AN ACT relating to step therapy protocols.
This legislation permits insurers to mandate that patients use biosimilar drugs prior to receiving coverage for equivalent brand-name medications, under certain conditions. It aims to standardize protocols and enhance transparency in the drug approval process.
Do you support it?
Want to know if it passes?
We'll email you when HB 220 moves — a committee vote, a floor vote, or a signature. Nothing else.
Free forever · unsubscribe in one click.
Your answer was recorded either way.
Which district are you in?
Your ZIP is all we need to match you to your own representatives — so we can tell you how they voted on HB 220.
You're tracking HB 220
We'll email you the moment it moves.
HB 220 — AN ACT relating to step therapy protocols.
Last action — signed by Governor (Acts Ch. 4)
No card. One bill, free forever — alerts when it moves.
-
✓Introduced
-
✓In Committee
-
✓Passed House
-
✓Passed Senate
-
✓To Executive
-
6Enacted
This bill has been enacted into law. Introduced January 10, 2024. Enacted.
Signed by Governor Andy Beshear (Democratic) on March 14, 2024.
Prognosis
Where this bill stands today.
Odds of enactment
HighHow often bills like it became law.
-
Enacted
Current position in the legislative process.
-
5 sponsors
5 primary, 0 co-sponsors signed on.
-
Bipartisan support
Sponsored across 2 parties (3 R · 1 D) — cross-party backing.
-
Cleared a recorded vote
Passed 2 recorded votes so far.
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
In plain language
The bill allows insurers to require patients to try cheaper biosimilars before branded drugs.
This legislation permits insurers to mandate that patients use biosimilar drugs prior to receiving coverage for equivalent brand-name medications, under certain conditions. It aims to standardize protocols and enhance transparency in the drug approval process.
What this means for you
- Patients: Patients may have to try biosimilar drugs before getting coverage for branded medications.
Summary
Amend KRS 304.17A-163 to permit insurers to require insureds to try biosimilar biological products prior to providing coverage for the equivalent branded prescription drug under certain circumstances; make findings and establish intent of Act.
Bill Text
What changed in the latest version
156 added · 201 removed156 line(s) added, 201 removed.
UNOFFICIALCHAPTER COPY4 241 RSCHAPTER 4 ( HB 220/GA220 ) AN ACT relating to step therapy protocols.
and (g) "Step therapy protocol" means a protocol, policy, or program that establishes the specific sequence in which prescription drugs that are for a specified medical condition and medically appropriate for a particular insured are Page 1 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA covered by an insurer or health plan.
Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY b.
and Page 2 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA 5.
(b) In the absence of clinical practice guidelines that meet the requirements of paragraph (a) of this subsection, an insurer, health plan, pharmacy benefit manager, or private review agent may use peer-reviewedpeer- reviewed publications to establish step therapy protocols.
(3) (a) When coverage of a prescription drug for the treatment of any medical condition is restricted for use by an insurer, health plan, private review agent, or a pharmacy benefit manager by a step therapy protocol, the insured and prescribing provider shall have access to a clear, readily accessible, and Page 3 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA convenient process to request a step therapy exception.
(4) (a) A step therapy exception request, or an internal appeal under KRS 304.17A-304.17A-617 617 of a step therapy exception request denial, shall be granted by the insurer, health plan, private review agent, or the pharmacy benefit manager within forty-eight (48) hours if:
Page 4 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA i.
Cause a significant barrier to the insured's adherence to or compliance with the CHAPTER 4 3 insured's plan of care;
(5) If a step therapy exception request determination, notification under subsection (4)(b) of this section, or internal appeal determination under KRS 304.17A-617 of a step therapy exception request denial by an insurer, health plan, pharmacy benefit manager, or private review agent is not received by the prescribing provider within the time period specified in subsection (4) of this section, the step therapy exception Page 5 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA request or internal appeal shall be deemed granted.
