KRS 205.5632: Prior authorization requirements -- Administrative regulations.

(1) Upon initial coverage by the Kentucky Medicaid program, a new drug shall be

exempt from prior authorization unless:

(a) There has been a review of the drug and recommendation regarding prior

authorization by the Pharmacy and Therapeutics Advisory Committee as

provided under KRS 205.564 and a final determination regarding prior

authorization by the secretary of the Cabinet for Health and Family Services;

or

(b) The drug is in a specific class of drugs for which the Pharmacy and

Therapeutics Advisory Committe e has recommended, and the secretary of

health and family services has determined, that all new drugs shall require

prior authorization upon initial availability, in which case the drug shall

require prior authorization and shall be scheduled for review by the Pharmacy

and Therapeutics Advisory Committee within seventy-five (75) days.

(2) The Cabinet for Health and Family Services shall promulgate an administrative

regulation in accordance with KRS Chapter 13A that describes the process by

which drugs under this section shall be determined to require prior authorization.