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Senate Bill 139

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Last Action 02/25/19: returned to Banking & Insurance (S)
Title AN ACT relating to coverage for pharmacy and pharmacist services.
Bill Documents Introduced
Fiscal Impact Statement Health Mandate
Bill Request Number 809
Sponsors J. Higdon, J. Carroll, C. Embry Jr., S. Meredith, J. Turner, M. Wilson
Summary of Original Version Create new sections of KRS 304-17A to set requirements for reasonably adequate and accessible pharmacy benefit manager networks; permit the commissioner of the Department of Insurance to review and approve a compensation program that is fair and reasonable; except information and data collected by the department from KRS 61.870 to 61.884; prohibit pharmacy benefit managers from taking actions related to payment and practices; permit the commissioner to promulgate administrative regulations prohibiting practices by pharmacy benefit managers; amend KRS 304.17A-161 to apply definitions to Sections 1 and 4 of the Act; add definitions of independent pharmacy and specialty drug; amend KRS 304.17A-162 to add adjustment to appeals process for price updates; amend KRS 304.17A-164 to require health benefit plans and pharmacy benefit managers to implement certain pharmacy services practices and utilization review procedures; amend KRS 304.17A-005 to add pharmacy to the definition of health care provider; make technical corrections; amend KRS 304.17A-741 to add recoupment requirements for pharmacy audits; amend KRS 18A.225 to require the state employee health plan to comply with the requirements of the Act; amend KRS 205.522 to require Medicaid managed care organizations to comply with the requirements of the Act; EFFECTIVE January 1, 2020.
Index Headings of Original Version Drugs and Medicines - Pharmacy benefit managers, restrict practices
Effective Dates, Delayed - Coverage for pharmacy and pharmacist services, EFFECTIVE January 1, 2020
Insurance, Health - Health care provider, add pharmacy to definition of
Insurance, Health - Pharmacy benefit managers, restrict practices
Insurance, Health - Pharmacy services, insurer practices, requirement of
Pharmacists - Pharmacy benefit managers, restrict practices
Pharmacists - Pharmacy services, insurer practices, requirement of
Public Medical Assistance - Medicaid managed care organizations, pharmacy services, insurer practices, requirement of
Public Medical Assistance - Medicaid managed care organizations, restrict pharmacy benefit manager practices for
State Employees - State employee health plan, pharmacy services, insurer practices, requirement of
State Employees - State employee health plan, restrict pharmacy benefit manager practices for
Health Benefit Mandate - State employee health plan, restrict pharmacy benefit manager practices for

Actions

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02/06/19
  • introduced in Senate
02/08/19
  • to Banking & Insurance (S)
02/22/19
  • taken from Banking & Insurance (S)
  • 1st reading
  • returned to Banking & Insurance (S)
02/25/19
  • taken from Banking & Insurance (S)
  • 2nd reading
  • returned to Banking & Insurance (S)


Last updated: 11/9/2023 3:08 PM (EST)