Kentucky 2022 Regular Session Status: Passed House Bipartisan · 38 R · 2 D cosponsors

HB 457 — AN ACT relating to pharmacy or pharmacist services.

Last action — to Appropriations & Revenue (S)

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2022 Regular Session. It reached “Passed House” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there are no live odds of enactment. It would have to be reintroduced in the current session to move again.

Summary

Amend KRS 304.17A-164 to prohibit insurers, pharmacy benefit managers, and other administrators of pharmacy benefits from imposing certain requirements on health plan insureds; create new sections of Subtitle 17A of KRS Chapter 304 to establish definitions for pharmacy-related insurance practices; require pharmacy benefit managers to establish reasonably adequate and accessible pharmacy networks; require pharmacy benefit managers to file, and the insurance commissioner to review, an annual report describing pharmacy networks; provide that information and data acquired by the Department of Insurance shall be considered proprietary and not subject to disclosure under KRS 61.870 to 61.884; establish requirements for certain contracts between a pharmacy or pharmacist and a pharmacy benefit manager; establish prohibited practices for pharmacy benefit managers; establish certain requirements for insurers and pharmacy benefit managers contracting for the provision of pharmacy benefit management services; prohibit administrators from offering any incentive or discount for use of an affiliated pharmacy benefit manager; establish a Pharmacy Benefits Management Advisory Council; create a new section of Subtitle 99 of KRS Chapter 304 to authorize the insurance commissioner to order reimbursement to persons who incurred a monetary loss as a result of a violation of provisions of legislation; amend KRS 304.9-054 to make technical changes; authorize the promulgation of administrative regulations; require pharmacy benefit managers to report certain information to the insurance commissioner; provide that certain reported information shall not be subject to disclosure under KRS 61.870 to 61.884; amend KRS 304.17A-708, 304.17A-712, and 304.17A-714 to conform; create a new section of Subtitle 17C of KRS Chapter 304 to apply provisions of legislation to limited health service benefit plans, including limited health service contracts; create a new section of Subtitle 38A of KRS Chapter 304 to apply provisions of legislation to limited health service organizations; amend 18A.225 to require the state employee health plan to comply with provisions of legislation; amend KRS 367.828 to establish certain requirements for the health discount plans that purport to offer discounts, or access to discounts, on prescription drugs; provide for staggered appointments to the Pharmacy Benefits Management Advisory Council; provide that provisions of this Act shall be severable; require the insurance commissioner to promulgate regulations to implement the Act on or before January 1, 2023; EFFECTIVE, in part, January 1, 2023.

