806 Ky. Admin. Regs. 17 – Health Insurance Contracts | Midpage

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Kentucky Administrative Regulations

Chapter 17

806 Ky. Admin. Regs. 17

Health Insurance Contracts

Public Protection Cabinet - Department of Insurance

005Health insurance forms and reports.010Refund of unearned premium 020Disclosure of other coverage in application.021Repeal of 806 KAR 17:110, 17:120, 17:205 030Surgical schedule.040Premium refunded to purchaser 050Inclusion of Medicaid as first payor prohibited.060Minimum standards for Medicare supplement policies 065Minimum standards for Medicare supplement insurance policies.066Medicare suppl. insurance policies 070Filing procedures for health insurance rates.080Long-term health care insurance 081Minimum standards for long-term care insurance policies.083Kentucky long-term care partnership insurance program.085Minimum standards for short-term nursing home insurance policies.090Preauthorization requirements for coverage of temporomandibular joint disorder and evaluation of medical necessity for treatment of craniomandibular jaw disorder 091Repeal of 806 KAR 17:010, 806 KAR 17:090, 806 KAR 17:130, 806 KAR 17:310, 806 KAR 17:320, 806 KAR 17:330, 806 KAR 17:440, 806 KAR 17:460, 806 KAR 17:500, 806 KAR 17:540, 806 KAR 17:545, 806 KAR 17:555 095Reimbursement for general anesthesia and facility charges for dental procedures.096Repeal of 806 KAR 017:095 100Certificate of filing for provider-sponsored networks.110Estab. of Kentucky Risk Assessment and Risk Adjustment System 130Twenty-four (24) Hour Pilot Insurance Program 140Health insurance rate filing requirements 141ERepeal of 806 KAR 17:140 150Health benefit plan rate filing requirements.160Creditable coverage for health insurance.170Genetic testing.180Standard health benefit plan.190Guaranteed Acceptance Program requirements.200ESeverity codes for high-cost conditions.205High-cost condition codes and severity questionnaire 210Reporting require. For KY Guaranteed Acceptance Program 211ERepeal of 806 KAR 17:210 220Approval criteria and require. for reentry into KY health insurance market 221Repeal of 806 KAR 17:220 230Requirements regarding medical director's signature on health care benefit denials.240Data reporting requirements.250Notification requirements for drug benefits.260Conversion policy minimum benefits.270Telehealth claim forms and records.280Registration, utilization review, and internal appeal.290Independent External Review Program.300Provider agreement and risk-sharing agreement filing requirements.310Prompt payment of claims reporting requirements 320Kentucky Access requirements 330Kentucky Access health benefit plans 350Guaranteed Acceptance Program (GAP) reporting requirements.360Prompt payment of claims.370Standardized health claim attachments.380Repeal of 806 KAR 17:066 390Benefits and disclosures in Medicare supplement insurance policies 391ERepeal of 806 KAR 17:390, 806 KAR 17:400, 806 KAR 17:410, 806 KAR 17:420 and 806 KAR 17:430 400Marketing and sales practices in Medicare supplement insurance policies 410Claims payment practices in Medicare supplement insurance policies 420Rates, premiums and lost ratio requirements in Medicare supplement insurance policies 430Reporting requirements in Medicare supplement insurance policies 440Provider agreement, subcontract agreement, and risk-sharing arrangement agreement and other filing requirements for insurers offering a limited health service benefit plan 450Insurance purchasing outlet requirements.460Requirements for autism benefits for children 470Data reporting to an employer-organized association health benefit plan.480Uniform evaluation and reevaluation of providers.490Hospice benefit requirements.500Basic health benefit plan requirements 510Health benefit plan exclusionary rider requirements.511Repeal of 806 KAR 17:095, 806 KAR 17:170, and 806 KAR 17:510.520Reimbursement of optometrists.530Copayment and coinsurance amounts for services of chiropractors and optometrists.531Repeal of 806 KAR 17:350.540ICARE Program high-cost conditions 545ICARE Program employer eligibility, application process, and requirements 555ICARE Program requirements.570Minimum standards for Medicare supplement insurance policies and certificates.575Pharmacy benefit managers.580Definition of Health Care Provider 585Annual report mental health parity nonquantitative treatment limitation compliance.590Annual report on providers prescribing medication for addiction treatment.