{"data":{"id":"us-ky/krs-304.17a-641","jurisdiction":"us-ky","citation":"KRS 304.17A-641","heading":"Treatment of a stabilized covered person with an emergency medical","body":"condition in a nonparticipating hospital's emergency room.\n(1) Where a covered person with an emergency medical condition has been stabilized,\nas required by the Consolidated Omnib us Budget Reconciliation Act of 1985\n(COBRA), 42 U.S.C. sec. 300bb, in the emergency department of a nonparticipating\nhospital, and an insurer under its health benefit plan requires prior authorization for\npoststabilization treatment, approval or denial un der the preauthorization\nrequirement shall be provided in a timely manner appropriate to conditions of the\npatient and delivery of the services, but in no case to exceed two (2) hours from the\ntime the request is made and all relevant information is provid ed. The insurer's\nfailure to make a determination within the two (2) hour time frame, shall constitute\nan authorization for the hospital to provide the medical service for which prior\nauthorization was sought.\n(2) The nonparticipating hospital providing em ergency room services, poststabilization\ntreatment, or both, shall be paid at a rate negotiated between the nonparticipating\nhospital and the insurer. Nothing in this section is to be construed as requiring the\npayment of one hundred percent (100%) of the billed charges.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29319","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:47Z","sha256":"0f11067f93418bac0c30664e5cd053c2ac8ba78da7d06b49b279b1a84120275c","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-640","next":"us-ky/krs-304.17a-643"},"notice":"GroundRules: Original legal text. Not legal advice."}