{"data":{"id":"us-ky/krs-314.198","jurisdiction":"us-ky","citation":"KRS 314.198","heading":"Definitions for KRS  314.198 and 314.199.","body":"As used in this section and KRS 314.199:\n(1) \"Direct primary care membership  agreement\" means  a written contractual\nagreement between a primary care provider and an individual patient or his or\nher legal guardian that:\n(a) Is for an agreed-upon fee over an agreed-upon period of time;\n(b) Describes the primary care services to be provided in exchange for the\nagreed-upon fee;\n(c) States that the primary care provider shall not bill a health benefit plan or\nthe Medicaid program on a fee-for-service basis for the primary care\nservices provided under the agreement;\n(d) Specifies automatic agreement renewal periods;\n(e) Specifies any additional fees that may  be charged for primary care\nservices that are not included in the agreement;\n(f) States that the patient is not required to pay more than twelve (12)\nmonths of the agreed-upon fee in advance;\n(g) States that the agreed-upon fee and any additional fees may be paid by a\nthird party;\n(h) Allows either party to terminate the agreement in writing, without penalty\nor payment of a termination fee, after notice;\n(i) Provides that, upon termination of the agreement by the patient or his or\nher legal guardian, all unearned fees are to be returned to the patient, his\nor her legal guardian, or any third-party payor; and\n(j) Contains a conspicuous and prominent statement that the agreement\ndoes not constitute a health benefit plan and does not meet any individual\nhealth benefit plan mandate that may be required by federal law;\n(2) \"Health benefit plan\" has the same meaning as in KRS 304.17A-005;\n(3) \"Primary care provider\" means  an advanced practice registered nurse as\ndefined by KRS  314.011 or an advanced practice registered nurse's practice\nthat enters into a direct primary care membership agreement;\n(4) \"Primary care service\" means  the screening, assessment, diagnosis, and\ntreatment for the purpose of promotion of health or the detection and\nmanagement  of disease or injury within the competency and training of the\nprimary care provider; and\n(5) \"Third party\" means  a legal guardian, the individual patient's employer, a\nspouse's employer, a family member  of the patient, or a state-sponsored direct\nprimary care payment  program. \"Third party\" does not include a network\ndesigned to merely accept payment from a patient and then direct the patient\nto one (1) of several independently owned clinics for the delivery of care.","path":["KRS Chapter 314"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=45772","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:58:10Z","sha256":"f25e35e4ce2ffd50c73f925f1f7a91bc550a0674fd6aa0de877e07c5c1bd0f27","source_id":"us-ky","stale":false,"prev":"us-ky/krs-314.196","next":"us-ky/krs-314.199"},"notice":"GroundRules: Original legal text. Not legal advice."}