Bill Text

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825 added · 986 removed

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UNOFFICIAL COPY 22 RS BR 1744 AN ACT relating to pharmacy or pharmacist services.
UNOFFICIAL COPY 22 RS HB 457/GA AN ACT relating to pharmacy or pharmacist services.
Page 1 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 (e) "Insurer":
Page 1 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (e) "Insurer":
or Page 2 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 2.
or Page 2 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA 2.
The retail pharmacy or pharmacist has agreed to accept reimbursement at no more than the amount that would have been reimbursed to the mail-order pharmaceutical distributer;
The retail pharmacy or pharmacist has agreed to accept reimbursement at no more than the amount that would have been reimbursed to the mail-order pharmaceutical distributor;
Pharmacy or pharmacist services that is not equally imposed upon all insureds in the same benefit category, class, or cost-sharing level under the health plan, unless otherwise required or permitted under Page 3 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 this section;
Pharmacy or pharmacist services that is not equally imposed upon all insureds in the same benefit category, class, or cost-sharing level under the health plan, unless otherwise required or permitted under Page 3 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA this section;
To any fully insured health benefit plan or self-insured plan provided to an employee under Section 14 of this Act;
To any fully insured health benefit plan or self-insured plan provided to an employee under Section 13 of this Act;
As used in Sections 2 to 6 of this Act:
As used in Sections 2 to 5 of this Act:
Page 4 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 (b) Includes a health benefit plan;
Page 4 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (b) Includes a health benefit plan;
(a) With which the pharmacy benefit manager shares common ownership, Page 5 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 management, or control;
(a) With which the pharmacy benefit manager shares common ownership, Page 5 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA management, or control;
A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 Page 6 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 IS CREATED TO READ AS FOLLOWS:
A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 Page 6 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA IS CREATED TO READ AS FOLLOWS:
A provider network that provides convenient access to pharmacies that are not mail-order pharmacies within a reasonable distance from the insured's residence, but in no event shall the distance be more than thirty (30) minutes or thirty (30) miles from each insured's residence, to the extent that services are available.
A provider network that provides convenient access to pharmacies that are not mail-order pharmacies within a reasonable distance from the insured's residence, but in no event shall the distance be more than thirty (30) minutes or thirty (30) miles from each insured's residence, to the extent that services are available;
(2) (a) All pharmacy benefit managers conducting business in this state shall file with the commissioner an annual report in the manner and form prescribed by the commissioner describing the pharmacy networks of the pharmacy benefit manager that are utilized for the provision of pharmacy or pharmacist services under a health plan.
and (2) (a) All pharmacy benefit managers conducting business in this state shall file with the commissioner an annual report in the manner and form prescribed by the commissioner describing the pharmacy networks of the pharmacy benefit manager that are utilized for the provision of pharmacy or pharmacist services under a health plan.
Page 7 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 SECTION 4.
Page 7 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA SECTION 4.
(e) "Net amount" means the amount paid to the pharmacy or pharmacist by the pharmacy benefit manager less any fees, price concessions, and all other revenue passing from the pharmacy or pharmacist to the pharmacy benefit manager;
and (e) "Net amount" means the amount paid to the pharmacy or pharmacist by the pharmacy benefit manager less any fees, price concessions, and all other revenue passing from the pharmacy or pharmacist to the pharmacy benefit manager;
and (f) "Wholesale acquisition cost" means the manufacturer's list price for the Page 8 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 drug to wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions in price, for the most recent month for which the information is available, as reported in wholesale price guides or other publications of drug pricing data.
(2) Every contract between a pharmacy or pharmacist and a pharmacy benefit Page 8 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA manager for the provision of pharmacy or pharmacist services under a health plan, either directly or through a pharmacy services administration organization, shall comply with subsections (3) and (4) of this section;
(2) Every contract between a pharmacy or pharmacist and a pharmacy benefit manager for the provision of pharmacy or pharmacist services under a health plan, either directly or through a pharmacy services administration organization, shall comply with subsections (3) and (4) of this section.
Page 9 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 b.
b.
and 3.
and Page 9 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA 3.
Retroactively denying, reducing reimbursement for, or seeking any refunds or recoupments for a claim for pharmacy or pharmacist services, in whole or in part, from the pharmacy or pharmacist after Page 10 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 returning a paid claim response as part of the adjudication of the claim, including claims for the cost of a medication or dispensed product and claims for services that are deemed ineligible for coverage, unless one (1) or more of the following occurred:
Retroactively denying, reducing reimbursement for, or seeking any refunds or recoupments for a claim for pharmacy or pharmacist services, in whole or in part, from the pharmacy or pharmacist after returning a paid claim response as part of the adjudication of the claim, including claims for the cost of a medication or dispensed product and claims for services that are deemed ineligible for coverage, unless one (1) or more of the following occurred:
or b.
or Page 10 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA b.
(e) Require that medication-assisted treatment prescriptions be exempt from any dispensing fee threshold established by the pharmacy benefit manager and that pharmacies or pharmacists receive a professional dispensing fee for each dispensing of a medication-assisted treatment prescription;
and (e) Require that medication-assisted treatment prescriptions be exempt from any dispensing fee threshold established by the pharmacy benefit manager and that pharmacies or pharmacists receive a professional dispensing fee for each dispensing of a medication-assisted treatment prescription;
and (f) Require reimbursement to the pharmacy or pharmacist for a prescription drug or other service:
1.
At a net amount that is equal to or greater than the national average drug acquisition cost for the drug or service at the time the drug or service is administered, dispensed, or provided;
or 2.
