require insurers, health plans, private review agents, and pharmacy benefit managers to disclose certain information about step therapy protocols on their website and ensure that the electronic process for requesting and transmitting prior authorization for a drug includes the ability for prescribing providers to electronically transmit a complete request for a step therapy exception; require coverage for a prescription drug on the date the provider submits a step therapy exception request; provide that requirements apply to Medicaid and KCHIP benefits to the extent authorized by federal law; require the Cabinet for Health and Family Services 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); provide that the Act applies to policies, certificates, contracts, and plans issued or renewed on or after the effective date of the Act.
What the bill says
An act relating to step therapy protocols.
From the introduced text:
AN ACT relating to step therapy protocols. Be it enacted by the General Assembly of the Commonwealth of Kentucky: Section 1. KRS 304.17A-163 is amended to read as follows: (1) As used in this section and KRS 304.17A-1631, unless the context requires otherwise: (a) "Clinical practice guidelines" means a systematically developed statement to assist decision making by health care providers and patients about appropriate healthcare for specific clinical circumstances and conditions; (b) "Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols, and clinical practice guidelines used by the insurer, health plan, pharmacy benefit manager, or private review agent to determine the medical necessity and appropriateness of health care services; (c) "Health plan": 1. Means any state-regulated policy, certificate, contract, or plan that offers or provides coverage in this state[, by direct payment, reimbursement, or otherwise,] for prescription drugs pursuant to a step therapy protocol, regardless of or b. The coverage is or ii. On a fully insured or self-insured basis or any combination thereof; and 2. Shall include but not be limited to a health benefit plan; (d) "Pharmacy benefit manager" has the same meaning as in KRS 304.9-020; (e) "Private review agent" has the same meaning as in KRS 304.17A-600; (f) "Step therapy exception" means a determination that a step therapy protocol XXXX 2/27/2026 7:55 AM …
Sponsors
- Karen Berg (D, SD-026) · primary sponsor
Latest actions
- : to Committee on Committees (S)
- : introduced in Senate
Subjects: Education, Higher, Medicaid, Insurance, Health, Children And Minors, Health Care Professionals, State Employee Health Plan Mandate, Physicians, Drugs And Medicines
Common questions
- What is SB307?
- SB307 is a bill in the Kentucky Legislature (2026 Regular Session): AN ACT relating to step therapy protocols.
- What does SB307 do?
- In its own words: An act relating to step therapy protocols.
- What is the status of SB307?
- In committee as of February 27, 2026. Latest action: to Committee on Committees (S) (February 27, 2026).
- Who sponsored SB307?
- Karen Berg (D, SD-026).
- Where is the official record for SB307?
- On the Kentucky Legislature website: https://apps.legislature.ky.gov/record/26rs/sb307.html
Source: official Kentucky record. Tracked by Delilah, AI for legislation across all 50 states and Congress.