KRS 205.8459: Emergency service.

(1) Any provider presented with a request for an emergency service, for a nonlife -

threatening condition or a condition that would not result in irreparable harm, by a

Medicaid recipient participating in a managed care program but not in a restricted

Medicaid s tatus, shall not provide the service on an emergency basis unless the

provider first makes a reasonable effort to contact the recipient's designated

managed care primary physician for prior approval. Any provider presented with a

request for an emergency s ervice, due to a life -threatening condition or a condition

that would result in irreparable harm, by a Medicaid recipient participating in a

managed care program but not in a restricted Medicaid status, may provide the

service without prior approval from the recipient's designated managed care primary

physician.

(2) For the purposes of implementing KRS 205.8455, 205.8457, and this section, the

Department for Medicaid Services, in consultation with the Recipient Utilization

Review Committee, shall in conform ity with the federal Emergency Medical

Treatment and Active Labor Act (42 U.S.C. sec. 1395dd, as amended) and any other

applicable federal law, and in administrative regulation promulgated pursuant to

KRS Chapter 13A, define an emergency service, irreparable harm, immediate grave

bodily harm, life-threatening condition, and nonlife-threatening condition.