Summary of Original Version

Create a new section of Subtitle 17A of KRS Chapter 304 to require health plans to include a generic drug or biosimilar on the plan's formulary under specified circumstances; define terms; establish cost-sharing requirements when a generic drug or biosimilar is required to be placed on the health plan's formulary; prohibit a health plan from imposing any prior authorization, step therapy, or other limitation on coverage for a generic drug or biosimilar required to be placed on the health plan's formulary or imposing any restriction on a pharmacist or pharmacy that makes it more difficult for the insured to obtain coverage or access to the generic drug or biosimilar compared to the reference drug or product; amend KRS 304.17C-125, 164.2871, and 18A.225 to require limited health service benefit plans, self-insured group health plans offered by a state postsecondary education institution, and the state employee health plan to comply with the requirements for generic drugs and biosimilars; direct that the Act applies to health plans issued or renewed on or after January 1, 2027; EFFECTIVE, January 1, 2027.

Statutes affected:
Introduced: 164.2871, 18A.225