{"data":{"id":"us-ky/krs-304.17a-577","jurisdiction":"us-ky","citation":"KRS 304.17A-577","heading":"Disclosure of payment or fee schedule to managed care plan health","body":"care provider -- Disclosure of schedule change -- Confidentiality of payment\ninformation.\n(1) (a) An insurer issuing a managed care plan shall, upon request of a health care\nprovider, provide or make available to the health care provider, when\ncontracting or renewing an existing contract with such provider, the payment\nor fee schedules or other information sufficient to enable the health care\nprovider to determine the manner and amou nt of payments under the contract\nfor the health care provider's services prior to final execution or renewal of the\ncontract. The payment or fee schedule or other information submitted to a\nhealth care provider pursuant to this section shall include a des cription of\nprocesses and factors that may be applicable and that may affect actual\npayment, including copayments, coinsurance, deductibles, risk sharing\narrangements, and liability of third parties. Nothing in this paragraph shall\nprohibit a plan from mak ing any part of the information requested available\nelectronically or via a Web site.\n(b) An insurer issuing a managed care plan, upon request of a health care\nprovider, shall provide or make available to the health care provider an\nexplanation of the meth odology, such as relative value unit system and\nconversion factor, percentage of Medicare payment system, or percentage of\nbilled charges, used to determine actual payment for procedures frequently\nperformed by the provider that involve combinations of ser vices or payment\ncodes, if the actual payment for the procedures cannot be ascertained from the\nfee schedule or other information submitted to a health care provider pursuant\nto this section. As applicable, the methodology disclosure provided for in this\nparagraph shall include:\n1. The name of any relative value system;\n2. The version, edition, or publication date of the relative value system;\nand\n3. Any applicable conversion or geographic factor.\nNothing in this paragraph shall prohibit a plan from making  any part of the\ninformation requested available electronically or via a Web site.\n(c) The provisions of this subsection requiring the submission of a fee schedule or\nother information upon renewal of an existing contract shall not be applicable\nto renewal  of an existing contract when the payment or fee schedule\npreviously provided to the health care provider has not changed.\n(2) Any change to payment or fee schedules applicable to providers under contract with\nan insurer issuing a managed care plan shall b e made available to such providers at\nleast ninety (90) days prior to the effective date of the amendment. This subsection\nshall not apply to changes in standard codes and guidelines developed by the\nAmerican Medical Association or a similar organization.\n(3) A health care provider receiving information pursuant to subsection (1) of this\nsection shall not share this information with an unrelated person without the prior\nwritten consent of the insurer issuing a managed care plan. The remedies available\nto an insurer issuing a managed care plan to enforce the provision of this subsection\nshall include without limitation injunctive relief. An insurer issuing a managed care\nplan seeking extraordinary relief to enforce this section shall not be required to\nestablish irreparable harm with regard to the sharing of competitively sensitive\ninformation.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17446","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:47Z","sha256":"23af2e07656d087f0fd9835c45685932d350779c948f4f775bccda4646d18af0","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-576","next":"us-ky/krs-304.17a-578"},"notice":"GroundRules: Original legal text. Not legal advice."}