{"data":{"id":"us-ky/krs-304.17c-080","jurisdiction":"us-ky","citation":"KRS 304.17C-080","heading":"Plan for selection and reevaluation of providers.","body":"(1) Each insurer shall have a process for the selection of health care providers who will\nbe on the plan's list of participating providers, with written policies and procedures\nfor review and approval used by the plan.\n(2) The plan shall establish minimum professional requirements for participating health\ncare providers. An insurer may not discriminate against a provider solely on the\nbasis of the provider's license by the state.\n(3) The plan shall demonstrate that it has consulted with appropriately qualified health\ncare providers to establish the minimum professional requirements.\n(4) The plan's selection process shall include verification of each health care provider's\nlicense, history of license suspension or revocation, and liability claims history.\n(5) An insurer shall establish a formal written, ongoing process for the reevaluation of\neach participating health care provider within a specified number of years after the\nprovider's initial acceptance into the plan. The reevaluation shall include an update\nof the previous review criteria and an assessment of the provider's performance\npattern based on criteria such as enrollee clinical outcomes, number of complaints,\nand malpractice actions.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29411","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:49Z","sha256":"933b770bc187d85f0245985729330f18622eac8f6f83e664dc9c9a87e898c0fc","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17c-070","next":"us-ky/krs-304.17c-085"},"notice":"GroundRules: Original legal text. Not legal advice."}