---
type: "Bill"
title: "AN ACT relating to step therapy protocols."
description: "Amend KRS 304.17A-163 to define terms; establish requirements for clinical review criteria and clinical practice guidelines used to establish step therapy protocols; require certain notices and disclosures relating to step therapy protocols; establish requirements for exception requests, internal appeals, and external reviews of step therapy protocols; create a new section of Subtitle 17A of KRS Chapter 304 to require the commissioner of insurance to promulgate administrative regulations; require insurers, health plans, pharmacy benefit managers, or private review agents to submit an annual report relating to step therapy exception requests; amend KRS 304.17A-168, 304.17A-535, 304.17A-600, 304.17A-607, 304.17A-617, and 304.17A-623 to conform; amend KRS 205.522, 205.6485, 164.2871, and 18A.225 to require Medicaid, the Kentucky Children's Health Insurance Program, self-insured employer group health plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the step therapy protocol requirements; apply to health plans delivered, issued for delivery, or renewed on or after the effective date of Sections 1 to 12 of the Act; require the Cabinet for Health and Family Services to seek a federal waiver of authorization if necessary; EFFECTIVE, in part, January 1, 2023."
jurisdiction: "us/states/ky"
legislature: "Kentucky General Assembly"
session: "2022RS"
identifier: "SB 140"
citation: "Kentucky SB 140 (2022RS)"
classification: ["bill"]
subjects: ["Administrative Regulations and Proceedings", "Children and Minors", "Drugs and Medicines", "Education", "Higher", "Effective Dates", "Delayed", "Insurance", "Health", "Medicaid", "Reports Mandated", "State Agencies", "State Employees"]
status: "enacted"
primary_sponsors: ["D. Carroll", "M. Wise"]
version_count: 3
action_count: 19
vote_count: 2
first_action: "2022-02-03T05:00:00+00:00"
last_action: "2022-03-17T04:00:00+00:00"
source: "openstates"
source_identifier: "ocd-bill/e54182e1-f7e7-45fa-b399-17758c4c17a8"
source_url: "https://apps.legislature.ky.gov/record/22RS/sb140.html"
source_hash: "98e104ef17a1c647eae26ac5a97c9f0b2e03a96cc1874e0ceb50cbd6441c59d8"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-ky"]
---

# Kentucky SB 140 (2022RS) — AN ACT relating to step therapy protocols.

Amend KRS 304.17A-163 to define terms; establish requirements for clinical review criteria and clinical practice guidelines used to establish step therapy protocols; require certain notices and disclosures relating to step therapy protocols; establish requirements for exception requests, internal appeals, and external reviews of step therapy protocols; create a new section of Subtitle 17A of KRS Chapter 304 to require the commissioner of insurance to promulgate administrative regulations; require insurers, health plans, pharmacy benefit managers, or private review agents to submit an annual report relating to step therapy exception requests; amend KRS 304.17A-168, 304.17A-535, 304.17A-600, 304.17A-607, 304.17A-617, and 304.17A-623 to conform; amend KRS 205.522, 205.6485, 164.2871, and 18A.225 to require Medicaid, the Kentucky Children's Health Insurance Program, self-insured employer group health plans provided by the governing board of a state postsecondary education institution, and the state employee health plan to comply with the step therapy protocol requirements; apply to health plans delivered, issued for delivery, or renewed on or after the effective date of Sections 1 to 12 of the Act; require the Cabinet for Health and Family Services to seek a federal waiver of authorization if necessary; EFFECTIVE, in part, January 1, 2023.

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Introduced** (filed) — [source](https://apps.legislature.ky.gov/recorddocuments/bill/22RS/sb140/orig_bill.pdf)
2. **Acts Chapter 19** (committee substitute) — [source](https://apps.legislature.ky.gov/law/acts/22RS/documents/0019.pdf)
3. **Current/Final** (committee substitute) — [source](https://apps.legislature.ky.gov/recorddocuments/bill/22RS/sb140/bill.pdf)

## Votes

- Final Passage — **pass** (pass) · upper
- PASS SB 140 W/ scs1 — **pass** (pass) · upper

## Sponsors

- D. Carroll — primary (person)
- M. Wise — primary (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2022-02-03T05:00:00+00:00** introduced in Senate `introduction`
- **2022-02-03T05:00:00+00:00** to Committee on Committees (S) `referral-committee`
- **2022-02-07T05:00:00+00:00** to Banking & Insurance (S) `referral-committee`
- **2022-02-15T05:00:00+00:00** reported favorably, 1st reading, to Calendar with Committee Substitute (1) `committee-passage`
- **2022-02-16T05:00:00+00:00** 2nd reading, to Rules `reading-2`
- **2022-02-16T05:00:00+00:00** posted for passage in the Regular Orders of the Day for Thursday, February 17, 2022
- **2022-02-17T05:00:00+00:00** 3rd reading, passed 35-0 with Committee Substitute (1) `passage, reading-3`
- **2022-02-17T05:00:00+00:00** received in House
- **2022-02-17T05:00:00+00:00** to Committee on Committees (H) `referral-committee`
- **2022-02-24T05:00:00+00:00** to Banking & Insurance (H) `referral-committee`
- **2022-03-02T05:00:00+00:00** reported favorably, 1st reading, to Calendar `committee-passage`
- **2022-03-03T05:00:00+00:00** 2nd reading, to Rules `reading-2`
- **2022-03-09T05:00:00+00:00** posted for passage in the Regular Orders of the Day for Thursday, March 10, 2022
- **2022-03-10T05:00:00+00:00** 3rd reading, passed 95-0 `passage, reading-3`
- **2022-03-11T05:00:00+00:00** received in Senate
- **2022-03-11T05:00:00+00:00** enrolled, signed by President of the Senate `passage`
- **2022-03-11T05:00:00+00:00** enrolled, signed by Speaker of the House `passage`
- **2022-03-11T05:00:00+00:00** delivered to Governor
- **2022-03-17T04:00:00+00:00** signed by Governor (Acts Ch. 19) `executive-signature`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/e54182e1-f7e7-45fa-b399-17758c4c17a8`. Confidence: reported (aggregated from official Kentucky legislature records).