Page 6 of 7 HB022010.100 - 980 - XXXX 2/2/2024 9:23 AM GA UNOFFICIAL COPY 24 RS HB 220/GA 262(i)(3), prior to providing coverage for the reference product;
262(i)(2), prior to providing coverage for the reference product;[equivalent branded prescription drug, ] Legislative Research Commission PDF Version ACTS OF THE GENERAL ASSEMBLY unless the requirement meets any of the criteria set forth in subsection (4)(a)2.
of this section pursuant to a step therapy exception request submitted under subsection (4) of this section;[ or] (b)[2.](b)[2.]An An insurer, health plan, pharmacy benefit manager, or private review agent from requiring a pharmacist to effect substitutions of prescription drugs consistent with KRS 217.814 to 217.896 and 304.17A-535;
PageSigned 7by ofGovernor 7March HB022010.10014, -2024. 980 - XXXX 2/2/2024 9:23 AM GA
AI-generated reading aid from the bill's amendatory text — verify against the official bill.
The bill amends existing law to enhance regulations around step therapy protocols, ensuring clearer guidelines for establishing protocols and improving the process for requesting exceptions.
-
KRS 304.17A-163
requiring[:This modification removes unnecessary language, streamlining the requirements placed on insurers regarding step therapy protocols.
-
KRS 304.17A-163
equivalent branded prescription drug, ]This change eliminates redundancy in the description of medications involved in step therapy, clarifying requirements.
-
KRS 304.17A-163
An insurer, health plan, pharmacy benefit manager, or private review agent may use its existing medical exceptions process to satisfy the requirements of paragraph (a) of this subsection;→ An insurer, health plan, pharmacy benefit manager, or private review agent shall, upon written request, provide all specific written clinical review criteria relating to a particular condition or disease, including clinical review criteria relating to a step therapy exception determination.This amendment requires insurers to provide specific clinical review criteria upon request, improving transparency.
-
KRS 304.17A-163
an AB-rated generic equivalent prior to providing coverage for the reference listed drug;[ or]→ a biosimilar biological product, as defined in 42 U.S.C. sec. 262(i)(2), prior to providing coverage for the reference product;This change clarifies that a biosimilar must also be tried before coverage for a reference product is granted.
-
KRS 304.17A-163
an interchangeable biological product, as defined in 42 U.S.C. sec. 262(i)(3), prior to providing coverage for the reference product; orThis revision eliminates unnecessary repetition of requirements related to interchangeable biological products for clarity.
-
KRS 304.17A-163
the duration of any step therapy protocol shall not be longer than a period of thirty (30) days if the treatment is deemed and documented as clinically ineffective by the prescribing provider.→ the duration of any step therapy protocol shall not be longer than a period of thirty (30) days if the treatment is deemed and documented as clinically ineffective by the prescribing provider, unless the prescribing provider can demonstrate, through sound clinical evidence, that the originally prescribed medication is likely to require more than thirty (30) days to provide any relief or amelioration to the insured.This adjustment clarifies the grounds on which the duration of step therapy protocols may be extended.
Action History
-
signed by Governor (Acts Ch. 4)
-
delivered to Governor
-
enrolled, signed by President of the Senate
-
enrolled, signed by Speaker of the House
-
received in House
-
3rd reading, passed 37-0
-
posted for passage in the Regular Orders of the Day for Thursday, March 07, 2024
-
2nd reading, to Rules
-
reported favorably, 1st reading, to Calendar
-
to Banking & Insurance (S)
-
to Committee on Committees (S)
-
received in Senate
-
3rd reading, passed 91-0 with Committee Substitute (1) and Committee Amendment (1-title)
-
posted for passage in the Regular Orders of the Day for Friday, February 02, 2024
-
2nd reading, to Rules
-
reported favorably, 1st reading, to Calendar with Committee Substitute (1) and Committee Amendment (1-title)
-
reassigned to Banking & Insurance (H)
-
to Health Services (H)
-
to Committee on Committees (H)
-
introduced in House
Sponsors
- Amy Neighbors · Primary
- D. Bentley · Primary
- Beverly Chester-Burton · Primary
- Derek Lewis · Primary
- Michael Sarge Pollock · Primary
Sponsorship breakdown
Export CSV (upgrade) →5 sponsors · 0 co-sponsors · 133 not signed on
Sponsors (5)
- Amy Neighbors Republican
- D. Bentley
- Beverly Chester-Burton Democrat
- Derek Lewis Republican
- Michael Sarge Pollock Republican
Co-sponsors (0)
None.
