{"data":{"id":"us-ky/krs-205.8451","jurisdiction":"us-ky","citation":"KRS 205.8451","heading":"Definitions for KRS 205.8451 to 205.8483.","body":"As used in KRS 205.8451 to 205.8483, unless the context otherwise requires:\n(1) \"Benefit\" means the receipt of money, goods, or anything of pecuniary value from\nthe Medical Assistance Program.\n(2) \"Fraud\" means an intentional deception or misrepresentation  made by a recipient or\na provider with the knowledge that the deception could result in some unauthorized\nbenefit to the recipient or provider or to some other person. It includes any act that\nconstitutes fraud under applicable federal or state law.\n(3) \"Immediate family member\" means a parent, grandparent, spouse, child, stepchild,\nfather-in-law, mother -in-law, son -in-law, daughter -in-law, sibling, brother -in-law,\nsister-in-law, or grandchild.\n(4) \"Intentional\" or \"intentionally\" means, with respect to a result or to conduct\ndescribed by a statute defining an offense, that a person's conscious objective is to\ncause that result or to engage in that conduct.\n(5) \"Knowingly\" means, with respect to conduct or to a circumstance described by a\nstatute defining an offense, that a person is aware that his conduct is of that nature\nor that the circumstance exists.\n(6) \"Medical Assistance Program\" means the program of medical assistance as\nadministered by the Cabinet for Health and Family Services in compliance with\nTitle XIX of the Federal Social Security Act and any administrative regulations\nrelated thereto.\n(7) \"Provider\" means an individual, company, corporation, association, facility, or\ninstitution which is providing or has been approved to provide medical serv ices,\ngoods, or assistance to recipients under the Medical Assistance Program.\n(8) \"Provider abuse\" means, with reference to a health care provider, practices that are\ninconsistent with sound fiscal, business, or medical practices, and that result in\nunnecessary cost to the Medical Assistance Program established pursuant to this\nchapter, or that result in reimbursement for services that are not medically necessary\nor that fail to meet professionally recognized standards for health care. It also\nincludes pra ctices that result in unnecessary cost to the Medical Assistance\nProgram.\n(9) \"Recipient\" means any person receiving or who has received medical assistance\nbenefits.\n(10) \"Recipient abuse\" means, with reference to a medical assistance recipient, practices\nthat result in unnecessary cost to the Medical Assistance Program or the obtaining\nof goods, equipment, medicines, or services that are not medically necessary, or that\nare excessive, or constitute flagrant overuse or misuse of Medical Assistance\nProgram benefits for which the recipient is covered.\n(11) \"Wantonly\" means, with respect to a result or to a circumstance described by a\nstatute defining an offense, that a person is aware of and consciously disregards a\nsubstantial and unjustifiable risk that the result will occur or that the circumstance\nexists. The risk must be of such nature and degree that disregard thereof constitutes\na gross deviation from the standard of conduct that a reasonable person would\nobserve in the situation. A person who creates su ch a risk but is unaware thereof\nsolely by reason of voluntary intoxication also acts wantonly with respect thereto.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=7851","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:05Z","sha256":"ba41ab94b348e915cd3bc0640ee1d39038dfdf0bc4639bf02defcb46d1aa9b9b","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.845","next":"us-ky/krs-205.8453"},"notice":"GroundRules: Original legal text. Not legal advice."}