If the national average drug acquisition cost is not available for a prescription drug at the time the drug is administered or dispensed, at a net amount that is equal to or greater than the wholesale acquisition cost for the drug.
(a) Release the pharmacy benefit manager from the obligation to make any Page 11 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 payments owed to the pharmacy or pharmacist for pharmacy or pharmacist services rendered prior to the termination of the pharmacy or pharmacist from a pharmacy network;
(a) Release the pharmacy benefit manager from the obligation to make any payments owed to the pharmacy or pharmacist for pharmacy or pharmacist services rendered prior to the termination of the pharmacy or pharmacist from a pharmacy network;
(e) Except as otherwise required in this section, establish a standard or formula containing one (1) or more variables for reimbursement of pharmacy or pharmacist services that permits the pharmacy benefit manager, at its sole discretion, to change or determine the value of any variable;
Page 11 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (e) Except as otherwise required in this section, establish a standard or formula containing one (1) or more variables for reimbursement of pharmacy or pharmacist services that permits the pharmacy benefit manager, at its sole discretion, to change or determine the value of any variable;
This paragraph shall not prohibit reimbursement for pharmacy care, including professional dispensing fees, from being based on patient Page 12 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 outcomes, scores, or metrics if the patient outcomes, scores, or metrics are disclosed to, and agreed to by, the pharmacy or pharmacist in advance.
This paragraph shall not prohibit reimbursement for pharmacy care, including professional dispensing fees, from being based on patient outcomes, scores, or metrics if the patient outcomes, scores, or metrics are disclosed to, and agreed to by, the pharmacy or pharmacist in advance;
(c) Reject offers or applications, including any pre-applications, to contract for the provision of pharmacy or pharmacist services under the health plan made by a pharmacy or pharmacist that, if required, has been credentialed, unless the following notice is provided, in writing and by telephone, to the pharmacy or pharmacist at least fifteen (15) calendar days prior to the rejection:
(c) Reject offers or applications, including any pre-applications, to contract for the provision of pharmacy or pharmacist services under the health plan made by a pharmacy or pharmacist that, if required, has been credentialed, Page 12 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA unless the following notice is provided, in writing and by telephone, to the pharmacy or pharmacist at least fifteen (15) calendar days prior to the rejection:
Page 13 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 1.
1.
or (e) Discriminate or otherwise retaliate against a pharmacy or pharmacist that makes a disclosure referenced in subsection (4)(d) of this section.
or (e) Discriminate or otherwise retaliate against a pharmacy or pharmacist that makes a disclosure referenced in subsection (4)(d) of this section;
(6) Conduct prohibited by subsection (5)(a) of this section includes but is not limited to:
and (6) Conduct prohibited by subsection (5)(a) of this section includes but is not limited to:
(b) Reimbursing a covered entity, including any pharmacy owned by or contracted with the covered entity, for a pharmacy-dispensed drug at an amount that is lower than the amount paid for the same drug by national drug code number to an entity that is not a covered entity or a pharmacy that is not owned by or contracted with a covered entity;
(b) Reimbursing a covered entity, including any pharmacy owned by or contracted with the covered entity, for a pharmacy-dispensed drug at an amount that is lower than the amount paid for the same drug by national Page 13 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA drug code number to an entity that is not a covered entity or a pharmacy that is not owned by or contracted with a covered entity;
Page 14 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 2.
2.
Communications to insureds regarding pharmacy networks and prices if the communication is accurate and includes information about all eligible nonaffiliated pharmacies;
Communications to insureds regarding pharmacy networks and prices if the communication is accurate and includes Page 14 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA information about all eligible nonaffiliated pharmacies;
Page 15 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 SECTION 5.
SECTION 5.
(1) As used in this section:
(1) For contracts between an insurer or its administrator and a pharmacy benefit manager for the provision of pharmacy benefit management services on behalf of a health plan:
(a) 1.
(a) Prior to entering into the contract, the pharmacy benefit manager shall disclose to the insurer any activity, policy, practice, contract, including any national pharmacy contract, or agreement that may directly or indirectly present a conflict of interest in the pharmacy benefit manager's relationship with the insurer;
"Income, payments, and financial benefits" means any rebates, other pricing discounts, inflationary payments, credits, clawbacks, fees, grants, chargebacks, reimbursements, or other benefits received, or to be received, from a manufacturer or other party by an insurer, a pharmacy benefit manager, or an administrator that are related to:
(b) The insurer shall monitor the activities carried out in this state on its behalf by the pharmacy benefit manager to ensure compliance with the requirements of this chapter;
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a.
and Page 15 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (c) The contract shall require the pharmacy benefit manager to:
Pharmacy or pharmacist services provided to insureds;
or b.
Pharmacy benefit management services provided on behalf of a health plan or an insurer.
2.
For purposes of this paragraph, "other party" means any natural person or entity, except:
a.
A pharmacy benefit manager;
b.
An insurer, including its administrator;
or c.
An insured under a health plan;
(b) "Pass-through pricing" means a payment model for pharmacy benefit management services that:
Limits payment by an insurer, or its administrator, to the pharmacy benefit manager to:
a.
The actual ingredient costs paid by the pharmacy benefit manager for prescription drugs provided under the insurer's or its administrator's contract or other arrangement;
b.
Dispensing fees paid by the pharmacy benefit manager to pharmacies or pharmacists for the provision of pharmacy or pharmacist services under the insurer's or its administrator's Page 16 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 contract or other arrangement;
c.
Any other amounts paid by the pharmacy benefit manager to pharmacies or pharmacists for the provision of pharmacy or pharmacist services under the insurer's or its administrator's contract or other arrangement;
and d.
An administrative fee;
2.
Requires the pharmacy benefit manager to pass through to the insurer the portion of any income, payments, and financial benefits received, or to be received, by the pharmacy benefit manager that are related to prescription drugs, or any other pharmacy benefit management services, provided under the insurer's or its administrator's contract or other arrangement, except an insurer may direct the pharmacy benefit manager to pass on any portion of the income, payments, and financial benefits to its insureds;
