{"data":{"id":"us-ky/krs-304.17c-060","jurisdiction":"us-ky","citation":"KRS 304.17C-060","heading":"Filing of agreements -- Provisions of agreements -- Procedures for","body":"changing agreement -- Filing of risk-sharing arrangements and subcontracts --\nAvailability of information.\n(1) An insurer shall file with the commissioner sample copies of any ag reements it\nenters into with providers for the provision of health care services. The\ncommissioner shall promulgate administrative regulations prescribing the manner\nand form of the filings required. The agreements shall include the following:\n(a) A hold h armless clause that states that the provider may not, under any\ncircumstance, including:\n1. Nonpayment of moneys due to providers by the insurer;\n2. Insolvency of the insurer; or\n3. Breach of the agreement,\nbill, charge, collect a deposit, seek compensati on, remuneration, or\nreimbursement from, or have any recourse against the subscriber, dependent\nof subscriber, enrollee, or any persons acting on their behalf, for services\nprovided in accordance with the provider agreement. This provision shall not\nprohibit collection of deductible amounts, copayment amounts, coinsurance\namounts, and amounts for noncovered services;\n(b) A survivorship clause that states the hold harmless clause and continuity of\ncare clause shall survive the termination of the agreement be tween the\nprovider and the insurer; and\n(c) A clause requiring that if a provider enters into any subcontract agreement\nwith another provider to provide health care services to the subscriber,\ndependent of the subscriber, or enrollee of a limited health se rvice benefit\nplan, the subcontract agreement must meet all requirements of this subtitle\nand that all such subcontract agreements shall be filed with the commissioner\nin accordance with this subsection.\n(2) Each insurer shall establish procedures for chan ging an existing agreement with a\nparticipating provider, as defined in KRS 304.17A -235, which comply with KRS\n304.17A-235.\n(3) An insurer that enters into any risk -sharing arrangement or subcontract agreement\nshall file a copy of the arrangement with the commissioner. The insurer shall also\nfile the following information regarding the risk-sharing arrangement:\n(a) The number of enrollees affected by the risk-sharing arrangement;\n(b) The health care services to be provided to an enrollee under the risk -sharing\narrangement;\n(c) The nature of the financial risk to be shared between the insurer and entity or\nprovider, including but not limited to the method of compensation;\n(d) Any administrative functions delegated by the insurer to the entity or provider.\nThe insurer shall describe a plan to ensure that the entity or provider will\ncomply with the requirements of this subtitle in exercising any delegated\nadministrative functions; and\n(e) The insurer's oversight and compliance plan regarding the standards and\nmethod of review.\n(4) Nothing in this section shall be construed as requiring an insurer to submit the\nactual financial information agreed to between the insurer and the entity or provider.\nThe commissioner shall have access to a specific risk -sharing arrangement with an\nentity or provider upon request to the insurer. Financial information obtained by the\ndepartment shall be considered to be a trade secret and shall not be sub ject to KRS\n61.872 to 61.884.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45440","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:49Z","sha256":"e0212b05caba25fae2486043cb376776873712f912633cc5e4118f42ed04a65f","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17c-050","next":"us-ky/krs-304.17c-070"},"notice":"GroundRules: Original legal text. Not legal advice."}