SB 270 – Kentucky

Status: In Process
Year Introduced: 2024

This bill proposes amendments to Kentucky law related to prior authorization for health care services. Prior authorization is the process of obtaining approval from a health insurer before a health care service can be performed. This process is used to help control healthcare costs and ensure that the appropriate care is provided to the patient. The proposed changes include new definitions for “health care provider” and “health care service”, set eligibility criteria and requirements for prior authorization exemptions, establish a process for rescinding prior authorization exemptions, and set forth procedures for external reviews of exemption denials or rescissions. Other significant proposals include the prohibition of retrospective denials or reduced payments for services for which a provider has prior authorization exemption. The bill also proposes to prohibit conflicts of interest regarding independent reviews of prior authorization exemptions and requires annual reporting from entities that conduct such reviews. In addition, the bill extends the requirement for prior authorization exemptions to certain insurers, private review agents, and managed care organizations providing Medicaid benefits.

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