and 3.
Requires the pharmacy benefit manager to:
a.
Fully disclose to the insurer:
i.
All ingredient costs paid by the pharmacy benefit manager for prescription drugs provided under the insurer's or its administrator's contract or other arrangement;
ii.
All ingredient costs, dispensing fees, and other payments made by the pharmacy benefit manager to any pharmacy or pharmacist in connection with the insurer's or its administrator's contract or other arrangement;
iii.
The sources, amounts, and payee of all income, payments, and financial benefits referred to in subparagraph 2.
of this paragraph;
and iv.
Its payment model for charging an administrative fee to the Page 17 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 insurer or its administrator;
and b.
Not utilize any form of spread pricing in the contract or other arrangement to provide pharmacy benefit management services;
and (c) "Spread pricing" means any technique by which a pharmacy benefit manager charges or claims an amount from an insurer, or its administrator, for payment of pharmacy or pharmacist services, including payment for a prescription drug, that is different than the amount the pharmacy benefit manager pays to the pharmacy or pharmacist that provided the services.
(2) An insurer contracting, either directly or through an administrator, with a pharmacy benefit manager to provide pharmacy benefit management services on behalf of a health plan shall:
(a) Prior to entering into the contract, require the pharmacy benefit manager to disclose any activity, policy, practice, contract, including any national pharmacy contract, or agreement that may directly or indirectly present a conflict of interest in the pharmacy benefit manager's relationship with the insurer;
and (b) Monitor the activities carried out in this state on behalf of the insurer by the pharmacy benefit manager to ensure compliance with the requirements of this chapter.
(3) Every contract between an insurer or its administrator and a pharmacy benefit manager for the provision of pharmacy benefit management services on behalf of a health plan shall:
(a) Require the use of pass-through pricing;
and (b) Provide that the pharmacy benefit manager shall:
1.
and Page 18 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 2.
and 2.
Comply with the requirements of this chapter.
Comply with the requirements of this chapter;
(4) (a) Each insurer shall report, annually, to the commissioner the aggregate amount of income, payments, and financial benefits received by the insurer, either directly or in accordance with a contract or other arrangement that utilizes pass-through pricing.
and (2) Administrators, including insurers acting as an administrator, shall not offer any incentive or discount to a health plan or other third-party payor for the use of a pharmacy benefit manager that is owned by or otherwise associated with the administrator.
(b) The commissioner shall consider the information in the report required under this subsection when reviewing any premium rates charged under health plans.
(5) Administrators, including insurers acting as an administrator, shall not offer any incentive or discount to a health plan or other third-party payor for the use of a pharmacy benefit manager that is owned by or otherwise associated with the administrator.
A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 IS CREATED TO READ AS FOLLOWS:
(1) There is hereby created and established a Pharmacy Benefits Management Advisory Council whose duties shall be to review and make recommendations to the commissioner as to the implementation, interpretation, and enforcement of insurance laws relating to:
(a) Pharmacy or pharmacist services provided to persons covered under a health plan;
and (b) Pharmacy benefit managers.
(2) (a) The council shall consist of six (6) members, which shall include the commissioner as a nonvoting member who shall serve as chair of the council.
(b) Except for the commissioner, the members shall serve two (2) year terms, be appointed by the Governor, with the advice of the commissioner, and be constituted as follows:
Page 19 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 1.
Three (3) members shall be pharmacists, at least two (2) of whom shall be affiliated with an independent pharmacy.
For the purposes of this paragraph, an independent pharmacy is a pharmacy:
a.
In which a pharmacy benefit manager does not have an ownership interest, either directly or through an affiliate or subsidiary;
and b.
That does not have an ownership interest, either directly or through an affiliate or subsidiary, in a pharmacy benefit manager;
2.
One (1) member shall be a pharmacy benefit manager licensed by the commissioner;
and 3.
One (1) member shall be an insurer.
(3) The first meeting of the council shall take place within thirty (30) days of the appointment of all the members.
(4) (a) The council shall meet at least quarterly, and may meet more frequently upon the call of the commissioner.
(b) A majority of the members shall constitute a quorum.
(c) Recommendations of the council shall require a majority of the members present, which shall include participation through distance communication technology, and eligible to vote.
(5) The advisory council shall be a budgetary unit of the department, which shall:
(a) Pay all of the advisory council's necessary operating expenses;
and (b) Furnish all office space, personnel, equipment, supplies, and technical or administrative services required by the advisory council in the performance of the functions established in this section.
(6) Members of the committee, except the commissioner, shall receive no compensation for service, but shall receive actual and necessary travel expenses Page 20 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 associated with attending meetings, which shall be in accordance with state administrative regulations relating to travel reimbursement.
SECTION 7.
Section 8.
Section 7.
(1) As used in this section:
(1) As used in this section, "rebate" has the same meaning as in Section 2 of this Act.
(a) "Income, payments, and financial benefits" has the same meaning as in Section 5 of this Act;
and (b) "Rebate" has the same meaning as in Section 2 of this Act.
However, the licensee may have the alternative, subject to the approval of the commissioner, to pay in lieu of part or all of the days of any suspension period a sum of one thousand dollars ($1,000) per day not to exceed two hundred fifty thousand Page 21 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 dollars ($250,000).
However, the Page 16 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA licensee may have the alternative, subject to the approval of the commissioner, to pay in lieu of part or all of the days of any suspension period a sum of one thousand dollars ($1,000) per day not to exceed two hundred fifty thousand dollars ($250,000).
(5)[(7)] (a) For contracts referenced in subsection (3) of Section 5 of this Act, a pharmacy benefit manager shall report to the commissioner, on a quarterly basis, for each insurer:
(5)[(7)] (a) For contracts referenced in subsection (1) of Section 5 of this Act, a pharmacy benefit manager shall report to the commissioner, on a quarterly Page 17 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA basis, for each insurer:
Page 22 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 2.
2.
(c) To the extent permitted under federal law, the annual report required under paragraph (b) of this subsection shall include but is not be limited to:
(c) To the extent permitted under federal law, the annual report required under paragraph (b) of this subsection shall include but not be limited to:
