KRS 304.17A-660: Definitions for KRS 304.17A-660 to 304.17A-669.

As used in KRS 304.17A-660 to 304.17A-669, unless the context requires otherwise:

(1) "Classification of benefits" means the classification of benefits set forth in 45

C.F.R. sec. 146.136(c)(2)(ii)(A);

(2) "Mental health condition" means any condition or d isorder that involves mental

illness or substance use disorder as defined in KRS 222.005 and that falls under any

of the diagnostic categories listed in the most recent version of the Diagnostic and

Statistical Manual of Mental Disorders or that is listed in the mental disorders

section of the most recent version of the International Classification of Disease;

(3) "Nonquantitative treatment limitation" means any limitation that is not expressed

numerically but otherwise limits the scope or duration of benefits for treatment;

(4) "Terms or conditions" includes day or visit limits, episodes of care, any lifetime or

annual payment limits, deductibles, copayments, prescription coverage,

coinsurance, out-of-pocket limits, and any other cost-sharing requirements; and

(5) "Treatment of a mental health condition" includes but is not limited to any

necessary outpatient, inpatient, residential, partial hospitalization, day treatment,

emergency detoxification, or crisis stabilization services.