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Resource Use (Cost/Utilization) Measurement and Reporting in Kentucky

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Resource Use (Cost/Utilization) Measurement and Reporting in Kentucky

Subtopic Statute/Regulation Description
Required utilization/cost reporting Administrative Regulations on Claims Payment Practices, Ky. Rev. Stat. Ann. § 304.17A-722 Administrative Regulations on Claims Payment Practices
Ambulance Transportation, 907 Ky. Admin. Regs. 1:060 Ambulance Transportation
Data Reporting by Health Care Providers, 900 Ky. Admin. Regs. 7:030 Data Reporting by Health Care Providers
Health Insuring Organization and Prepaid Health Plan Services, 907 Ky. Admin. Regs. 1:120 Health Insuring Organization and Prepaid Health Plan Services
Medicaid Program Integrity, 907 Ky. Admin. Regs. 1:675 Medicaid Program Integrity
Payments for Ambulance Transportation, 907 Ky. Admin. Regs. 1:061 Payments for Ambulance Transportation
Payments for Health Insuring Organizations and Prepaid Health Plan Services, 907 Ky. Admin. Regs. 1:130 Payments for Health Insuring Organizations and Prepaid Health Plan Services
Payments for Outpatient Hospital Services, 907 Ky. Admin. Regs. 10:015 Payments for Outpatient Hospital Services
Use of Public Funds for Abortion or In Vitro Fertilization, Ky. Rev. Stat. Ann. § 311.715 Use of Public Funds for Abortion or In Vitro Fertilization
Access to health care cost information Cancellation of Health Insurance Policy, Ky. Rev. Stat. Ann. § 304.17-415 Cancellation of Health Insurance Policy
Data on Health Care Services, K.R.S. § 216.2929 Data on health care services charges and quality and outcome measures to be publicly available on cabinet’s website; reports required by board...
HMO Information to Enrollees, Ky. Rev. Stat. Ann. § 304.38-080 HMO Information to Enrollees
Patients Can Request Itemized Statement of Charges, Ky. Rev. Stat. Ann. § 216B.250 Patients Can Request Itemized Statement of Charges
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
Provider cost reporting Claim Payment Status Information, Ky. Rev. Stat. Ann. § 304.17A-704 Claim Payment Status Information
Claims Payment Time Frames, Ky. Rev. Stat. Ann. § 304.17A-702 Claims Payment Time Frames
Disclosure of Claims Payment Information to Provider, Ky. Rev. Stat. Ann. § 304.17A-710 Disclosure of Claims Payment Information to Provider
HMO Annual Report, Ky. Rev. Stat. Ann. § 304.38-090 HMO Annual Report
Payment for Home Health Services, 907 Ky. Admin. Regs. 1:031 Payment for Home Health Services
Reimbursement Provisions and Requirements, 907 Ky. Admin. Regs. 1:045 Reimbursement Provisions and Requirements for Community Mental Health Center Services
Supplemental Payments to Participating DRG Hospitals, 907 Ky. Admin. Regs. 10:183 Supplemental Payments to Participating DRG Hospitals
Financial information data collection Department's Evaluation And Revision of Rates and Plans, Ky. Rev. Stat. Ann. § 304.17B-017 Department's Evaluation And Revision of Rates and Plans
Duties to Report and Provide Information for Kentucky Access, Ky. Rev. Stat. Ann. § 304.17B-023 Duties to Report and Provide Information for Kentucky Access
Establishment of Health Maintenance Organizations, Ky. Rev. Stat. Ann. § 304.38-040 Establishment of Health Maintenance Organizations
Filing of Agreements for Limited Health Service Benefit Plans, Ky. Rev. Stat. Ann. § 304.17C-060 Filing of Agreements for Limited Health Service Benefit Plans
Financial Solvency Requirements for Network, Ky. Rev. Stat. Ann. § 304.17A-310 Financial Solvency Requirements for Network.   
Insurance Purchasing Outlets Financial Statements, Ky. Rev. Stat. Ann. § 304.17A-758 Insurance Purchasing Outlets Financial Statements
Payment for Family Planning Services, 907 Ky. Admin. Regs. 1:049 Payment for Family Planning Services
Payment for Medical Assistance Services Furnished Out of State, 907 Ky. Admin. Regs. 1:084 Payment for Medical Assistance Services Furnished Out of State
Premium Rates for Health Benefit Plan Under Kentucky Access, Ky. Rev. Stat. Ann. § 304.17B-013 Premium Rates for Health Benefit Plan Under Kentucky Access
Self Insured Association Group Examination of Financial Condition, Ky. Rev. Stat. Ann. § 304.17A-820 Self Insured Association Group Examination of Financial Condition
Self Insured Association Group Statement of Financial Condition, Ky. Rev. Stat. Ann. § 304.17A-832 Self Insured Association Group Statement of Financial Condition
State Aid for Regional Mental Health Programs, Ky. Rev. Stat. Ann. § 210.410 State Aid for Regional Mental Health Programs,
Click on the individual state law in the table above to see our summary of the individual law.


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