For health plan contracts entered during the immediately preceding calendar year:
For health plan contracts entered during the immediately preceding calendar year, the aggregate amount of rebates that the pharmacy benefit manager received for all insurers.
a.
(d) All information and data acquired by the department under this subsection that is generally recognized as confidential or proprietary shall not be Page 18 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA subject to disclosure under KRS 61.870 to 61.884, except the department may publicly disclose aggregated information not descriptive of any readily identifiable person or entity.
The aggregate amount of income, payments, and financial benefits that the pharmacy benefit manager received for all insurers and each insurer;
(6) (a) The department may impose a fee upon pharmacy benefit managers, in addition to a license fee, to cover the costs of implementation and enforcement of KRS 205.647 and any provision of this chapter applicable to pharmacy benefit managers, including but not limited to this section and KRS [205.647, ]304.9-053, 304.9-055, and 304.17A-162.
and b.
The aggregate amount of rebates that the pharmacy benefit manager received for all insurers.
(d) All information and data acquired by the department under this subsection Page 23 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 that is generally recognized as confidential or proprietary shall not be subject to disclosure under KRS 61.870 to 61.884, except the department may publicly disclose aggregated information not descriptive of any readily identifiable person or entity.
(6) (a) Except as provided in paragraph (b) of this subsection, pharmacy benefit managers shall file a quarterly report with the commissioner of any drugs that are reimbursed by the pharmacy benefit manager at ten percent (10%) or more:
1.
Below the national average drug acquisition cost at the time the drug is administered or dispensed;
and 2.
Above the national average drug acquisition cost at the time the drug is administered or dispensed.
(b) Paragraph (a) of this subsection shall not apply to drugs that:
1.
Are dispensed pursuant to 42 U.S.C.
sec.
256b;
or 2.
Do not appear on the national average drug acquisition cost list.
(c) For each drug in the report, the pharmacy benefit manager shall include:
1.
The month the drug was dispensed;
2.
The quantity of the drug dispensed;
3.
The amount the pharmacy was reimbursed;
4.
Whether the dispensing pharmacy was a pharmacy affiliate;
5.
Whether the drug was dispensed under a governmental plan;
and 6.
The average national average drug acquisition cost for the month the drug was dispensed.
(d) A copy of the report required under this subsection shall also be publicly available on the pharmacy benefit manager's Web site for a period of at least twenty-four (24) months.
(7) (a) The department may impose a fee upon pharmacy benefit managers, in Page 24 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 addition to a license fee, to cover the costs of implementation and enforcement of KRS 205.647 and any provision of this chapter applicable to pharmacy benefit managers, including but not limited to this section and KRS [205.647, ]304.9-053, 304.9-055, and 304.17A-162.
Section 9.
Section 8.
(3) (a) Except in cases of fraud, an insurer may only retroactively deny reimbursement to a provider during the twenty-four (24) month period after the date that the insurer paid the claim submitted by the provider.
Page 19 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (3) (a) Except in cases of fraud, an insurer may only retroactively deny reimbursement to a provider during the twenty-four (24) month period after the date that the insurer paid the claim submitted by the provider.
(b) An insurer that retroactively denies reimbursement to a provider under this Page 25 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 section shall give the provider a written or electronic statement specifying the basis for the retroactive denial.
(b) An insurer that retroactively denies reimbursement to a provider under this section shall give the provider a written or electronic statement specifying the basis for the retroactive denial.
Section 10.
Section 9.
(2) A pharmacy benefit manager shall not request a refund or make a recoupment in violation of Section 4 of this Act.
Page 20 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (2) A pharmacy benefit manager shall not request a refund or make a recoupment in violation of Section 4 of this Act.
Section 11.
Section 10.
(1) Except for overpayments which are a result of an error in the payment rate or Page 26 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 method, an insurer that determines that a provider was overpaid shall, within twenty-four (24) months from the date that the insurer paid the claim, provide written or electronic notice to the provider of the amount of the overpayment, the covered person's name, patient identification number, date of service to which the overpayment applies, insurer reference number for the claim, and the basis for determining that an overpayment exists.
(1) Except for overpayments which are a result of an error in the payment rate or method, an insurer that determines that a provider was overpaid shall, within twenty-four (24) months from the date that the insurer paid the claim, provide written or electronic notice to the provider of the amount of the overpayment, the covered person's name, patient identification number, date of service to which the overpayment applies, insurer reference number for the claim, and the basis for determining that an overpayment exists.
(4) All disputes submitted by providers pursuant to subsection (2) of this section shall be processed in accordance and completed within thirty (30) days with the insurer's provider appeals process.
Page 21 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (4) All disputes submitted by providers pursuant to subsection (2) of this section shall be processed in accordance and completed within thirty (30) days with the insurer's provider appeals process.
(5) An insurer may recover an overpayment resulting from an error in the payment rate Page 27 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 or method by requesting a refund from the provider or making a recoupment of the overpayment from the provider, subject to the provisions of subsection (6) of this section.
(5) An insurer may recover an overpayment resulting from an error in the payment rate or method by requesting a refund from the provider or making a recoupment of the overpayment from the provider, subject to the provisions of subsection (6) of this section.
SECTION 12.
SECTION 11.
SECTION 13.
SECTION 12.
Section 14.
Section 13.
1.
Page 22 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA 1.
or by any city, urban-county, charter county, county, or consolidated local Page 28 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 government, whose legislative body has opted to participate in the state- sponsored health insurance program pursuant to KRS 79.080;
or by any city, urban-county, charter county, county, or consolidated local government, whose legislative body has opted to participate in the state- sponsored health insurance program pursuant to KRS 79.080;
