Pharmacists for Fair Reimbursement What your state's PBM laws actually mean for community pharmacies
State Tracker Updated June 15, 2026

Kentucky: what the PBM reimbursement law requires

Kentucky requires PBMs to reimburse pharmacies at no less than the national average drug acquisition cost (NADAC) — or the wholesale acquisition cost where NADAC is unavailable — plus a professional dispensing fee of at least $10.64 for retail independent pharmacies, for plan contracts issued or renewed on or after January 1, 2025.

Status Enacted
Law SB 188 (2024) / Chapter 104 — KRS Chapter 304, Subtitle 17A; appeals under KRS 304.17A-162
Effective date Applies to PBM contracts issued, renewed, extended, or amended on or after January 1, 2025
Reimbursement basis No less than NADAC (or WAC where NADAC is unavailable), using the most recent monthly NADAC; reconciliation clawbacks below this are prohibited
Professional dispensing fee At least $10.64 for retail independent pharmacies (before plan years on/after Jan 1, 2027, when a cost-of-dispensing survey takes over)
Appeal route Reimbursement appeals are adjudicated under the existing MAC appeals statute, KRS 304.17A-162; complaints may also be filed with the commissioner

Kentucky’s SB 188 (2024) set a clear NADAC floor. For plan contracts issued or renewed on or after January 1, 2025, a PBM must reimburse at no less than the most recent monthly NADAC — or the wholesale acquisition cost where NADAC is not available — plus a professional dispensing fee.

For retail independent pharmacies, that dispensing fee is at least $10.64 until plan years beginning January 1, 2027, when a periodic cost-of-dispensing survey takes over. Reconciliation or “effective-rate” clawbacks that pull reimbursement below the floor are prohibited. Reimbursement appeals run through Kentucky’s existing MAC appeals statute, KRS 304.17A-162.

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