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SB 190

AN ACT relating to chronic pain treatments.

2026 Regular Session Introduced by Shelley Frommeyer

Kentucky health plans must cover up to 20 visits per event for listed chronic pain therapies with no higher cost-sharing, plus stricter monitoring for certain opioids.

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Bill Summary · SB 190

Summary of SB 190 (2026 Regular Session, Kentucky)

Purpose and intent

SB 190 aims to expand insurance coverage and clinical requirements related to chronic pain treatments. The act requires health benefit plans to cover certain chronic pain therapies and establishes related oversight provisions for controlled substance prescribing and Medicaid administration. The overarching goal is to improve access to non-opioid chronic pain treatments while aligning prescribing practices with established safeguards.

Key provisions

  • Section 1 – Health benefit plan coverage for chronic pain treatments

    • Health benefit plans that cover hospital, medical, or surgical expenses must provide coverage for up to 20 visits per event of chronic pain treatments when delivered by a licensed professional in one of these areas:
    • Acupuncture
    • Chiropractic services
    • Chronic pain management
    • Hyperbaric oxygen therapy
    • Massage therapy
    • Occupational therapy
    • Osteopathic manipulation
    • Physical therapy
    • Psychotherapy
    • Insured individuals may seek treatment from these licensed professionals without requiring a referral from another health care provider.
    • Deductibles, coinsurance, and copays for these chronic pain treatments cannot exceed those for a primary care visit.
    • The section does not require exhausting all chronic pain treatments before opioids nor does it create coverage under Subtitle 39 of Chapter 304 for these treatments.

  • Section 2 – Medicaid-related provisions

    • Medicaid-related entities (Department for Medicaid Services, managed care organizations, etc.) must comply with a specified set of statutes, including Section 1 of this Act, and report per KRS 304.17A-732.

  • Section 3 – Regulations for controlled substances and chronic pain treatment discussions

    • Before prescribing or dispensing Schedule II or hydrocodone-containing Schedule III substances, practitioners must:
    • Take a medical history and perform appropriate examinations, documented in the medical record.
    • Query the prescription monitoring data for the prior 12 months and use that data in care decisions.
    • Develop a written treatment plan and discuss risks/benefits, including tolerance and dependence risks.
    • Discuss and refer to, or prescribe, chronic pain treatments from licensed professionals listed in Section 1.
    • Obtain written consent for treatment.
    • For ongoing prescriptions, practitioners must:
    • Review the care plan at reasonable intervals.
    • Provide new information about treatment and adjust/terminate as needed.
    • If the course extends beyond 3 months, more stringent monitoring is required (monthly or quarterly data checks, as specified) before issuing further Schedule II or hydrocodone-containing prescriptions.
    • Require comprehensive medical records for patients on Schedule II or hydrocodone-containing Schedule III prescriptions, including history, results, treatments, medications, and periodic reviews.
    • Allow exemptions in specific clinical and logistical situations (emergency care, hospital/long-term care settings, hospice, cancer treatment, pre/post-operative contexts, research, etc.), with procedures for notifying the state drug policy office if exemptions are pursued.

  • Section 4 – Applicability

    • The new health plan coverage requirements apply to health benefit plans issued or renewed on or after January 1, 2027.

  • Section 5 – Federal authorization contingency

    • If federal authorization or approval is required to implement Section 2 (Medicaid-related provisions) and would impact federal funding, state agencies must seek it within 90 days and may delay only those provisions that require federal approval.

  • Section 6–7 – Effective dates

    • Sections 2 and 5 create specific authorizations; the act generally takes effect January 1, 2027.

Who/what is affected

  • Individuals with Kentucky health benefit plans (including private plans and plans administered through Medicaid/managed care entities) will gain coverage for up to 20 visits per event of listed chronic pain treatments.
  • Patients needing chronic pain management services, including acupuncture, physical/occupational therapy, chiropractic care, psychotherapy, and related modalities.
  • Prescribers of Schedule II and certain Schedule III opioids will face enhanced administrative and monitoring requirements.
  • Medicaid services (Department for Medicaid Services and managed care organizations) must align with the new provisions and reporting requirements.
  • Regulatory bodies may implement exemptions and related regulations to balance safety with access.

Timelines and procedural notes

  • Effective date for the new coverage rules: January 1, 2027.
  • Administrative and regulatory adjustments are anticipated for controlled substances monitoring and for Medicaid-related compliance, with potential federal waivers/authorizations as needed.
  • The act provides a framework for exemptions and requires specific reporting and data monitoring to support safe prescribing practices.

If you’d like, I can provide a glossary of terms (e.g., Schedule II substances, KRS references) or a side-by-side comparison with current Kentucky law.

Compiled from official sources — confirm details with the bill’s official record.

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