Not signed on (133)
133 members have not signed on to this bill.
Show all 133 →"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.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 28 | 0 | 0 | 0 |
| Unaffiliated | 7 | 0 | 0 | 0 |
| Democrat | 2 | 0 | 0 | 1 |
| Total | 37 | 0 | 0 | 1 |
| % of votes cast | 97% | 0% | 0% | 3% |
How each member voted (38)
| Member | Party | Vote |
|---|---|---|
| Turner | — | Yea |
| Schickel | — | Yea |
| Southworth | — | Yea |
| Westerfield | — | Yea |
| Thayer | — | Yea |
| Yates | — | Yea |
| Harper Angel | — | Yea |
| Cassie Chambers Armstrong | Democrat | Yea |
| Gerald A. Neal | Democrat | Yea |
| Karen Berg | Democrat | Not Voting |
| Amanda Mays Bledsoe | Republican | Yea |
| Brandon J. Storm | Republican | Yea |
| Christian McDaniel | Republican | Yea |
| Danny Carroll | Republican | Yea |
| David P. Givens | Republican | Yea |
| Donald Douglas | Republican | Yea |
| Gary Boswell | Republican | Yea |
| Greg Elkins | Republican | Yea |
| Jared Carpenter | Republican | Yea |
| Jason Howell | Republican | Yea |
| Jason Nemes | Republican | Yea |
| Jimmy Higdon | Republican | Yea |
| Julie Raque Adams | Republican | Yea |
| Lindsey Tichenor | Republican | Yea |
| Matthew Deneen | Republican | Yea |
| Max Wise | Republican | Yea |
| Michael Meredith | Republican | Yea |
| Nick Wilson | Republican | Yea |
| Phillip Wheeler | Republican | Yea |
| Rick Girdler | Republican | Yea |
| Robby Mills | Republican | Yea |
| Robert Stivers | Republican | Yea |
| Robin L. Webb | Republican | Yea |
| Shelley Funke Frommeyer | Republican | Yea |
| Stephen West | Republican | Yea |
| Tom Smith | Republican | Yea |
| Wade Williams | Republican | Yea |
| Walker Thomas | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democrat | 13 | 0 | 0 | 2 |
| Republican | 68 | 0 | 0 | 4 |
| Unaffiliated | 10 | 0 | 0 | 1 |
| Total | 91 | 0 | 0 | 7 |
| % of votes cast | 93% | 0% | 0% | 7% |
How each member voted (98)
| Member | Party | Vote |
|---|---|---|
| Heath | — | Yea |
| Dixon | — | Yea |
| Bentley | — | Yea |
| Palumbo | — | Yea |
| Timoney | — | Yea |
| Pratt | — | Yea |
| Raymond | — | Yea |
| Graham | — | Yea |
| Justice | — | Not Voting |
| Bratcher K. | — | Yea |
| Stevenson C | — | Yea |
| Adrielle Camuel | Democrat | Yea |
| Al Gentry | Democrat | Not Voting |
| Ashley Tackett Laferty | Democrat | Yea |
| Beverly Chester-Burton | Democrat | Yea |
| Chad Aull | Democrat | Yea |
| Daniel Grossberg | Democrat | Yea |
| George Brown Jr. | Democrat | Yea |
| Keturah J. Herron | Democrat | Yea |
| Lindsey Burke | Democrat | Yea |
| Lisa Willner | Democrat | Yea |
| Nima Kulkarni | Democrat | Yea |
| Pamela Stevenson | Democrat | Not Voting |
| Rachel Roarx | Democrat | Yea |
| Sarah Stalker | Democrat | Yea |
| Tina Bojanowski | Democrat | Yea |
| Adam Bowling | Republican | Yea |
| Amy Neighbors | Republican | Yea |
| Bill Wesley | Republican | Yea |
| Bobby McCool | Republican | Not Voting |
