Subtitle 38. Health Maintenance Organizations
- KY ST T. XXV, Ch. 304, Subt. 38, Refs & Annos
- 304.38–010 Title
- 304.38–020 Purpose
- 304.38–030 Definitions for Subtitle
- 304.38–035 Certificate Required for Health Maintenance Organization
- 304.38–040 Establishment of Health Maintenance Organizations
- 304.38–042 Requirements for Provider-Sponsored Integrated Health Networks to Connect to Health Maintenance Organization
- 304.38–050 Evidence of Coverages and Charges for Health Care Service; Exception
- 304.38–060 Issuance of Certificate of Authority
- 304.38–065 Certificate of Authority to Designate Type of Services Authorized—Repealed
- 304.38–070 Requirements for Protection Against Insolvency; Risk-Based Capital Requirements; Requirements for Health Maintenance Organizations
- 304.38–073 Deposit of Cash or Securities for Performance of Obligations to Enrollees
- 304.38–075 Requirements for Transfer of Risk to Provider; Additional Reserves May be Required
- 304.38–077 Single Service Organization; Net Worth and Risk-Based Capital Requirements—Repealed
- 304.38–080 Information to Enrollees
- 304.38–090 Annual Report
- 304.38–095 Application of KRS 304.2–205
- 304.38–098 Compliance with KRS 304.18–124 to 304.18–127
- 304.38–100 Investments
- 304.38–110 Agent of Health Maintenance Organization; Licensing; Continuing Education; Appointment
- 304.38–120 Financial Condition, Market Conduct, and Business Practices Subject to Examination
- 304.38–130 Revocation or Suspension of Certificate of Authority
- 304.38–140 Rehabilitation, Liquidation, or Conservation of Health Maintenance Organization
- 304.38–150 Rules and Regulations
- 304.38–160 Fees—Repealed
- 304.38–170 Public Documents; Statutory Construction
- 304.38–180 Prohibited Practices
- 304.38–185 Coordination of Benefits
- 304.38–190 Powers of Insurers
- 304.38–191 Conversion and Continuation Rights upon Termination of Group Coverage
- 304.38–192 Continuation of Group Coverage—Repealed
- 304.38–193 Coverage for Treatment for Mental Illness
- 304.38–1933 Coverage for Services of Licensed Psychologist or Licensed Clinical Social Worker
- 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
- 304.38–1935 Coverage for Mammograms
- 304.38–1936 Coverage for Treatment of Breast Cancer
- 304.38–1937 Coverage for Treatment of Temporomandibular Joint Disorders and Craniomandibular Jaw Disorders
- 304.38–194 Pooling of Claims Experience Required
- 304.38–195 Policy Covering Services Performed by Dentist Deemed to Cover Such Services Performed by Physician
- 304.38–1955 Construction of Provisions for Services by Licensed Optometrist or Licensed Ophthalmic Dispenser to Include Same Services from Licensed Physician
- 304.38–196 Indemnity Payable for Services Performed by Chiropractors, Physicians, Osteopaths, or Podiatrists
- 304.38–197 Coverage for Treatment of Alcoholism
- 304.38–198 Optional Nursery Care Coverage for a Well Newly Born Child
- 304.38–199 Coverage for Newly-Born Child
- 304.38–200 Application of Other Subtitles
- 304.38–205 Medicare Supplement Coverage for Persons Not Eligible for Medicare by Reason of Age
- 304.38–210 Health Maintenance Organizations as Insurers to Offer Home Health Care Coverage; Conditions
- 304.38–220 Long-Term Health Care Benefits
- 304.38–225 Requirements for Health Maintenance Organization that Provides Hospital Benefits Coverage and Requires Utilization Review of Benefits
- 304.38–230 Funding of Benefits by Employer or Group Contract Holder
- 304.38–240 Solicitation of Proposals Designating Medical Necessity Criteria for Medicaid Managed Care Organizations; Administrative Regulation
- Health Discount Plans