Insights

On March 21, 2017, Kentucky Gov. Matt Bevin signed legislation (SB 89) into law, which requires insured group health benefit plans to provide coverage for certain smoking cessation medications and services.

Specifically, plans must provide coverage for all tobacco cessation:

• Medications approved by the U.S. Food and Drug Administration; and
• Services recommended by the U.S. Preventive Services Task Force, including, but not limited to, individual, group and telephone counseling or any combination of these services.

Additionally, coverage for tobacco cessation services can't be subject to:

• Counseling requirements for medication;
• Limits on duration of services, including but not limited to annual or lifetime limits on number of attempts to quit; or
• Copayments or other out-of-pocket cost sharing, including deductibles.

Utilization management requirements cannot be imposed on any tobacco cessation services, including prior authorization and step therapy, except in the following circumstances where plans can require prior authorization:

• For a treatment that exceeds the duration recommended by the most recent U.S. Public Health Service clinical practice guidelines on treating tobacco use and dependence; or
• For services associated with more than two attempts to quit smoking within a 12-month period.

The law takes effect 90 days after close of the Kentucky legislative session, which is projected to be on or about June 29, 2017.

SB 89 »