Health Benefit Mandate Legislation - Kentucky

Create new sections of Subtitle 17A of KRS Chapter 304 to require a health benefit plan with a provider network to provide coverage for the dialysis provider of the insured's choice; prevent restriction of the dialysis benefit during open enrollment; define "unreasonable distance" and prohibit travel of such distance for in-network dialysis service; provide coverage for out-of-network dialysis if the distance for in-network dialysis is unreasonable; require written notice of any change to a health plan with a provider network that would affect a dialysis patient's coverage or benefit level concerning out-of-network coverage; require payment directly to the dialysis provider and not to the patient; require the executive director of the Office of Insurance to conduct a review of all filings to determine compliance within 120 days of the effective date of the Act; require insurers to notify the office of any violations; authorize the office to promulgate necessary regulations to implement [...]

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Create new sections of Subtitle 17A of KRS Chapter 304 to provide for payment by a managed care plan to a physician seeking expedited credentialing; require insurers to provide payment or fee schedules to health care providers when contracting or renewing contracts with providers to enable providers to determine the manner and amount of payments under the contract prior to final execution or renewal of the contract; require any change to payment or fee schedules applicable to providers be made available to providers at least 30 days prior to the effective date of the amendment; provide that if an insurer issuing a managed care plan modifies an agreement it has entered into with a participating provider, the insurer must provide the provider with at least 30 days notice of the modification and notify the provider that the provider has the option to withdraw from the agreement at the end of the 30 day period prior to the modification becoming effective; require such provider who opts to withdraw [...]

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Create new sections of Subtitle 17A of KRS Chapter 304 to require a health benefit plan with a provider network to provide coverage for the dialysis provider of the insured's choice; establish a method of determining the payment rate for out-of-network dialysis services; prevent restriction of the insured's choice; prevent restriction of the dialysis benefit during open enrollment; define "unreasonable distance" and prohibit travel of such distance for in-network dialysis service; provide coverage for out-of-network dialysis if the distance for in-network dialysis is unreasonable; require written notice of any change to a health plan with a provider network that would affect a dialysis patient's coverage or benefit level concerning out-of-network coverage; require payment directly to the dialysis provider and not to the patient; require the executive director of the Office of Insurance to conduct a review of all findings to determine compliance within 120 days of the effective date of this [...]

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Create new sections of Subtitle 17A of KRS Chapter 304 to provide for payment by a managed care plan to a physician seeking expedited credentialing; require insurers to provide payment or fee schedules to health care providers when contracting or renewing contracts with providers to enable providers to determine the manner and amount of payments under the contract prior to final execution or renewal of the contract; require any change to payment or fee schedules applicable to providers be made available to providers at least 30 days prior to the effective date of the amendment; provide that if an insurer issuing a managed care plan modifies an agreement it has entered into with a participating provider, the insurer must provide the provider with at least 30 days notice of the modification and notify the provider that the provider has the option to withdraw from the agreement at the end of the 30 day period prior to the modification becoming effective; require such provider who opts to withdraw [...]

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Create new sections of Subtitle 17A of KRS Chapter 304 to require a health benefit plan with a provider network to provide coverage for the dialysis provider of the insured's choice; establish a method of determining the payment rate for out-of-network dialysis services; prevent restriction of the insured's choice; prevent restriction of the dialysis benefit during open enrollment; define "unreasonable distance" and prohibit travel of such distance for in-network dialysis service; provide coverage for out-of-network dialysis if the distance for in-network dialysis is unreasonable; require written notice of any change to a health plan with a provider network that would affect a dialysis patient's coverage or benefit level concerning out-of-network coverage; require payment directly to the dialysis provider and not to the patient; require the executive director of the Office of Insurance to conduct a review of all findings to determine compliance within 120 days of the effective date of this [...]

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