In the 2018 legislative term, Kentucky introduced healthcare price transparency legislation aimed at prescription drugs and regulation of pharmacy benefit managers (PBM). The state passed HB 463, which prohibits overpayment for prescription drugs (“clawbacks”) as well as “gag clauses” that forbid pharmacists from telling consumers about cheaper options. The legislature also passed SB 5, which requires PBMs to disclose their contracts with Kentucky managed care organizations and provides the state authority to review and approve the contracts. The legislation hopes to improve transparency to help make prescription medications more affordable. The Kentucky legislature also introduced a number of bills aimed at addressing surprise billing (balance billing), but none were passed at the end of the session.
In the 2016 legislative term, Kentucky sought to regulate price transparency in the very narrow area of air ambulance pricing. HB171, which was introduced but did not pass, would have required air ambulance providers to disclose certain price information to the Kentucky Board of Emergency Medical Services and would have required health benefit plans to “prominently provide notice in each contract” whether air ambulance is covered, and if so, the amount of coverage.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare. We currently cover bills from the 2017-2018 legislative term and key statutes from each state. Search the database for specific bills, statutes or cases by using keyword, key issue category, and/or jurisdiction.