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SB 307

AN ACT relating to step therapy protocols.

2026 Regular Session Introduced by Karen Berg

Kentucky SB 307 standardizes step therapy protocols to ensure evidence-based, timely approvals with clear exceptions, transparency, and provider input.

to Committee on Committees (S)
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Bill Summary · SB 307

Bill Overview

SB 307 (2026 Regular Session, Kentucky) is an act related to step therapy protocols. The bill appears to focus on the management and oversight of step therapy requirements used by health plans and insurers when authorizing and approving prescription medications for members.

Purpose and Intent

  • Establish standards and procedures for step therapy protocols to govern how prescription drug therapies are prescribed and prior-authorized.
  • Promote appropriate, evidence-based treatment while aiming to improve patient access and reduce unnecessary delays in care.

Key Provisions and Changes

Note: The exact text of the bill is not provided in the summary history. Based on typical step therapy legislation, expected areas of focus may include:
- Definition of step therapy: Criteria for when a health plan may require a patient to try and fail lower-cost or preferred medications before approving a more expensive or alternative therapy.
- Medical necessity and clinical appropriateness: Requirements that step therapy protocols be based on evidence-based guidelines and updated periodically.
- Prior authorization process: Standards for notification, documentation, and timelines for approvals or exceptions.
- Exceptions process: Clear pathways for requesting expedited or non-formulary alternatives based on safety, effectiveness, or patient-specific factors (e.g., allergies, prior responses to therapy).
- Transparency and consumer protection: Obligations for plans to provide rationale for step therapy decisions and access to appeal procedures.
- Provider involvement: Provisions enabling physicians and prescribers to request exceptions or provide justification for bypassing step therapy.
- Administrative oversight: Possible involvement of state regulators or the Department of Insurance to review and enforce compliance with step therapy protocols.
- Reporting and accountability: Requirements for reporting outcomes, utilization, or appeal data related to step therapy.

Who would be Affected

  • Health insurers and group health plans operating in Kentucky that implement step therapy protocols.
  • Healthcare providers (physicians, pharmacists, and other prescribers) who prescribe medications and may need to navigate step therapy and exceptions processes.
  • Patients and high-need populations who rely on prescription therapies, particularly those with chronic or complex conditions.
  • State regulatory bodies (e.g., Kentucky Department of Insurance) responsible for oversight and enforcement.

Procedural and Timeline Aspects

  • Introduction: February 27, 2026, in the Kentucky Senate.
  • Committee status: Referred to the Committee on Committees (S) on the same date; no further actions listed in the provided history.
  • If enacted, the bill would likely specify effective dates for implementation, timelines for appeals or exceptions, and any transitional provisions for existing step therapy protocols.

Potential Impacts

  • Improved standardization of step therapy practices across plans, potentially reducing arbitrary or inconsistent requirements.
  • Enhanced patient access through clearer exceptions processes and faster determinations when clinically appropriate.
  • Increased transparency for patients and providers regarding rationale for step therapy decisions.
  • Administrative workload implications for plans and the regulatory agency to monitor compliance and handle appeals.

If you have access to the full text of SB 307, I can refine this summary to reflect the exact provisions, definitions, timelines, and any fiscal impact statements included in the bill.

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

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