{"data":{"id":"us-ky/krs-304.17a-264","jurisdiction":"us-ky","citation":"KRS 304.17A-264","heading":"Coverage under health benefit plan for cancer screening, test, or","body":"procedure.\n(1) As used in this section:\n(a) \"Cancer screening, test, or procedure\" means any preventive screening, test,\nor procedure performed for the purpose of det ecting cancer, including but not\nlimited to lung, breast, cervical, prostate, and colorectal cancer; and\n(b) \"Health benefit plan\" has the same meaning as in KRS 304.17A -005, except\nthat for purposes of this section the term includes:\n1. Short-term limited duration coverage; and\n2. Student health insurance offered by a Kentucky -licensed insurer under\nwritten contract with a university or college whose students it proposes\nto insure.\n(2) Except as provided in subsection (3) of this section:\n(a) All health benefit plans shall provide coverage for:\n1. Any cancer screening, test, or procedure that is required under federal\nlaw, including but not limited to 42 U.S.C. sec. 300gg -13, as amended;\nand\n2. Any other cancer screening, test, or procedure that is:\na. Consistent with nationally recognized clinical practice guidelines,\nincluding but not limited to:\ni. The recommendations of the United States Preventive\nServices Task Force;\nii. Clinical practice g uidelines established by the American\nCancer Society; and\niii. Clinical practice guidelines established by the National\nComprehensive Cancer Network; and\nb. Ordered or prescribed by a health care provider legally authorized\nto order or prescribe the cancer screening, test, or procedure; and\n(b) The coverage required under this subsection shall not be subject to:\n1. Utilization management requirements, including prior authorization,\nexcept for the purpose of determining that the cancer screening, test, or\nprocedure meets the requirements of paragraph (a)2.a. of this\nsubsection; or\n2. Any deductible, coinsurance, copayment, or other cost -sharing\nrequirement.\n(3) (a) If the application of any requirement of subsection (2)(b)2. of this section\nwould be the sole cause of a health benefit plan's failure to qualify as a Health\nSavings Account-qualified High Deductible Health Plan under 26 U.S.C. sec.\n223, as amended, then the requirement shall not apply to that health benefit\nplan until the minimum deductible under 26 U.S.C. sec. 223, as amended, is\nsatisfied.\n(b) If the application of any requirement of subsection (2) of this section to a\nqualified health plan as defined in 42 U.S.C. sec. 18021(a)(1), as amended,\nwould result in a determination that the state must m ake payments to defray\nthe cost of the requirement under 42 U.S.C. sec. 18031(d)(3) and 45 C.F.R.\nsec. 155.170, as amended, then the requirement shall not apply to the qualified\nhealth plan until the cost defrayal requirement is no longer applicable.\n(4) (a) This section shall not be construed to limit coverage:\n1. Provided under a health benefit plan; or\n2. Required under any other law.\n(b) In the case of a conflict between this section and any other law, this section\nshall control unless application of th is section would result in a reduction of\ncoverage or benefits for any insured.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=55747","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:47Z","sha256":"41abffc448e363e7adc2c7d596f4fb897e6e388caa8b5742b18da3cf2688996d","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-263","next":"us-ky/krs-304.17a-265"},"notice":"GroundRules: Original legal text. Not legal advice."}