KY SB307

Requires insurers, health plans, and pharmacy benefit managers to implement electronic systems by January 1, 2027 that allow prescribing providers to electronically submit complete step therapy exception requests, including selecting grounds for the exception from a standardized list

Mandates that prescription drug coverage begin on the date a provider submits a step therapy exception request, with insurers prohibited from retroactively denying or seeking refunds for coverage provided while the request is pending

Establishes a 48-hour deadline for insurers to grant or respond to step therapy exception requests and internal appeals when all required information is provided; if no response is received within this timeframe, the exception is automatically deemed granted

Limits step therapy protocol duration to 30 days if treatment is documented as clinically ineffective by the prescribing provider, with a possible 7-day extension when clinical evidence shows the medication requires longer to take effect

Extends step therapy requirements to Medicaid and KCHIP benefits to the extent authorized by federal law, with the Cabinet for Health and Family Services required to request necessary federal approvals within 90 days of the act's effective date