KRS 304.17A-144: Liaison for autism spectrum disorders treatment benefits.

(1) An insurer offering a health benefit plan that provides benefits for the treatment of

autism spectrum disorders shall make available to members a liaison to facilitate

communication between the member and the insurer.

(2) The responsibilities of the liaison shall include but not be limited to:

(a) Explaining to the member the benefits for the treatment of autism under the

member's health benefit plan and the specific process to access those benefits;

(b) Explaining to the member the process for prior author ization of treatment,

including communicating specific documentation needed from the member or

provider for the insurer to consider the request;

(c) Monitoring the adjudication of the member's claims for the treatment of

autism services;

(d) Explaining to the member the proper coding to use when submitting claims

for applied behavioral analysis therapy and any supporting documentation

required to be attached to the claim;

(e) Explaining to the member, upon request, how claims for the treatment of

autism services were adjudicated, including the application of any deductibles,

copayments, coinsurance, and benefit limitations; and

(f) Explaining to the member, upon request, any appeal rights the member may

have regarding coverage for the treatment of autism tha t has been denied or

limited.