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KRS 304.17A-712

Claim refunds and overpayments

Effective: January 1, 2025 History: Amended 2024 Ky

(1) Except as provided in subsection (2) of this section, if an insurer determines that payment was made for services rendered to an individual who was not eligible for coverage or that payment was made for services not covered by a covered person's health benefit plan, the insurer shall give written notice to the provider and:

(a) Request a refund from the provider; or (b) Make a recoupment of the overpayment from the provider in accordance with KRS 304.17A-714.

(2) An insurer, a pharmacy benefit manager, or any other administrator of pharmacy benefits shall not request a refund or make a recoupment in violation of KRS 304.17A-595.

Official source: Kentucky General Assembly. Reproduced from public-domain Kentucky statutes; confirm against the official source for the current text. Not legal advice.