2017 Kentucky Revised Statutes
CHAPTER 304 - INSURANCE CODE
Subtitle 17A - Health Benefit Plans
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.

Universal Citation: KY Rev Stat § 304.17A-138 (2017)

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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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