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KentuckyHB 1762026 Regular SessionHouseWALLET

AN ACT relating to prior authorization.

Sponsored By: Kimberly Poore Moser (Republican)

Signed by Governor

Administrative Regulations And ProceedingsEffective Dates, DelayedHealth And Medical ServicesInsurance, HealthMedicaidReports MandatedState AgenciesState EmployeesState Employee Health Plan MandateHealth Benefit Plan MandateActuarial AnalysisLocal Mandate

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

Less prior authorization with trusted providers

Beginning January 1, 2028, health insurers must run a program that lets in‑network providers earn exemptions from prior authorization for specific services. If your provider has an exemption for a service, the plan cannot require prior authorization for that service. Insurers must review providers each year and tell eligible providers within 30 days; they cannot make a 93% approval rate a condition. Insurers may choose extra terms, like a value‑based deal, EHR access, or up to a one‑year participation period. If they set use limits, the minimum use cannot be over 24 and any maximum cannot be under 110% of the provider’s past use. Insurers cannot do a retro review just because a provider is exempt, except to check ongoing qualification. Independent behavioral health clinicians are included as providers under this program. These rules apply to plans and review agents, and to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028.

No prior auth for addiction meds

Health plans cannot require prior or concurrent review for key addiction‑treatment drugs. This covers medicines for alcohol or opioid use disorder that contain methadone, buprenorphine, naltrexone, or an opioid antagonist, and drugs the FDA approved before January 1, 2022 to ease opioid withdrawal. For Kentucky Medicaid, this starts January 1, 2028 and applies only if it is allowed under federal rules. These changes speed access to treatment and cut delays.

New Medicaid review rules and reports

Beginning January 1, 2028, Kentucky Medicaid managed care plans must keep a utilization review plan that meets federal rules. Any review agents they use must follow state utilization review laws. Plans must use the medical‑necessity criteria chosen by the state insurance department. Medicaid does not have to run the new provider prior‑authorization exemption program that applies to commercial plans. Beginning January 1, 2027, the Medicaid agency must submit an annual public report on prior authorization.

Sponsors & Cosponsors

Sponsor

  • Kimberly Poore Moser

    Republican • House

Cosponsors

  • Beverly Chester-Burton

    Democrat • House

  • Bobby McCool

    Republican • House

  • Chad Aull

    Democrat • House

  • Daniel Grossberg

    Democrat • House

  • Robert Duvall

    Republican • House

  • Sarah Stalker

    Democrat • House

Roll Call Votes

All Roll Calls

Yes: 127 • No: 1

Senate vote • 3/31/2026

passed

Yes: 38 • No: 0

House vote • 1/21/2026

3rd reading, passed

Yes: 89 • No: 1

Actions Timeline

  1. signed by Governor (Acts Ch. 102)

    4/13/2026

  2. delivered to Governor

    4/1/2026

  3. enrolled, signed by President of the Senate

    4/1/2026House

  4. enrolled, signed by Speaker of the House

    4/1/2026House

  5. received in House

    3/31/2026House

  6. passed 38-0

    3/31/2026Senate

  7. Floor Amendment (1) withdrawn

    3/31/2026Senate

  8. 3rd reading

    3/31/2026Senate

  9. passed over and retained in the Orders of the Day

    3/27/2026Senate

  10. posted for passage in the Regular Orders of the Day for Friday, March 27 2026

    3/26/2026Senate

  11. floor amendment (1) filed

    3/26/2026Senate

  12. 2nd reading, to Rules as a consent bill

    3/19/2026Senate

  13. reported favorably, 1st reading, to Consent Calendar

    3/18/2026Senate

  14. to Health Services (S)

    3/16/2026Senate

  15. to Committee on Committees (S)

    1/22/2026Senate

  16. received in Senate

    1/22/2026Senate

  17. 3rd reading, passed 89-1

    1/21/2026House

  18. posted for passage in the Regular Orders of the Day for Tuesday, January 20, 2026

    1/16/2026House

  19. 2nd reading, to Rules

    1/15/2026House

  20. reported favorably, 1st reading, to Calendar

    1/14/2026House

  21. to Banking & Insurance (H)

    1/12/2026House

  22. to Committee on Committees (H)

    1/7/2026House

  23. introduced in House

    1/7/2026House

Bill Text

  • Current

    1/21/2026

    PDF

  • Introduced

    1/21/2026

    PDF

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