Last Action | 03/29/22: floor amendments (1) and (2) filed to Committee Substitute , floor amendment (3-title) filed to bill |
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Title | AN ACT relating to pharmacy benefit claim verification and declaring an emergency. |
Bill Documents |
Current/Final
Introduced |
Bill Request Number | 441 |
Sponsors | R. Alvarado, C. Embry Jr. |
Summary of Original Version | Create a new section of KRS Chapter 18A to require the secretary of the Finance and Administration Cabinet to contract with an independent entity to monitor all Public Employee Health Insurance Program pharmacy benefit claims; establish eligibility requirements for an entity seeking to contract with the cabinet to monitor pharmacy benefit claims; establish requirements for analyzing and monitoring claims; create a new section of KRS Chapter 205 to define terms; require the Department for Medicaid Services to contract with an independent entity to monitor all Medicaid pharmacy benefit claims; establish eligibility requirements for an entity seeking to contract with the department to monitor pharmacy benefit claims; establish requirements for analyzing and monitoring claims; EMERGENCY. |
Index Headings of Original Version |
Drugs and Medicines - Pharmacy benefit claims, independent monitoring Effective Dates, Emergency - Pharmacy benefit claims, independent monitoring Pharmacists - Pharmacy benefit claims, independent monitoring Public Medical Assistance - Pharmacy benefit claims, independent monitoring State Agencies - Department for Medicaid Services, pharmacy benefit claims, independent monitoring State Agencies - Finance and Administration Cabinet, pharmacy benefit claims, independent monitoring State Agencies - Personnel Cabinet, pharmacy benefit claims, independent monitoring Medicaid - Pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Department for Medicaid Services, pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Personnel Cabinet, pharmacy benefit claims, independent monitoring Reports Mandated - Pharmacy benefit claims, independent monitoring |
Jump to Proposed Amendments |
House Committee Substitute 1 House Floor Amendment 1 House Floor Amendment 2 House Floor Amendment 3 |
Votes | Vote History |
01/10/22 |
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01/18/22 |
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01/26/22 |
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01/27/22 |
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02/07/22 |
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02/09/22 |
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02/10/22 |
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03/16/22 |
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03/24/22 |
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03/25/22 |
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03/29/22 |
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Amendment | House Committee Substitute 1 |
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Summary | Retain original provisions, except limit compensation paid to the contracted entity to not more than 30% of the savings to the Commonwealth generated by the contracted entity and delete requirement that the contracted entity have at least, five years of experience auditing pharmacy benefit claims; EMERGENCY. |
Index Headings |
Drugs and Medicines - Pharmacy benefit claims, independent monitoring Effective Dates, Emergency - Pharmacy benefit claims, independent monitoring Pharmacists - Pharmacy benefit claims, independent monitoring Public Medical Assistance - Pharmacy benefit claims, independent monitoring State Agencies - Department for Medicaid Services, pharmacy benefit claims, independent monitoring State Agencies - Finance and Administration Cabinet, pharmacy benefit claims, independent monitoring State Agencies - Personnel Cabinet, pharmacy benefit claims, independent monitoring Medicaid - Pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Department for Medicaid Services, pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Personnel Cabinet, pharmacy benefit claims, independent monitoring Reports Mandated - Pharmacy benefit claims, independent monitoring |
Amendment | House Floor Amendment 1 |
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Sponsor | K. Moser |
Summary | Retain original provisions, except delete provisions requiring the Department for Medicaid Services to contract with an independent entity to monitor Medicaid pharmacy benefit claims; EMERGENCY. |
Index Headings |
Drugs and Medicines - Pharmacy benefit claims, independent monitoring Effective Dates, Emergency - Pharmacy benefit claims, independent monitoring Pharmacists - Pharmacy benefit claims, independent monitoring Public Medical Assistance - Pharmacy benefit claims, independent monitoring State Agencies - Department for Medicaid Services, pharmacy benefit claims, independent monitoring State Agencies - Finance and Administration Cabinet, pharmacy benefit claims, independent monitoring State Agencies - Personnel Cabinet, pharmacy benefit claims, independent monitoring Medicaid - Pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Department for Medicaid Services, pharmacy benefit claims, independent monitoring Administrative Regulations and Proceedings - Personnel Cabinet, pharmacy benefit claims, independent monitoring Reports Mandated - Pharmacy benefit claims, independent monitoring |
Amendment | House Floor Amendment 2 |
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Sponsor | S. Sheldon |
Summary | Amend KRS 304.17A-164 to prohibit insurers, pharmacy benefit managers, and other administrators of pharmacy benefits from imposing certain requirements on health plan insureds; create new sections of Subtitle 17A of KRS Chapter 304 to establish definitions for pharmacy-related insurance practices; establish requirements for certain contracts between a pharmacy or pharmacist and a pharmacy benefit manager; establish prohibited practices for pharmacy benefit managers; establish certain requirements for insurers and pharmacy benefit managers contracting for the provision of pharmacy benefit management services; create a new section of Subtitle 99 of KRS Chapter 304 to authorize the insurance commissioner to order reimbursement to persons who incurred a monetary loss as a result of a violation of provisions of legislation; amend KRS 304.9-054 to make technical changes; authorize the promulgation of administrative regulations; require pharmacy benefit managers to report certain information to the insurance commissioner; provide that certain reported information shall not be subject to disclosure under KRS 61.870 to 61.884; create a new section of Subtitle 17C of KRS Chapter 304 to apply provisions of legislation to limited health service benefit plans, including limited health service contracts; create a new section of Subtitle 38A of KRS Chapter 304 to apply provisions of legislation to limited health service organizations; provide that provisions of Act shall be severable; require the insurance commissioner to promulgate regulations to implement the Act on or before January 1, 2023; EFFECTIVE, in part, January 1, 2023. |
Index Headings |
Drugs and Medicines - Pharmacy or pharmacist services, trade practice requirements Effective Dates, Delayed - Pharmacy or pharmacist services, trade practice requirements, January 1, 2023 Federal Laws and Regulations - Pharmacy-related trade practices, compliance with federal law Insurance, Health - Pharmacy benefit manager contracts, requirements Insurance, Health - Pharmacy benefit managers, prohibited practices Insurance, Health - Pharmacy or pharmacist services, coverage requirements Pharmacists - Pharmacy benefit provider contracts, requirements State Employees - Health plan, pharmacy or pharmacist services, coverage requirements State Employees - Pharmacy benefit manager contracts, requirements Administrative Regulations and Proceedings - Department of Insurance, pharmacy benefit managers, regulation Reports Mandated - Department of Insurance, administration of pharmacy benefits |
Amendment | House Floor Amendment 3 |
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Sponsor | S. Sheldon |
Summary | Make title amendment. |
Index Headings | Title Amendments - SB 68/GA |
Last updated: 2/8/2023 2:57 PM (EST)