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Private Insurance Data Requirements in Kentucky

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Private Insurance Data Requirements in Kentucky

Subtopic Statute/Regulation Description
Grievance procedures Abortion Facilities, 902 Ky. Admin. Regs. 20:360 Abortion Facilities
Client Civil Rights Complaint Process, 920 Ky. Admin. Regs. 1:090 Client Civil Rights Complaint Process
Complaints for Emergency Medical Services, Ky. Rev. Stat. Ann. § 311A.055 Complaints for Medical Emergency Services. 
Disciplinary Procedures Applicable for Local Health Department Employees, 902 Ky. Admin. Regs. 8:100 Discplinary Procedures Applicable for Local Health Department Employees
Personal Care Homes Operation and Services, 902 Ky. Admin. Regs. 20:036 Personal Care Homes Operation and Services
Requirements for Insurer for Utilization Review of Benefits, Ky. Rev. Stat. Ann. § 304.17-412 Requirements for Insurer for Utilization Review of Benefits
Validation and Complaint Investigation Procedures for Deemed Hospitals, 906 Ky. Admin. Regs. 1:140 Validation and Complaint Investigation Procedures for Deemed Hospitals
Disclosure of information held by health plan, including notice requirements Abortion Information, 902 Ky. Admin. Regs. 4:110 Abortion Information
Disclosure for Limited Health Service Benefit Plans, Ky. Rev. Stat. Ann. § 304.17C-030 Disclosure for Limited Health Service Benefit Plans
Disclosure of Claims Payment Information to Covered Person, Ky. Rev. Stat. Ann. § 304.17A-718 Disclosure of Claims Payment Information to Covered Person
Disclosure of Limitations on Coverage, Ky. Rev. Stat. Ann. § 304.17A-540 Disclosure of Limitations on Coverage
Duties of Insurer Offering Health Benefit Plan, Ky. Rev. Stat. Ann. § 304.17A-254 Duties of Insurer Offering Health Benefit Plan
Enrollee Choice of Primary Care Providers, Ky. Rev. Stat. Ann. § 304.17A-520 Enrollee Choice of Primary Care Providers
Health Insurance Scope and Format of Policy, Ky. Rev. Stat. Ann. § 304.17-030 Health Insurance Scope and Format of Policy
HMO Information to Enrollees, Ky. Rev. Stat. Ann. § 304.38-080 HMO Information to Enrollees
HMO Operations and Services, 902 Ky. Admin. Regs. 20:054 HMO Operations and Services. 
HMOs as Insurers to Offer Home Health Care Coverage, Ky. Rev. Stat. Ann. § 304.38-210 HMOs as Insurers to Offer Home Health Care Coverage
Institutional Care Patient's Rights, 908 Ky. Admin. Regs. 3:010 Institutional Care Patient's Rights
Insurance Purchasing Outlets Disclosure to Members, Ky. Rev. Stat. Ann. § 304.17A-762 Insurance Purchasing Outlets Disclosure to Members
Notification By Insurer Offering Managed Care Plans, Ky. Rev. Stat. Ann. § 304.17A-510 Notification By Insurer Offering Managed Care Plans
Prohibition Against Limiting Disclosure of Options, Ky. Rev. Stat. Ann. § 304.17A-530 Prohibition Against Limiting Disclosure to Patient of Medical Condition or Treatment Options
Prohibition of Contract to Limit Disclosure to Enrollee, Ky. Rev. Stat. Ann. § 304.17C-070 Prohibition of Contract to Limit Disclosure to Enrollee
Providing Requested Information by Group Health Benefit Plan Insurers, Ky. Rev. Stat. Ann. § 304.17A-846 Providing Requested Information by Group Health Benefit Plan Insurers
Access to individual’s own records (Cross reference Medical Records Collection) Confidentiality and Reporting Requirements for HIV Reporting System, Ky. Rev. Stat. Ann. § 214.645 Confidentiality and Reporting Requirements for HIV Reporting System
Correction/deletion of insurance information Duty to Provide Insurer with New Information, Ky. Rev. Stat. Ann. § 304.17A-619 Duty to Provide Insurer with New Information
Health Insurance Right to Examine and Return Policy, Ky. Rev. Stat. Ann. § 304.17-170 Health Insurance right to Examine and Return Policy.   
Privacy notices required to be given to consumers (Cross reference to Privacy & Confidentiality) Emergency Care for Victims of Sexual Offenses, Ky. Rev. Stat. Ann. § 216B.400 Emergency Care for Victims of Sexual Offenses
Required testing by insurance company(genetic and HIV/STD) EPSDT, 907 Ky. Admin. Regs. 11:034 Early and Periodic Screening, Diagnosis, and Treatment Services
Procedures and Tests for HIV, Ky. Rev. Stat. Ann. § 214.625 Consent for Medical Procedures and Tests for HIV
Information for advertising purposes Establishment of Health Maintenance Organizations, Ky. Rev. Stat. Ann. § 304.38-040 Establishment of Health Maintenance Organizations
Preexisting condition information: How the insurer may use preexisting condition information Health Benefit Plans Standard Plan and Denial of Coverage, Ky. Rev. Stat. Ann. § 304.17A-250 Health Benefit Plans Standard Plan and Denial of Coverage
Pre-existing Condition Exclusion in Group Coverage, Ky. Rev. Stat. Ann. § 304.17A-220 Pre-existing Condition Exclusion in Group Coverage
Pre-existing Condition Exclusion in Individual Market, Ky. Rev. Stat. Ann. § 304.17A-230 Pre-existing condition exclusion in individual market.   
Types of Health Benefits Plans to be Issued Under Kentucky Access, Ky. Rev. Stat. Ann. § 304.17B-019 Types of Health Benefits Plans to be Issued Under Kentucky Access
Cost reporting by insurance companies (Cross reference Provider Resource Use) Home Health Care Coverage, Ky. Rev. Stat. Ann. § 304.17-313 Individual Health Insurance to Offer Home Health Care Coverage
Health plan required reporting Induced Termination of Pregnancy Required Reporting, Ky. Rev. Stat. Ann. § 213.101 Induced Termination of Pregnancy Required Reporting
Out of Network Benefits, Ky. Rev. Stat. Ann. § 304.17A-550 Out of Network Benefits
Click on the individual state law in the table above to see our summary of the individual law.


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