KRS 304.38-075: Requirements for transfer of risk to provider -- Additional reserves

may be required.

(1) Any health maintenance organization that contracts with a provider or provider

organization for the transfer of risk to the provider shall take reasonable ste ps to

ensure the transferee is able to accept and manage the risk to be transferred. The

health maintenance organization shall submit a plan for evaluating a provider's or

provider organization's ability to accept and manage risk to the department for

approval at least forty-five (45) days prior to the proposed date of the transfer of any

risk.

(2) If a health maintenance organization transfers risk to a provider:

(a) Not in compliance with the standards listed in its approved plan; or

(b) Prior to filing or receiving approval of its plan;

the commissioner may require the health maintenance organization to retain

additional reserves to cover the risk transferred.