KRS 304.17A-590: Participating provider directories.

(1) An insurer that offers a managed care plan or a risk-bearing managed care plan shall

notify an enrollee, in writing, of the availability, in a manner consistent with KRS

304.14-420 to 304.14-450, in writing, at the time of enrollment and thereafter upon

request, and as new providers are contracted with by the plans, or as the directory

may change, of a current participating provider directory providing information on a

covered person's access to primary care physicians and specialists, optometrists,

chiropractors, and hospitals, including available participating physicians,

optometrists, chiropractors, and hospitals, by provider category or specialty and by

county. The directory shall include the following:

(a) Professional office addresses and telephone num bers for all participating

providers;

(b) The benefits for each provider type;

(c) General information about the type of financial incentives between

participating providers under contract with the insurer and other participating

health care providers and facilities to which the participating providers refer

their managed care patients; and

(d) Grievance procedures available under the plans for complaint resolutions.

In addition to making the information available in a printed document, an insurer

may also make the information available in an accessible electronic format.

(2) The insurer shall promptly notify each covered person on the termination or

withdrawal from the insurer's provider network of the covered person's designated

primary care provider.

(3) The provisions of this section shall be implemented prior to any open enrollment

period for which the effective date of coverage will be January 1, 1999, or for which

the effective date shall commence after an open enrollment period, and shall

continue for each open enrollment period thereafter.