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Read. Follow. Verify.Kentucky creates prior authorization exemption programs for health care providers and bans pre-authorization for specific addiction treatments
Last action · April 13, 2026: signed by Governor (Acts Ch. 102)Sponsors: Kim Moser and 6 others
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What This Bill Does
Kentucky enacts a law requiring insurers to establish exemption programs for participating health care providers based on past approval rates, and prohibits prospective or concurrent pre-authorization for certain addiction treatment medications under health benefit plans and Medicaid.
Health care providers meeting specific performance standards can bypass requirements for routine services, while insurers and the Department for Medicaid Services must submit annual reports detailing prior authorization approval and denial percentages to legislative committees starting in 2027 and 2028.
- Prior authorization processes by health insurers and Medicaid managed care organizations have been a subject of ongoing legislative focus regarding administrative burdens on medical providers. context
Who It Affects
Groups the bill's text affects, as described in the record. Being affected is not a position for or against it.
Participating health care providers
Participating health care providers become eligible for prior authorization exemptions for specific health care services based on annual evaluations and past approval rates.
Insurers and private review agents
Insurers and private review agents must establish prior authorization exemption programs, conduct annual evaluations, send notification notices, and submit annual implementation reports.
Medicaid managed care organizations
Medicaid managed care organizations must comply with utilization review plans, use designated medical necessity criteria, and report prior authorization statistics.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What is a prior authorization exemption program for health care providers?
Are all prescription drugs subject to prior authorization under the new law?
When do the main prior authorization exemption requirements take effect for insurance contracts?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Current status: Signed into law.
Procedural history
15 actions- Apr 13, 2026HouseEnrolledsigned by Governor (Acts Ch. 102)
- Apr 1, 2026HouseEnrolledenrolled, signed by Speaker of the House enrolled, signed by President of the Senate delivered to Governor
- Mar 31, 2026HouseFloor3rd reading Floor Amendment (1) withdrawn passed 38-0 received in House
- Mar 27, 2026Housepassed over and retained in the Orders of the Day
- Mar 26, 2026Housefloor amendment (1) filed posted for passage in the Regular Orders of the Day for Friday, March 27 2026
- Mar 19, 2026HouseFloor2nd reading, to Rules as a consent bill
Show 9 earlier actions
- Mar 18, 2026Housereported favorably, 1st reading, to Consent Calendar
- Mar 16, 2026SenateCommitteeto Health Services (S)
- Jan 22, 2026SenateIntroducedreceived in Senate to Committee on Committees (S)
- Jan 21, 2026HouseFloor3rd reading, passed 89-1
- Jan 16, 2026Houseposted for passage in the Regular Orders of the Day for Tuesday, January 20, 2026
- Jan 15, 2026HouseFloor2nd reading, to Rules
- Jan 14, 2026Housereported favorably, 1st reading, to Calendar
- Jan 12, 2026HouseCommitteeto Banking & Insurance (H)
- Jan 7, 2026HouseIntroducedintroduced in House to Committee on Committees (H)
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Mandatory Exemption Programs
Insurers are required to shift from universal pre-authorization requirements to structured exemption programs that reward participating providers based on historical approval rates.
Connected Entities
Sources
apps.legislature.ky.gov
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy35Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz40Current news / social attention level
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