All Roll Calls
Yes: 127 • No: 1
KentuckyHB 1762026 Regular SessionHouseWALLET
AN ACT relating to prior authorization.
Sponsored By: Kimberly Poore Moser (Republican)
Signed by Governor
Actuarial AnalysisAdministrative Regulations And ProceedingsEffective Dates, DelayedHealth And Medical ServicesHealth Benefit Plan MandateInsurance, HealthLocal MandateMedicaidReports MandatedState AgenciesState Employee Health Plan MandateState Employees
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 1 benefits, 0 costs, 3 mixed.
No prior authorization for addiction meds
Beginning January 1, 2028, health plans cannot require advance or concurrent review for key addiction treatment drugs. This includes methadone, buprenorphine, naltrexone, other opioid antagonists, and FDA‑approved drugs from before January 1, 2022 that ease opioid withdrawal. Medicaid follows the same rule where federal law allows. This helps people start treatment faster.
Less prior authorization for trusted providers
Beginning January 1, 2028, insurers must run a program that lets in-network providers earn exemptions from prior authorization for specific services. Reviews happen every 12 months and line up with contract dates. If a provider qualifies, the plan cannot require prior authorization for the listed services, and must tell the provider within 30 days. The rules cap insurer hurdles: no approval-rate threshold over 93%, no minimum use above 24 claims, and no maximum set below 110% of the provider’s prior use. Insurers may give group-level exemptions or include drugs, and may require a value‑based deal, up to one year of network tenure, and electronic health record access. Providers can choose how they get notices. Insurers can revoke exemptions for fraud or overuse, and they cannot do retrospective reviews just because a provider is exempt, except to confirm the provider still qualifies.
Medicaid review rules and carveouts
Beginning January 1, 2028, each Medicaid managed care plan keeps a utilization‑review plan that meets federal rules. Plans must use the medical‑necessity criteria the Department of Insurance selects. Medicaid agencies and plans do not have to use the private‑plan prior‑authorization exemption program. Beginning January 1, 2027, the Medicaid agency can write rules to run Medicaid reporting and operations.
Who must follow and when
Beginning January 1, 2028, the Insurance Commissioner can write rules, including emergency rules, to run this law. The prior‑authorization rules apply to insurers and private review agents that do utilization review for health plans. Sections 1–4 apply only to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028.
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
Max Wise
Republican • Senate
Robert Duvall
Republican • House
Sarah Stalker
Democrat • House
Roll Call Votes
Senate vote • 3/31/2026
passed
Yes: 38 • No: 0
House vote • 1/21/2026
3rd reading, passed
Yes: 89 • No: 1
Actions Timeline
Exempt the state employee health plan from the requirement to offer a prior authorization exemption program and prior authorization reporting requirements.
4/13/2026M. Wise
4/13/2026Sponsor
4/13/2026signed by Governor (Acts Ch. 102)
4/13/2026delivered to Governor
4/1/2026enrolled, signed by President of the Senate
4/1/2026enrolled, signed by Speaker of the House
4/1/2026received in House
3/31/2026Housepassed 38-0
3/31/2026Floor Amendment (1) withdrawn
3/31/20263rd reading
3/31/2026passed over and retained in the Orders of the Day
3/27/2026posted for passage in the Regular Orders of the Day for Friday, March 27 2026
3/26/2026floor amendment (1) filed
3/26/20262nd reading, to Rules as a consent bill
3/19/2026reported favorably, 1st reading, to Consent Calendar
3/18/2026to Health Services (S)
3/16/2026Senateto Committee on Committees (S)
1/22/2026Senatereceived in Senate
1/22/2026Senate3rd reading, passed 89-1
1/21/2026posted for passage in the Regular Orders of the Day for Tuesday, January 20, 2026
1/16/20262nd reading, to Rules
1/15/2026reported favorably, 1st reading, to Calendar
1/14/2026to Banking & Insurance (H)
1/12/2026Houseto Committee on Committees (H)
1/7/2026House
Bill Text
Current
1/21/2026
Introduced
1/21/2026
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