304.3 2-330 Requirements for self -insured employer that provides health coverage and requires utilization review of benefits. (1) Every employer in this state which provides coverage of hospital benefits on a self - insured basis and requires the utilization rev iew of such benefits by an insurer, its designee, or a private review agent shall: (a) Be a registered private review agent in accordance with KRS 304.17A -607 and administrative regulations promulgated under the authority of KRS 304.17A -613; or (b) Contrac t with a private review agent that has been registered in accordance with KRS 304.17A -607 and administrative regulations promulgated under the authority of KRS 304.17A -613. (2) Notwithstanding any other provision of KRS 304.17A -603, 304.17A -605, 304.17A - 607, 304.17A -609, 304.17A -611, 304.17A -613, and 304.17A -615, a self -insured employer shall not deny or reduce payment of health benefits to any person, licensed practitioner, or health facility for covered services which have been rendered to an insured unle ss: (a) Notice of denial has been issued; and (b) The self -insured employer is in compliance with subsection (1) of this section. ity for covered services which have been rendered to an insured unle ss: (a) Notice of denial has been issued; and (b) The self -insured employer is in compliance with subsection (1) of this section. Effective: July 14, 2000 History: Amended 2000 Ky. Acts ch. 262, sec. 30, effective July 14, 2000. -- Created 1990 Ky. Acts ch . 451, sec. 10, effective July 13, 1990.
Kentucky Legal Code