HB 423: AN ACT relating to prior authorization.

Official summary

Abstract published by the legislature (via Open States). Text as published by the legislature; reproduced verbatim.

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 timeframes 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; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2027; EFFECTIVE, in part, January 1, 2026, and January 1, 2027.

Sponsors

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. March 28, 2025passed over and retained in the Orders of the Day
2. March 27, 2025passed over and retained in the Orders of the Day
3. March 14, 2025passed over and retained in the Orders of the Day
4. March 13, 2025passed over and retained in the Orders of the Day
5. March 12, 2025passed over and retained in the Orders of the Day
6. March 11, 2025passed over and retained in the Orders of the Day
7. March 7, 2025posted for passage in the Regular Orders of the Day for Tuesday, March 11, 2025
8. March 5, 20252nd reading, to Rules
9. March 4, 2025reported favorably, 1st reading, to Calendar with Committee Substitute (1)
10. February 27, 2025to Banking & Insurance (S)
11. February 25, 2025to Committee on Committees (S)
12. February 25, 2025received in Senate

Showing 12 most recent of 19 actions. Full history