Any person who is a present or future recipient of a retirement allowance from the Kentucky Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement System, the Legislators' Retirement Plan, the Judicial Retirement Plan, or the Kentucky Community and Technical College System's optional retirement plan authorized by KRS 161.567, except that a person who is receiving a retirement allowance and who is age sixty-five (65) or older shall not be included, with the exception of persons covered under KRS 61.702(4)(c), unless he or she is actively employed pursuant to subparagraph 1.
Any person who is a present or future recipient of a retirement allowance from the Kentucky Retirement Systems, County Employees Retirement System, Kentucky Teachers' Retirement System, the Legislators' Retirement Plan, the Judicial Retirement Plan, or the Kentucky Community and Technical College System's optional retirement plan authorized by KRS 161.567, except that a person who is Page 23 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA receiving a retirement allowance and who is age sixty-five (65) or older shall not be included, with the exception of persons covered under KRS 61.702(4)(c), unless he or she is actively employed pursuant to subparagraph 1.
and Page 29 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 5.
and 5.
The contracts shall include but not be limited to designating the entity responsible for filing any federal forms, adoption of policies required for proper plan administration, acceptance of the contractual provisions with health insurance carriers or third-party administrators, and adoption of the payment and reimbursement methods necessary for efficient administration of the health insurance program.
The contracts shall include but not be limited to designating the entity responsible for filing any federal forms, adoption of policies required for proper plan administration, acceptance of the contractual Page 24 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA provisions with health insurance carriers or third-party administrators, and adoption of the payment and reimbursement methods necessary for efficient administration of the health insurance program.
Health insurance coverage provided to state employees under this section shall, at a minimum, contain Page 30 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 the same benefits as provided under Kentucky Kare Standard as of January 1, 1994, and shall include a mail-order drug option as provided in subsection (13) of this section.
Health insurance coverage provided to state employees under this section shall, at a minimum, contain the same benefits as provided under Kentucky Kare Standard as of January 1, 1994, and shall include a mail-order drug option as provided in subsection (13) of this section.
(d) Any carrier bidding to offer health care coverage to employees shall agree to provide enrollment, claims, and utilization data to the Commonwealth in a format specified by the Personnel Cabinet with the understanding that the data shall be owned by the Commonwealth;
(d) Any carrier bidding to offer health care coverage to employees shall agree to provide enrollment, claims, and utilization data to the Commonwealth in a format specified by the Personnel Cabinet with the understanding that the data Page 25 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA shall be owned by the Commonwealth;
The Personnel Cabinet shall take strict precautions Page 31 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 to protect the confidentiality of each individual employee;
The Personnel Cabinet shall take strict precautions to protect the confidentiality of each individual employee;
(f) If any agency participating in the state-sponsored employee health insurance program for its active employees terminates participation and there is a state appropriation for the employer's contribution for active employees' health insurance coverage, then neither the agency nor the employees shall receive the state-funded contribution after termination from the state-sponsored employee health insurance program.
(f) If any agency participating in the state-sponsored employee health insurance program for its active employees terminates participation and there is a state appropriation for the employer's contribution for active employees' health insurance coverage, then neither the agency nor the employees shall receive the state-funded contribution after termination from the state-sponsored Page 26 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA employee health insurance program.
Page 32 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 (h) Each entity participating in the state-sponsored health insurance program shall provide an amount at least equal to the state contribution rate for the employer portion of the health insurance premium.
(h) Each entity participating in the state-sponsored health insurance program shall provide an amount at least equal to the state contribution rate for the employer portion of the health insurance premium.
(5) No payment of premium by any department, board, agency, public postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall constitute compensation to an insured employee for the purposes of any statute fixing or limiting the compensation of such an employee.
(5) No payment of premium by any department, board, agency, public postsecondary Page 27 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall constitute compensation to an insured employee for the purposes of any statute fixing or limiting the compensation of such an employee.
Any premium or other expense incurred by any Page 33 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 department, board, agency, public postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall be considered a proper cost of administration.
Any premium or other expense incurred by any department, board, agency, public postsecondary educational institution, or branch of state, city, urban-county, charter county, county, or consolidated local government shall be considered a proper cost of administration.
The secretary shall also appoint two (2) members from a list of five (5) names submitted by the Kentucky Education Association, two (2) members from a list of five (5) names submitted by the largest state employee organization of nonschool state employees, two (2) members from a list of five (5) names submitted by the Kentucky Association of Counties, two (2) members from a list of five (5) names Page 34 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 submitted by the Kentucky League of Cities, and two (2) members from a list of names consisting of five (5) names submitted by each state employee organization that has two thousand (2,000) or more members on state payroll deduction.
The secretary shall also appoint two (2) members from a list of five (5) names Page 28 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA submitted by the Kentucky Education Association, two (2) members from a list of five (5) names submitted by the largest state employee organization of nonschool state employees, two (2) members from a list of five (5) names submitted by the Kentucky Association of Counties, two (2) members from a list of five (5) names submitted by the Kentucky League of Cities, and two (2) members from a list of names consisting of five (5) names submitted by each state employee organization that has two thousand (2,000) or more members on state payroll deduction.
(13) (a) The policies of health insurance coverage procured under subsection (2) of this section shall include a mail-order drug option for maintenance drugs for state employees.
(13) (a) The policies of health insurance coverage procured under subsection (2) of Page 29 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA this section shall include a mail-order drug option for maintenance drugs for state employees.
