Kentucky Health News
Attorney General Russell Coleman has issued a formal opinion affirming that a pharmacy benefit manager (PBM) reform law is enforceable and applies broadly to protect Kentucky patients and pharmacies, according to a news release issued by the Senate Majority Caucus.
Senate Bill 188, sponsored by Senate Majority Leader Max Wise, R-Campbellsville, passed the Senate 35-1 and the House 97-0 in the 2024 legislative session before being signed into law.
The legislation was designed to crack down on PBM practices that steer patients to affiliated pharmacies and extend fair-market protections to the commercial market. It was built on Wise’s 2020 reforms in SB 50, which created a single state-managed PBM for Medicaid and banned spread pricing, steering and hidden fees.
In February, the Beshear administration’s Department of Insurance claimed portions of the law were unenforceable and refused to apply anti-steering protections and would not regulate out-of-state PBMs.
The Kentucky Pharmacists Association and the Kentucky Independent Pharmacy Alliance disputed that interpretation and urged full enforcement of the law. In June, Wise formally requested an attorney general’s opinion to address the matter.
Coleman’s opinion rejects the administration’s interpretation by finding the anti-steering provisions in Section 4 of SB 188 are enforceable under the U.S. Supreme Court’s Rutledge precedent, and that PBMs domiciled outside Kentucky — but doing business here — are subject to regulation when their coverage impacts Kentuckians.
“Independent pharmacies have long shouldered the burden of unfair PBM practices, and we are grateful to Sen. Wise for never giving up this fight,” Rosemary Smith, founder of the Kentucky Independent Pharmacy Alliance, said in the release. “We are grateful as well to Attorney General Coleman and his team for standing with patients and pharmacies. This opinion gives pharmacies the chance to compete fairly and Kentuckians the access to care they deserve.”
Wise said the opinion confirms what he and the legislature intended all along.
“When we passed Senate Bill 188, our goal was simple: protect patients and strengthen independent pharmacies in every Kentucky community,” he said in the release. “This opinion affirms that vision. It’s a win for our pharmacy community, for the legislature, and most importantly for the Kentuckians who depend on fair access to care.”
