Section 304.17A-593 - [Effective 1/1/2025] Requirement to provide reasonably adequate and accessible pharmacy networks - Annual report to commissioner - Confidential information not subject to disclosureTo the extent permitted under federal law:
(1)(a) An insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits that utilizes a network to provide pharmacy or pharmacist services under a health plan shall ensure that the network is reasonably adequate and accessible with respect to the provision of pharmacy or pharmacist services.(b) A reasonably adequate and accessible network, with respect to the provision of pharmacy or pharmacist services, shall, at a minimum:1. Offer an adequate number of accessible pharmacies that are not mail-order pharmacies; and2. Provide convenient access to pharmacies that are not mail-order pharmacies within a reasonable distance from the insured's residence, but in no event shall the distance be more than thirty (30) miles from each insured's residence, to the extent that pharmacy or pharmacist services are available; and(2)(a) An insurer, a pharmacy benefit manager, and any other administrator of pharmacy benefits conducting business in this state shall file with the commissioner an annual report, in the manner and form prescribed by the commissioner, describing the networks of the insurer, pharmacy benefit manager, or other administrator that are utilized for the provision of pharmacy or pharmacist services under a health plan.(b) The commissioner shall review each network to ensure that the network complies with this section.(c) All information and data acquired by the department under this subsection that is generally recognized as confidential or proprietary shall not be subject to disclosure under KRS 61.870 to 61.884, except the department may publicly disclose aggregated information not descriptive of any readily identifiable person or entity.Added by 2024 Ky. Acts ch. 104,§ 2, eff. 1/1/2025.