(b) A health insurer shall not discriminate against any retail pharmacy located Page 35 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 within the geographic coverage area of the health benefit plan and that meets the terms and conditions for participation established by the insurer, including price, dispensing fee, and copay requirements of a mail-order option.
(b) A health insurer shall not discriminate against any retail pharmacy located within the geographic coverage area of the health benefit plan and that meets the terms and conditions for participation established by the insurer, including price, dispensing fee, and copay requirements of a mail-order option.
(17) If a state employee's residence and place of employment are in the same county, and if the hospital located within that county does not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the employee may select a plan available in a contiguous county that does provide those services, and the state contribution for the plan shall be the amount available in the county where the plan selected is located.
(17) If a state employee's residence and place of employment are in the same county, and if the hospital located within that county does not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the employee may select a plan available in a contiguous county that does provide those services, and the state contribution for the plan shall be the amount available in the county Page 30 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA where the plan selected is located.
(18) If a state employee's residence and place of employment are each located in counties in which the hospitals do not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization Page 36 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 services, and magnetic resonance imaging services, the employee may select a plan available in a county contiguous to the county of residence that does provide those services, and the state contribution for the plan shall be the amount available in the county where the plan selected is located.
(18) If a state employee's residence and place of employment are each located in counties in which the hospitals do not offer surgical services, intensive care services, obstetrical services, level II neonatal services, diagnostic cardiac catheterization services, and magnetic resonance imaging services, the employee may select a plan available in a county contiguous to the county of residence that does provide those services, and the state contribution for the plan shall be the amount available in the county where the plan selected is located.
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the carrier all of the counties included in its bid within the region.
(d) If the Personnel Cabinet accepts a carrier's bid, the cabinet shall award the Page 31 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA carrier all of the counties included in its bid within the region.
and Page 37 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 (e) Nothing in this subsection shall prohibit the Personnel Cabinet from including other requirements or criteria in the request for proposal.
and (e) Nothing in this subsection shall prohibit the Personnel Cabinet from including other requirements or criteria in the request for proposal.
and (m) Administrative regulations promulgated pursuant to statutes listed in this subsection.
and Page 32 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA (m) Administrative regulations promulgated pursuant to statutes listed in this subsection.
[(23) Any fully insured health benefit plan or self-insured plan issued or renewed on or after January 1, 2022, to public employees pursuant to this section shall comply Page 38 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 with KRS 304.17A-148.] Section 15.
[(23) Any fully insured health benefit plan or self-insured plan issued or renewed on or after January 1, 2022, to public employees pursuant to this section shall comply with KRS 304.17A-148.] SECTION 14.
A NEW SECTION OF KRS CHAPTER 365 IS CREATED TO READ AS FOLLOWS:
(1) As used in this section:
(a) "Pharmacy or pharmacist services" has the same meaning as in Section 2 of this Act;
and (b) "Pharmacy services administration organization" means an entity that provides a pharmacy or pharmacist with administrative, contracting, or payment services relating to the provision of pharmacy or pharmacist services under any health insurance policy, health plan, or other contract that provides coverage in this state for pharmacy or pharmacist services.
(2) When contracting on behalf of one (1) or more pharmacies or pharmacists with a pharmacy benefit manager, insurer, or other third-party payor, or providing any other services on behalf of one (1) or more pharmacies or pharmacists, the pharmacy services administration organization shall owe a fiduciary duty to the pharmacies or pharmacists.
Section 15.
(a) The health discount plan clearly states in bold and prominent type on all cards or other purchasing devices, promotional materials, and advertising that the discounts are not insurance;
(a) The health discount plan clearly states in bold and prominent type on all cards Page 33 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA or other purchasing devices, promotional materials, and advertising that the discounts are not insurance;
or (b) Any card, program, device, or mechanism that is not insurance and which is Page 39 of 40 XXXX Jacketed UNOFFICIAL COPY 22 RS BR 1744 administered by a health insurer authorized to transact the business of insurance in this state, if the card, program, device, or mechanism does not purport to offer discounts or access to discounts on prescription drugs.
or (b) Any card, program, device, or mechanism that is not insurance and which is administered by a health insurer authorized to transact the business of insurance in this state, if the card, program, device, or mechanism does not purport to offer discounts or access to discounts on prescription drugs.
All of the remedies, powers, and duties delegated to the Attorney General by KRS 367.190 to 367.300 and penalties pertaining to acts and practices declared unlawful under KRS 367.170 shall be applied to acts and practices in violation of this section.
All of the remedies, powers, and duties delegated to the Attorney General by KRS 367.190 to 367.300 and penalties pertaining to acts and practices declared unlawful under KRS 367.170 shall be applied to acts and practices in violation of this Page 34 of 35 HB045710.100 - 1744 - XXXX GA UNOFFICIAL COPY 22 RS HB 457/GA section.
Sections 4 and 5 of this Act shall apply to contracts issued, delivered, entered, renewed, extended, or amended on or after January 1, 2023.
Sections 4, 5, and 14 of this Act shall apply to contracts issued, delivered, entered, renewed, extended, or amended on or after January 1, 2023.
Notwithstanding subsection (2) of Section 6 of this Act, initial appointments to the Pharmacy Benefits Management Advisory Council established in Section 6 of this Act shall be staggered so that three of the appointments expire at three years after appointment.
Thereafter, all appointments to the council shall be for terms of two years.
Section 19.
Section 20.
Section 19.
Section 21.
Section 20.
Sections 1 to 18 of this Act take effect on January 1, 2023.
Sections 1 to 17 of this Act take effect on January 1, 2023.
Page 40 of 40 XXXX Jacketed
Page 35 of 35 HB045710.100 - 1744 - XXXX GA
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Action History

