1. Kentucky, Public Protection Cabinet/Department of Insurance, Bulletin, Insurance Legislation Adopted by the 2013 Kentucky General Assembly (Regular Session) (05/31/2013) - ensures that associations are treated as large groups for purposes of the Affordable Care Act.
2. Kentucky, Cabinet for Health and Family Services/Office of the Kentucky Health Benefit Exchange, Exchange Participation Requirements and Certification, 900 KAR 10:010 (05/13/2013) - establishes the policies and procedures relating to the certification of a qualified health plan to be offered on the Kentucky Health Benefit Exchange, pursuant to and in accordance with 42 U.S.C. 18031 and 45 C.F.R. Parts 155 and 156 in implementing the Affordable Care Act.
3. Kentucky, Cabinet for Health and Family Services/Office of the Kentucky Health Benefit Exchange, Exchange Participation Requirements and Certification, 900 KAR 10:010 (05/13/2013) - establishes the criteria for certification as a qualified health plan or a qualified dental plan to be offered on the Kentucky Health Benefit Exchange as required by 45 C.F.R. Parts 155 and 156 in implementing the Affordabl Care Act.
4. Kentucky, Cabinet for Health and Family Services/Department for Medicaid Services/Division of Provider Operations, Supplemental Payments for Primary Care and Vaccines, 907 KAR 3:015 (04/03/2013) - establishes policies and requirements regarding supplemental Medicaid program payments for certain primary care evaluation and management services and vaccines provided by the Affordable Care Act.
5. Kentucky, Cabinet for Health and Family Services/Department for Medicaid Services/Office of the Commissioner, Health Care-Acquired Conditions, 907 KAR 14:005 (11/13/2012) - establishes the Medicaid program policies, including managed care and non-managed care, regarding health care-acquired conditions and provider preventable conditions as required by the Affordable Care Act.
6. Kentucky, Public Protection Cabinet/Department of Insurance, Bulletin, Claims and Internal Appeals Preemption Issues (11/18/2011) -
With respect to internal claims and appeals processes, Section 2719 of the PHS Act requires insurers to incorporate the internal claims and appeals processes related to the U.S. Department of Labor (DOL) claims at 29 CFR 2560.503-1 and updates those processes as directed by the Secretary of Labor. Also, with respect to the individual health insurance market, insurers must initially incorporate the internal claims and appeals processes set forth in applicable state law and update those processes in accordance with standards established by the Secretary of the U.S. Department of Health and Human Services (HHS).
There are provisions in the regulations promulgated by HHS that preempt, in whole or in part, Kentuckys internal appeal procedures outlined in KRS Chapter 304, Subtitle 17A. This Bulletin outlines provisions of the federal law that impact the states internal appeal statutes and regulations, to the extent those provisions have been identified. Any state laws that do not meet the federal minimum standards are preempted.
Although Section 2719 of the PHS Act does not apply to grandfathered plans, the Department is applying this Bulletin to all insurers issuing or renewing health benefit plans in the Commonwealth of Kentucky, regardless of whether the health benefit plans are grandfathered.
Sharon P. Clark, Commissioner, Kentucky Department of Insurance
7. Kentucky, Public Protection Cabinet/Department of Insurance/Health and Life Division, Standard Health Benefit Plan, 806 KAR 17:180 (06/15/2011) - establishes one (1) standard health benefit plan that may be offered by an insurer in the individual and small group markets and establishes procedures for modifications to the standard health benefit plan and conforms it at a minimum to the requirements of the Affordable Care Act.
8. Kentucky, Public Protection Cabinet/Department of Insurance, Bulletin, External Review Preemption Issues (05/10/2011) - applies external review of certain denied claims where an insured can appeal a claim denied on the basis that the service is not medically necessary or is experimental or investigational for review by an independent review entity (IRE) and not by the insurer. This ensures that KY insurers adhere to the requirements of the Affordable Care Act which preempts claims denial review processes of states that are in conflict.
