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HB 176

BillStateKYHouse
AN ACT relating to prior authorization.
About This Bill
Latest Action · Apr 13, 2026
signed by Governor (Acts Ch. 102)
Session
2026RS
Introduced
Jan 7, 2026
Primary Sponsor
K. Moser· primary

Summary

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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 time frames 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; amend KRS 205.536 to conform; apply the provisions to contracts delivered, entered, renewed, extended, or amended on or after January 1, 2028; EFFECTIVE, in part, January 1, 2027, and January 1, 2028.

Subjects

Actuarial AnalysisAdministrative Regulations And ProceedingsEffective Dates, DelayedHealth And Medical ServicesHealth Benefit Plan MandateInsurance, HealthLocal MandateMedicaidReports MandatedState AgenciesState Employee Health Plan MandateState Employees

Co-sponsors (6)

R. Duvall · primary
C. Aull · primary
B. Chester-Burton · primary
D. Grossberg · primary
B. McCool · primary
S. Stalker · primary

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