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Subtitle

Subtitle 38. Health Maintenance Organizations

  • KRS 304.38-010— Title
  • KRS 304.38-020— Purpose
  • KRS 304.38-030— Definitions for subtitle
  • KRS 304.38-035— Certificate required for health maintenance organization
  • KRS 304.38-040— Establishment of health maintenance organizations
  • KRS 304.38-042— Requirements for provider-sponsored integrated health networks to convert to health maintenance organization
  • KRS 304.38-050— Evidence of coverages and charges for health care service -- Exception
  • KRS 304.38-060— Issuance of certificate of authority
  • KRS 304.38-065— Repealed, 2002
  • KRS 304.38-070— Requirements for protection against insolvency -- Risk-based capital requirements -- Requirements for health maintenance organizations
  • KRS 304.38-073— Deposit of cash or securities for performance of obligations to enrollees
  • KRS 304.38-075— Requirements for transfer of risk to provider -- Additional reserves may be required
  • KRS 304.38-077— Repealed, 2002
  • KRS 304.38-080— Information to enrollees
  • KRS 304.38-090— Annual report
  • KRS 304.38-095— Application of KRS 304.2-205
  • KRS 304.38-098— Compliance with KRS 304.18-124 to 304.18-127
  • KRS 304.38-100— Investments
  • KRS 304.38-110— Agent of health maintenance organization -- Licensing -- Continuing education -- Appointment
  • KRS 304.38-120— Financial condition, market conduct, and business practices subject to examination
  • KRS 304.38-130— Revocation or suspension of certificate of authority
  • KRS 304.38-140— Rehabilitation, liquidation, or conservation of health maintenance organization
  • KRS 304.38-150— Rules and regulations
  • KRS 304.38-160— Repealed, 1982
  • KRS 304.38-170— Public documents -- Statutory construction
  • KRS 304.38-180— Prohibited practices
  • KRS 304.38-185— Coordination of benefits
  • KRS 304.38-190— Powers of insurers
  • KRS 304.38-191— Conversion and continuation rights upon termination of group coverage
  • KRS 304.38-192— Repealed, 1986
  • KRS 304.38-193— Coverage for treatment for mental illness
  • KRS 304.38-194— Pooling of claims experience required
  • KRS 304.38-195— Policy covering services performed by dentist deemed to cover such services performed by physician
  • KRS 304.38-196— Indemnity payable for services performed by chiropractors, physicians, osteopaths, or podiatrists
  • KRS 304.38-197— Coverage for treatment of alcoholism
  • KRS 304.38-198— Optional nursery care coverage for a well newly born child
  • KRS 304.38-199— Coverage for newly-born child
  • KRS 304.38-200— Application of other subtitles
  • KRS 304.38-205— Medicare supplement coverage for persons not eligible for Medicare by reason of age
  • KRS 304.38-210— Health maintenance organizations as insurers to offer home health care coverage -- Conditions
  • KRS 304.38-220— Long-term health care benefits
  • KRS 304.38-225— Requirements for health maintenance organization that provides hospital benefits coverage and requires utilization review of benefits
  • KRS 304.38-230— Funding of benefits by employer or group contract holder
  • KRS 304.38-240— Solicitation of proposals designating medical necessity criteria for Medicaid managed care organizations -- Administrative regulation
  • KRS 304.38-500— Repealed, 2002
  • KRS 304.38-505— Repealed, 2002
  • KRS 304.38-510— Repealed, 2002
  • KRS 304.38-1933— Coverage for services of licensed psychologist or licensed clinical social worker
  • KRS 304.38-1934— Coverage for medical and surgical benefits with respect to mastectomy, diagnosis and treatment of endometrioses and endometritis, and bone density testing -- Duties of health maintenance organization
  • KRS 304.38-1935— Coverage for mammograms -- Prohibition on cost-sharing requirements for covered diagnostic breast examinations or supplemental breast examinations
  • KRS 304.38-1936— Coverage for treatment of breast cancer
  • KRS 304.38-1937— Coverage for treatment of temporomandibular joint disorders and craniomandibular jaw disorders
  • KRS 304.38-1955— Construction of provisions for services by licensed optometrist or licensed ophthalmic dispenser to include same services from licensed physician