Opinion affirms anti-steering protections and state regulation of out-of-state PBMs.
FRANKFORT, Ky. (Sept. 25, 2025) – Senate Majority Floor Leader Max Wise, R-Campbellsville, announced today that Attorney General Russell Coleman issued a formal opinion affirming that Wise’s bipartisan pharmacy benefit manager (PBM) reform law is enforceable and applies broadly to protect Kentucky patients and pharmacies.
Senate Bill 188, sponsored by Wise in the 2024 Legislative Session, passed the Senate 35-1 and the House 97-0 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 built on Wise’s 2020 reforms in Senate Bill 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. The administration signaled it would not regulate out-of-state PBMs, leaving Kentucky as an outlier compared to other states. Counsel for the Kentucky Pharmacists Association and the Kentucky Independent Pharmacy Alliance quickly disputed that interpretation and urged full enforcement of the law. In June, Wise formally requested an attorney general opinion to settle the matter.
The opinion issued Wednesday, OAG 25-11, rejects the administration’s interpretation and validates Wise’s position by finding the anti-steering provisions in Section 4 of Senate Bill 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,” said Rosemary Smith, founder of the Kentucky Independent Pharmacy Alliance. “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,” Wise said. “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.”
Wise added that the ruling leaves the Beshear administration with no excuses.
“The Beshear administration should meet its constitutional responsibility and implement this law in full,” he said. “Kentuckians deserve more than selective enforcement — they deserve every protection in Senate Bill 188 carried out as the legislature intended, not a watered-down version that ignores patients and picks winners and losers.”
Find the attorney general’s opinion by clicking here, and access Wise’s June opinion request at this link.
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Sen. Max Wise, R-Campbellsville, represents the 16th Senate District, including Adair, Allen, Metcalfe, Monroe, and Taylor Counties and eastern Warren County. He is the Senate Majority Floor Leader. As a member of Senate majority leadership, he serves on the Legislative Research Commission. Wise is a member of the Interim Joint Committees on Economic Development and Workforce Investment; Education; Families and Children; and Tourism, Small Business, and Information Technology.
Please visit Legislature.ky.gov for information on Senate Majority Caucus members, legislative committees, and additional resources.
Lawmakers returned to Frankfort in June to start the 2025 Interim. During this period, committees will meet to study policy issues, review implementation of recently passed legislation, and begin evaluating proposals for the 2026 Regular Session, which begins Tuesday, January. 6.
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(Dustin R. Isaacs – Office of Senate Majority Floor Leader Max Wise)