{"data":{"id":"us-ky/krs-304.32-1593","jurisdiction":"us-ky","citation":"KRS 304.32-1593","heading":"Coverage for medical and surgical benefits with respect to","body":"mastectomy, diagnosis and treatment of endometrioses and endometritis, and\nbone density testing -- Duties of insurer.\n(1) All nonprofit hospital, medical -surgical, dental, and health servi ce corporations\nissuing contracts in this Commonwealth providing hospital, medical, or surgical\nexpense benefits shall make available and offer to the purchaser coverage for:\n(a) The following, if medical and surgical benefits with respect to a mastectomy\nare covered, in a manner determined in consultation with the attending\nphysician and the covered person, and subject to annual deductibles and\ncoinsurance provisions as may be deemed appropriate and as are consistent\nwith those established for other benefits under the coverage:\n1. All stages of breast reconstruction surgery of the breast on which the\nmastectomy has been performed;\n2. Surgery and reconstruction of the other breast to produce a symmetrical\nappearance; and\n3. Prostheses and physical complicati ons of all stages of mastectomy,\nincluding lymphedemas;\n(b) Diagnosis and treatment of endometriosis and endometritis if the insurer also\ncovers hysterectomies; and\n(c) Bone density testing for women age thirty -five (35) years and older, as\nindicated by th e health -care provider, in accordance with standard medical\npractice, to obtain baseline data for the purpose of early detection of\nosteoporosis.\n(2) No insurer under this section shall offer medical and surgical benefits with respect\nto a mastectomy that requires the procedure be performed on an outpatient basis.\n(3) An insurer shall provide written notice to a covered person of the availability of\nmedical and surgical benefits with respect to a mastectomy upon enrollment and\nannually thereafter.\n(4) An insurer shall not:\n(a) Deny eligibility, or continued eligibility, to an individual to enroll or to renew\ncoverage under the terms of the plan, solely for the purpose of avoiding the\nrequirements of 42 U.S.C. secs. 300gg-6 and 300gg-52; and\n(b) Penalize or o therwise reduce or limit the reimbursement of an attending\nprovider or provide incentives to an attending provider, to induce the provider\nto provide care to an individual in a manner inconsistent with 42 U.S.C. secs.\n300gg-6 and 300gg-52.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29790","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:54Z","sha256":"d6a17b733948c8591bfaf239d11d87b3c0afd7dd72171c262d7e303c2359981f","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.32-1591","next":"us-ky/krs-304.32-1595"},"notice":"GroundRules: Original legal text. Not legal advice."}