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304.99-123 Penalties for noncompliance with KRS 304.17A-700
304.17A-730 and KRS 205.593, 304.14-135, and 304.99-123.
(1)
(2)
to
In addition to any other penalty or remedy authorized by law, the department
may assess the following fines for noncompliance with KRS 304.17A-700 to
304.17A-730 and KRS 205.593, 304.14-135, and 304.99-123:
(a) A fine of one thousand dollars ($1,000) per day or ten percent (10%) of
the unpaid claim amount, whichever is greater, for each day that a clean
claim remains unpaid in violation of KRS 304.17A-700 to 304.17A-730
and KRS 205.593, 304.14-135, and 304.99-123; and
(b) Except for the late payment of claims under subsection (2) of this section,
a fine of up to ten thousand dollars ($10,000) where the commissioner
determines that an insurer has willfully and knowingly violated KRS
304.17A-700 to 304.17A-730 and KRS 205.593, 304.14-135, and
304.99-123 or has a pattern of repeated violations of KRS 304.17A-700 to
304.17A-730 and KRS 205.593, 304.14-135, and 304.99-123.
For purposes of paragraph (a) of subsection (1) of this section, an insurer is in
compliance when:
(a) Ninety-five percent (95%) of the clean claims received by the insurer, its
agent, or designee during each calendar quarter, excluding
pharmaceutical claims, were adjudicated within the claims payment
timeframes in accordance with KRS 304.17A-702; and
(b) At least ninety percent (90%) of the total dollar amount for clean claims
received by the insurer, its agent, or designee during each calendar
quarter, excluding pharmaceutical claims, that were not denied or
contested, was paid within the claims payment timeframes established in
KRS 304.17A-702.
Effective:July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1659, effective July 15, 2010. -Amended 2002 Ky. Acts ch. 181, sec. 18, effective July 15, 2002. -- Created
2000 Ky. Acts ch. 436, sec. 17, effective July 14, 2000.
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