KY SB211

Health plans must immediately add generic drugs to formularies with lower cost-sharing than brand-name reference drugs when the generic has a lower wholesale acquisition cost, and cannot impose prior authorization, step therapy, or pharmacy restrictions on those generics

Health plans must add at least one biosimilar to formularies with lower cost-sharing than the reference biological product when the biosimilar has a lower wholesale acquisition cost, without prior authorization or step therapy requirements

Plans are not required to continue covering brand drugs after generics or biosimilars become available, and pharmacy committees may remove drugs deemed no longer medically appropriate or cost-effective

Requirements apply to fully insured and self-insured health plans, including state employee health plans, limited health service benefit plans, and postsecondary education institution self-insured plans

Effective January 1, 2027, applying to health plans issued or renewed on or after that date