  1. to Appropriations & Revenue (S)

  2. to Committee on Committees (S)

  3. received in Senate

  4. 3rd reading, passed 88-3 with Committee Substitute (1)

  5. posted for passage in the Regular Orders of the Day for Thursday, March 17, 2022

  6. 2nd reading, to Rules

  7. reported favorably, 1st reading, to Calendar with Committee Substitute (1)

  8. to Health & Family Services (H)

  9. to Committee on Committees (H)

  10. introduced in House

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

56 sponsors · 0 co-sponsors · 82 not signed on · 2 voted No

Sponsors (56)

Co-sponsors (0)

None.

Not signed on (82)

82 members have not signed on to this bill.

Show all 82 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Pass

Passed 88 Yea · 3 Nay · 9 Other
Party YeaNayPresentNot Voting
Republican 47006
Unaffiliated 32303
Democrat 9000
Total 88309
% of votes cast 88%3%0%9%
How each member voted (100)
Member Party Vote
DuPlessis — Yea
Meredith — Yea
Santoro — Yea
Scott — Yea
Bechler — Yea
Fischer — Yea
Jenkins — Yea
Bentley — Yea
Minter — Yea
Sheldon — Yea
Smith — Yea
Nemes — Yea
Palumbo — Yea
Thomas — Yea
Timoney — Yea
Graham — Yea
Pratt — Yea
Prunty — Yea
Cantrell — Yea
Webber — Yea
Hatton — Yea
Massey — Yea
Raymond — Yea
Dixon — Yea
Heath — Yea
Westrom — Yea
Donohue — Yea
McCoy — Yea
Wheatley — Yea
Koenig — Nay
Burch — Not Voting
Flood — Not Voting
Rowland — Not Voting
Huff R — Yea
Kirk McCormick — Yea
Miller C — Yea
Miller J — Nay
Stevenson C — Nay
Al Gentry Democrat Yea
Ashley Tackett Laferty Democrat Yea
George Brown Jr. Democrat Yea
Keturah J. Herron Democrat Yea
Lisa Willner Democrat Yea
Mary Lou Marzian Democrat Yea
Nima Kulkarni Democrat Yea
Pamela Stevenson Democrat Yea
Tina Bojanowski Democrat Yea
Aaron Reed Republican Yea
Adam Bowling Republican Yea
Bill Wesley Republican Yea
Bobby McCool Republican Yea
Chris Freeland Republican Yea
Chris Fugate Republican Yea
DJ Johnson Republican Yea
Daniel Elliott Republican Yea
Daniel Fister Republican Yea
David Hale Republican Yea
David Meade Republican Yea
David W. Osborne Republican Yea
Deanna Gordon Republican Yea
Derek Lewis Republican Yea
Felicia Rabourn Republican Yea
James Tipton Republican Yea
Jason Petrie Republican Yea
Jennifer Decker Republican Yea
Jim Gooch Jr. Republican Not Voting
John Blanton Republican Yea
Josh Branscum Republican Yea
Josh Bray Republican Yea
Josh Calloway Republican Not Voting
Ken Fleming Republican Yea
Ken Upchurch Republican Yea
Kim Banta Republican Yea
Kim King Republican Yea
Kimberly Poore Moser Republican Yea
Mark Hart Republican Yea
Mary Beth Imes Republican Yea
Matt Lockett Republican Yea
Matthew Koch Republican Not Voting
Michael Sarge Pollock Republican Yea
Myron Dossett Republican Yea
Nancy Tate Republican Not Voting
Patrick Flannery Republican Yea
Randy Bridges Republican Yea
Richard White Republican Not Voting
Ryan Dotson Republican Yea
Samara Heavrin Republican Yea
Savannah Maddox Republican Yea
Scott Lewis Republican Yea
Scott Sharp Republican Yea
Shane Baker Republican Yea
Shawn McPherson Republican Yea
Steve Bratcher Republican Yea
Steve Riley Republican Yea
Steven Rudy Republican Yea
Suzanne Miles Republican Yea
T.J. Roberts Republican Not Voting
Thomas Huff Republican Yea
Timmy Truett Republican Yea
William Lawrence Republican Yea

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HB 457 do?
Amend KRS 304.17A-164 to prohibit insurers, pharmacy benefit managers, and other administrators of pharmacy benefits from imposing certain requirements on health plan insureds; create new sections of Subtitle 17A of KRS Chapter 304 to establish definitions for pharmacy-related insurance practices; require pharmacy benefit managers to establish reasonably adequate and accessible pharmacy networks; require pharmacy benefit managers to file, and the insurance commissioner to review, an annual report describing pharmacy networks; provide that information and data acquired by the Department of Insurance shall be considered proprietary and not subject to disclosure under KRS 61.870 to 61.884; establish requirements for certain contracts between a pharmacy or pharmacist and a pharmacy benefit manager; establish prohibited practices for pharmacy benefit managers; establish certain requirements for insurers and pharmacy benefit managers contracting for the provision of pharmacy benefit management services; prohibit administrators from offering any incentive or discount for use of an affiliated pharmacy benefit manager; establish a Pharmacy Benefits Management Advisory Council; create a new section of Subtitle 99 of KRS Chapter 304 to authorize the insurance commissioner to order reimbursement to persons who incurred a monetary loss as a result of a violation of provisions of legislation; amend KRS 304.9-054 to make technical changes; authorize the promulgation of administrative regulations; require pharmacy benefit managers to report certain information to the insurance commissioner; provide that certain reported information shall not be subject to disclosure under KRS 61.870 to 61.884; amend KRS 304.17A-708, 304.17A-712, and 304.17A-714 to conform; create a new section of Subtitle 17C of KRS Chapter 304 to apply provisions of legislation to limited health service benefit plans, including limited health service contracts; create a new section of Subtitle 38A of KRS Chapter 304 to apply provisions of legislation to limited health service organizations; amend 18A.225 to require the state employee health plan to comply with provisions of legislation; amend KRS 367.828 to establish certain requirements for the health discount plans that purport to offer discounts, or access to discounts, on prescription drugs; provide for staggered appointments to the Pharmacy Benefits Management Advisory Council; provide that provisions of this Act shall be severable; require the insurance commissioner to promulgate regulations to implement the Act on or before January 1, 2023; EFFECTIVE, in part, January 1, 2023.
Who sponsors HB 457?
HB 457 is sponsored by S. Sheldon, D. Bentley, Shane Baker (Republican), Kim Banta (Republican), L. Bechler, John Blanton (Republican), Adam Bowling (Republican), Josh Branscum (Republican), Josh Bray (Republican), Randy Bridges (Republican), Josh Calloway (Republican), J. Dixon, Myron Dossett (Republican), J. DuPlessis, Daniel Elliott (Republican), Daniel Fister (Republican), Chris Freeland (Republican), Chris Fugate (Republican), David Hale (Republican), A. Hatton, R. Heath, Samara Heavrin (Republican), Thomas Huff (Republican), DJ Johnson (Republican), Kim King (Republican), William Lawrence (Republican), Derek Lewis (Republican), Scott Lewis (Republican), Matt Lockett (Republican), Mary Lou Marzian (Democrat), C. Massey, Bobby McCool (Republican), Shawn McPherson (Republican), Kimberly Poore Moser (Republican), Jason Nemes (Republican), R. Palumbo, Jason Petrie (Republican), Steve Bratcher (Republican), P. Pratt, M. Prunty, B. Reed, Steve Riley (Republican), S. Santoro, Scott Sharp (Republican), Tom Smith (Republican), Ashley Tackett Laferty (Democrat), Nancy Tate (Republican), Walker Thomas (Republican), K. Timoney, Ken Upchurch (Republican), R. Webber, Bill Wesley (Republican), S. Westrom, Michael Sarge Pollock (Republican), and Ken Fleming (Republican).
What is the current status of HB 457?
This bill died with 2022 Regular Session. It reached “Passed House” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HB 457?
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