2012 Kentucky Revised Statutes
CHAPTER 304 INSURANCE CODE
SUBTITLE 17A. Health Benefit Plans
17A..138 Prohibition against health benefit plan excluding coverage for telehealth -- Benefits subject to deductible, co-payment, or coinsurance -- Payment subject to provider network arrangements -- Administrative regulations.
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<![CDATA[304.17A-138 Prohibition against health benefit plan excluding coverage for
telehealth -- Benefits subject to deductible, co-payment, or coinsurance -Payment subject to provider network arrangements -- Administrative
regulations.
(1)
(2)
(3)
(4)
(a)
A health benefit plan shall not exclude a service from coverage solely because
the service is provided through telehealth and not provided through a face-toface consultation if the consultation is provided through the telehealth
network established under KRS 194A.125. A health benefit plan may provide
coverage for a consultation at a site not within the telehealth network at the
discretion of the insurer.
(b) A telehealth consultation shall not be reimbursable under this section if it is
provided through the use of an audio-only telephone, facsimile machine, or
electronic mail.
Benefits for a service provided through telehealth required by this section may be
made subject to a deductible, copayment, or coinsurance requirement. A deductible,
copayment, or coinsurance applicable to a particular service provided through
telehealth shall not exceed the deductible, copayment, or coinsurance required by
the health benefit plan for the same service provided through a face-to-face
consultation.
Payment made under this section may be consistent with any provider network
arrangements that have been established for the health benefit plan.
The department shall promulgate an administrative regulation in accordance with
KRS Chapter 13A to designate the claim forms and records required to be
maintained in conjunction with this section.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1215, effective July 15, 2010. -Amended 2007 Ky. Acts ch. 24, sec. 28, effective June 26, 2007. -- Created 2000 Ky.
Acts ch. 376, sec. 7, effective July 15, 2001.
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