| Candy Massaroni | 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 |
| Emily Callaway | Republican | Yea |
| Felicia Rabourn | Republican | Yea |
| James Tipton | Republican | Yea |
| Jared Bauman | Republican | Yea |
| Jason Nemes | Republican | Yea |
| Jason Petrie | Republican | Yea |
| Jennifer Decker | Republican | Yea |
| Jim Gooch Jr. | Republican | Yea |
| John Blanton | Republican | Yea |
| John Hodgson | Republican | Yea |
| Josh Branscum | Republican | Yea |
| Josh Bray | Republican | Yea |
| Josh Calloway | Republican | Yea |
| Ken Fleming | Republican | Yea |
| Ken Upchurch | Republican | Yea |
| Kevin Jackson | Republican | Yea |
| Kim Banta | Republican | Yea |
| Kim King | Republican | Yea |
| Kimberly Poore Moser | Republican | Not Voting |
| Marianne Proctor | Republican | Yea |
| Mark Hart | Republican | Yea |
| Mary Beth Imes | Republican | Yea |
| Matt Lockett | Republican | Yea |
| Matthew Koch | Republican | Yea |
| Michael Meredith | Republican | Yea |
| Michael Sarge Pollock | Republican | Yea |
| Mike Clines | Republican | Yea |
| Myron Dossett | Republican | Yea |
| Nancy Tate | Republican | Yea |
| Nick Wilson | Republican | Yea |
| Patrick Flannery | Republican | Yea |
| Randy Bridges | Republican | Yea |
| Rebecca Raymer | Republican | Yea |
| Richard White | Republican | Yea |
| Robert Duvall | Republican | Yea |
| 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 |
| Stephanie Dietz | Republican | Yea |
| Steve Bratcher | Republican | Yea |
| Steve Rawlings | Republican | Yea |
| Steve Riley | Republican | Yea |
| Steven Doan | Republican | Yea |
| Steven Rudy | Republican | Yea |
| Susan Witten | Republican | Yea |
| Suzanne Miles | Republican | Yea |
| T.J. Roberts | Republican | Yea |
| Thomas Huff | Republican | Yea |
| Timmy Truett | Republican | Not Voting |
| Tom Smith | Republican | Yea |
| Wade Williams | Republican | Yea |
| Walker Thomas | Republican | Yea |
| William Lawrence | Republican | Not Voting |
Subjects
Frequently asked questions
- What does HB 220 do?
- Amend KRS 304.17A-163 to permit insurers to require insureds to try biosimilar biological products prior to providing coverage for the equivalent branded prescription drug under certain circumstances; make findings and establish intent of Act.
- Who sponsors HB 220?
- HB 220 is sponsored by Amy Neighbors (Republican), D. Bentley, Beverly Chester-Burton (Democrat), Derek Lewis (Republican), and Michael Sarge Pollock (Republican).
- What is the current status of HB 220?
- This bill has been enacted into law. Introduced January 10, 2024. Enacted.
- Where can I track HB 220?
- Track HB 220 free on One Click Politics — get push/email alerts when it moves.
Make your voice heard on HB 220
Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.
Stay ahead of HB 220
Last checked for changes 3 months ago · updated continuously
One Click Politics tracks every bill in Congress and all 50 states.
Track this bill →