MANAGED CARE PLANS

Section 304.17A-500 - Definitions for KRS 304.17A-500 to 304.17A-590
Section 304.17A-505 - Disclosure of terms and conditions of health benefit plan - Filing with department
Section 304.17A-510 - Notification by insurer offering managed care plans of availability of printed document
Section 304.17A-515 - Requirements for managed care plan
Section 304.17A-520 - Enrollee choice of primary care providers
Section 304.17A-525 - Standards for provider participation - Mechanisms for consideration of provider applications - Policy for removal or withdrawal
Section 304.17A-527 - Filing of provider agreements, risk-sharing arrangements, and subcontract agreements with commissioner - Contents - Disclosure of financial information not required
Section 304.17A-530 - Prohibition against contract limiting disclosure to patient of patient medical condition or treatment options
Section 304.17A-532 - Prohibition against contract requiring mandatory use of hospitalist
Section 304.17A-533 - [Repealed]
Section 304.17A-535 - Drug utilization waiver program - Limitations on generic substitution - Application to drug formulary
Section 304.17A-540 - Disclosure of limitations on coverage - Denial letter
Section 304.17A-545 - Medical director for managed care plan - Duties - Quality assurance or improvement standards - Process to select health care providers - Uniform application form and guidelines for health care provider evaluations
Section 304.17A-550 - Out-of-network benefits
Section 304.17A-555 - Patient's right of privacy regarding mental health or chemical dependency - Authorized disclosure
Section 304.17A-560 - Most-favored-nation provision
Section 304.17A-565 - Commissioner to enforce KRS 304.17A-500 to 304.17A-570 - Administrative regulations
Section 304.17A-570 - Applicability of KRS 304.17A-500 to 304.17A-570 for health insurance contracts or certificates
Section 304.17A-575 - Definitions for KRS 304.17A-575 to 304.17A-577
Section 304.17A-576 - Notice by managed care plan insurer of health care provider's application for credentialing - Payments to applicant
Section 304.17A-577 - Disclosure of payment or fee schedule to managed care plan health care provider - Disclosure of schedule change - Confidentiality of payment information
Section 304.17A-578 - Renumbered
Section 304.17A-580 - Education of insured about appropriate use of emergency and medical services - Coverage of emergency medical conditions and emergency department services - Emergency personnel to contact primary care provider or insurer - Exclusion of limited-benefit health insurance policies
Section 304.17A-590 - Participating provider directories
Section 304.17A-264 - [Effective 1/1/2025] Coverage under health benefit plan for cancer screening, test, or procedure
Section 304.17A-591 - [Effective 1/1/2025] Definitions for KRS 304.17A-591 to 304.17A-599
Section 304.17A-593 - [Effective 1/1/2025] Requirement to provide reasonably adequate and accessible pharmacy networks - Annual report to commissioner - Confidential information not subject to disclosure
Section 304.17A-595 - [Effective 1/1/2025] Definitions for section - Requirements for contract for provision of pharmacy services - Minimum reimbursements - Administrative regulations
Section 304.17A-597 - [Effective 1/1/2025] Prohibition against certain actions of administrator of pharmacy benefits against pharmacy - Right of pharmacist to provide information about lower cost alternatives to insured
Section 304.17A-599 - [Effective 1/1/2025] Commissioner review of alleged violations of KRS 304.17A-593, 304.17A-595, or 304.17A-597