16th District Representative Jason Petrie is the sponsor of a bill in the Kentucky House, which he said would create additional reform in the pharmacy industry in Kentucky.
House Bill 749 would amend KRS 304.17A-535 to require managed care plans to include a drug utilization review program focused on enhancing the quality of care for enrollees. The program must include a retrospective review of prescription drugs, education on appropriate drug use, and ongoing data examination. The program must also comply with specific regulations and utilize clinical criteria and standards for drug therapy. Providers can prescribe non-generic drugs when medically necessary and managed care plans must have an exceptions policy for covering prescription drugs not on the formulary.
Representative Petrie said the legislation comes as the way people receive prescriptions has changed in recent years.
Petrie added that anything dealing with pharmacies is a difficult issue to bring up.
Additionally, a bill in the Kentucky Senate would also affect pharmacies. Senate Bill 188, if passed, establishes new requirements for pharmacy networks and contracts between pharmacies, pharmacy benefit managers, and other pharmacy benefit administrators. It also authorizes the insurance commissioner to order reimbursement for monetary losses resulting from certain pharmacy-related insurance laws, with various sections applying to contracts issued or renewed on or after January 1, 2025.
As of Wednesday afternoon, neither bill has passed out of their respective committees. Rep. Petrie represents a portion of Christian County and all of Logan and Todd counties in the Kentucky House of Representatives.
