KRS 304.17A-641: Treatment of a stabilized covered person with an emergency medical

condition in a nonparticipating hospital's emergency room.

(1) Where a covered person with an emergency medical condition has been stabilized,

as required by the Consolidated Omnib us Budget Reconciliation Act of 1985

(COBRA), 42 U.S.C. sec. 300bb, in the emergency department of a nonparticipating

hospital, and an insurer under its health benefit plan requires prior authorization for

poststabilization treatment, approval or denial un der the preauthorization

requirement shall be provided in a timely manner appropriate to conditions of the

patient and delivery of the services, but in no case to exceed two (2) hours from the

time the request is made and all relevant information is provid ed. The insurer's

failure to make a determination within the two (2) hour time frame, shall constitute

an authorization for the hospital to provide the medical service for which prior

authorization was sought.

(2) The nonparticipating hospital providing em ergency room services, poststabilization

treatment, or both, shall be paid at a rate negotiated between the nonparticipating

hospital and the insurer. Nothing in this section is to be construed as requiring the

payment of one hundred percent (100%) of the billed charges.