AN ACT relating to step therapy protocols.

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.