The proposal: a sliding scale, not a flat rate
Senate Bill 20, introduced in the 2018 session, would have capped contingency fees in medical malpractice cases specifically: 35% of the first $100,000 recovered, 25% of the next $100,000, and 10% of anything beyond that. Its sponsor, Senator Ralph Alvarado, framed it as modeled on Delaware's approach, noting that roughly two dozen other states used a similar sliding-scale structure at the time.
Part of a broader package
The fee cap wasn't the bill's only provision. Senate Bill 20 was an omnibus tort-reform measure that also would have required malpractice plaintiffs to file an affidavit of merit from a medical professional, regulated the fees hospitals could charge for copying medical records, and barred the use of expressions of sympathy as evidence of fault in malpractice cases.
It passed the Senate, then stalled
The bill cleared the Kentucky Senate by a 20–16 vote in early March 2018. It did not survive the rest of the legislative process, dying in committee before reaching a final floor vote that would have sent it to the governor.
Today: no cap, by default rather than by design
Because Senate Bill 20 never became law, Kentucky's current rule is simply the absence of a specific statute — attorney fees in every type of personal injury case, including medical malpractice, are governed solely by the general reasonableness standard of SCR 3.130(1.5)(a). This is a meaningfully different situation from a state that has deliberately chosen not to regulate fees; it's closer to a reform effort that came close and then fell short.