| Last Action | 04/13/26: signed by Governor |
|---|---|
| Title | AN ACT relating to prior authorization. |
| Bill Documents |
Current/Final
Introduced |
| Fiscal Impact Statements |
Actuarial Analysis
Health Mandate Local Mandate State Employee Health Plan Impact |
| Bill Request Number | 119 |
| Sponsors | K. Moser, R. Duvall, C. Aull, B. Chester-Burton, D. Grossberg, B. McCool, S. Stalker |
| Summary of Original Version | Create new sections of KRS 304.17A-600 to 304.17A-633 to define terms; prohibit insurers of health benefit plans from requiring prior authorization for a health care service for which the provider has an exemption; require insurers of health benefit plans to establish a program under which participating providers may qualify for exemptions from prior authorization; establish mandatory and permitted provisions of an insurer's prior authorization exemption program; establish requirements for sending forms and notices; require the commissioner of the Department of Insurance to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 304.17A-605 to conform; amend KRS 304.17A-611 to prohibit conducting a retrospective review that is based solely on a participating provider having a prior authorization exemption; provide that certain utilization review time frames do not apply to retrospective reviews conducted for the purposes of determining eligibility for a prior authorization exemption; create a new section of KRS Chapter 205 to require the commissioner of the Department for Medicaid Services to submit an annual report relating to prior authorization, provide a detailed briefing upon request, and promulgate administrative regulations; amend KRS 205.536 to conform; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028; EFFECTIVE, in part, January 1, 2027, and January 1, 2028. |
| Index Headings of Original Version |
Actuarial Analysis - Health plan, prior authorization, exemption program Administrative Regulations And Proceedings - Department for Medicaid Services, commissioner, prior authorization, report Administrative Regulations And Proceedings - Department of Insurance, commissioner, prior authorization, report Effective Dates, Delayed - Department for Medicaid Services, prior authorization report, January 1, 2027 Effective Dates, Delayed - Prior authorization, exemption program, January 1, 2028 Health And Medical Services - Prior authorization, exemption program Health Benefit Plan Mandate - Health plan, prior authorization, exemption program Insurance, Health - Prior authorization, exemption program Local Mandate - Health plan, prior authorization, exemption program Medicaid - Prior authorization, report Reports Mandated - Department for Medicaid Services, commissioner, prior authorization Reports Mandated - Department of Insurance, commissioner, prior authorization State Agencies - Department for Medicaid Services, prior authorization, report State Agencies - Department of Insurance, commissioner, prior authorization State Employee Health Plan Mandate - Prior authorization, exemption program State Employees - Health plan, prior authorization, exemption program |
| Jump to Proposed Amendments | Senate Floor Amendment 1 |
| Votes | Vote History |
| 01/07/26 |
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| 01/12/26 |
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| 01/14/26 |
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| 01/15/26 |
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| 01/16/26 |
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| 01/21/26 |
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| 01/22/26 |
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| 03/16/26 |
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| 03/18/26 |
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| 03/19/26 |
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| 03/26/26 |
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| 03/27/26 |
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| 03/31/26 |
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| 04/01/26 |
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| 04/13/26 |
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| Amendment | Senate Floor Amendment 1 |
|---|---|
| Sponsor | M. Wise |
| Summary | Exempt the state employee health plan from the requirement to offer a prior authorization exemption program and prior authorization reporting requirements. |
| Index Headings |
Health And Medical Services - Prior authorization, exemption program and reporting, exception, state employee health plan Insurance, Health - Prior authorization, exemption program and reporting, exception, state employee health plan State Employees - Health plan, prior authorization, exemption program and reporting, exception |
Last updated: 4/20/2026 5:04 PM (EDT)