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Care Coordination/Care Management in Kentucky

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Care Coordination/Care Management in Kentucky

Subtopic Statute/Regulation Description
Informed consent requirements (If the information is going beyond the patient and provider Abortion Facilities, 902 Ky. Admin. Regs. 20:360 Abortion Facilities
Confidential Nature of Records - Ky. Rev. Stat. Ann. § 210.235 Mental health information is confidential and privileged to the patient, except as provided for in the statute. The statute does not preclude the...
Emergency Care for Victims of Sexual Offenses, Ky. Rev. Stat. Ann. § 216B.400 Emergency Care for Victims of Sexual Offenses
Hospitals Operations and Services, 902 Ky. Admin. Regs. 20:016 Hospitals Operations and Services
Hospitals; operations and services under the cabinet for health and family services department for public health regulations - 902 KY. ADMIN. REGS. 20:016 Section 3. (11)   Hospital records shall be maintained in accordance with professional standards for all patients.   A registered records...
Insure Patient's Informed Consent and Maintain Confidentiality, Ky. Rev. Stat. Ann. § 311.5975 Duty of Physician to Insure Patient's Informed Consent and Maintain Confidentiality
Testing of Organs, Skin or Other Tissue, Ky. Rev. Stat. Ann. § 311.281 Testing of Organs, Skin or Other Tissue for HIV and Other Communicable Diseases
When Informed Consent is Deemed Given, Ky. Rev. Stat. Ann. § 304.40-320 When informed consent is deemed given. 
Licensure laws requiring or recommending care coordination or care management activities (Cross reference with private insurance/Medicaid/Medicare data requirements) Ambulance Transportation, 907 Ky. Admin. Regs. 1:060 Ambulance Transportation
Denial, Suspension, and Revocation of Application or License, Ky. Rev. Stat. Ann. § 304.17A-756 Denial, Suspension, and Revocation of Application or License
Disclosure of Terms and Conditions of Health Benefit Plan, Ky. Rev. Stat. Ann. § 304.17A-505 Disclosure of Terms and Conditions of Health Benefit Plan
Duties of County Health Departments,Ky. Rev. Stat. Ann. § 212.240 Duties of County Health Departments
Establishment of Health Maintenance Organizations, Ky. Rev. Stat. Ann. § 304.38-040 Establishment of Health Maintenance Organizations
Group Health Insurers to Offer Home Health Care Coverage, Ky. Rev. Stat. Ann. § 304.18-037 Group Health insurers to offer home health coverage.   
Health Insuring Organization and Prepaid Health Plan Services, 907 Ky. Admin. Regs. 1:120 Health Insuring Organization and Prepaid Health Plan Services
Home Health Agencies Operations and Services, 902 Ky. Admin. Regs. 20:081 Home health agencies-- operations and services.   
Hospital Examination Services, 902 Ky. Admin. Regs. 20:012 Hospital Examination Services
Hospital Furnished Nursing Facility Services, 907 Ky. Admin. Regs. 1:037 Hospital Furnished Nursing Facility Services
Hospitals Cannot Deny Treatment, Ky. Rev. Stat. Ann. § 222.311 Hospitals Cannot Deny Treatment Because of Alcohol or Drug Abuse
Inpatient Hospital Service Coverage, 907 Ky. Admin Regs. 10:012 Inpatient hospital service coverage.   
Insurance Application and Approval, Ky. Rev. Stat. Ann. § 304.17A-754 Insurance Application and Approval
Licensing Procedures for Drug Abuse Prevention Programs, 908 Ky. Admin. Regs. 1:380 Licensing Procedures for Drug Abuse Prevention Programs
Licensing Procedures, 908 Ky. Admin. Regs. 1:370 Licensing Procedures for Nonmedical Based Drug Abuse Treatment Programs
Nursing Facility Services and Intermediate Care Facilities, 907 Ky. Admin. Regs. 1:022 Nursing Facility Services and Intermediate Care Facilities
Operations and Services for Private Duty Nursing Agencies, 902 Ky. Admin. Regs. 20:370 Operations and services for private duty nursing agencies.   
Outpatient Hospital Service Coverage Provisions and Requirements, 907 Ky. Admin. Regs. 10:014 Outpatient Hospital Service Coverage Provisions and Requirements
Payments for Outpatient Hospital Services, 907 Ky. Admin. Regs. 10:015 Payments for Outpatient Hospital Services
Plan for Selection and Reevaluation of Providers, Ky. Rev. Stat. Ann. § 304.17C-080 Plan for Selection and Reevaluation of Providers
Preventative and Remedial Public Health Services, 907 Ky. Admin. Regs. 1:360 Preventative and Remedial Public Health Services
Procedures for Substance Abuse Prevention, 908 Ky. Admin. Regs. 1:400 Procedures for Substance Abuse Prevention
Requirements for Insurers for Utilization Review of Benefits, Ky. Rev. Stat. Ann. § 304.18-045 Requirements for Insurers for Utilization Review of Benefits
Special Health Clinics, 902 Ky. Admin. Regs. 20:260 Special Health Clinics
Suspension or Revocation of Certificate of Authority, Ky. Rev. Stat. Ann. § 304.38A-090 Suspension or Revocation of Certificate of Authority
Disease management Confidential Record of Treatment, 908 Ky. Admin. Regs. 1:320 Confidential record of treatment for federally-assisted alcohol and other drug abuse programs Federally-assisted substance abuse treatment programs...
Information sharing across providers (including communication with other providers, across state lines, patient transfer) Criteria for Certification for Out of State Residential Services, 907 Ky. Admin. Regs. 3:035 Criteria for Certification for Out of State Residential Services
Disclosure of Confidential Client Information for Councils, 908 Ky. Admin. Regs. 5:010 Disclosure of Confidential Client Information for Councils
Long Term Care Transfer and Discharge Rights, 900 Ky. Admin. Regs. 2:050 Long Term Care Transfer and Discharge Rights
Nurse Aide Abuse Registry, 906 Ky. Admin. Regs. 1:100 Nurse aide abuse registry.   
Out of Network Benefits, Ky. Rev. Stat. Ann. § 304.17A-550 Out of Network Benefits
Outpatient Pharmacy Program, 907 Ky. Admin. Regs. 1:019 Outpatient Pharmacy Program
Payment for Medical Assistance Services Furnished Out of State, 907 Ky. Admin. Regs. 1:084 Payment for Medical Assistance Services Furnished Out of State
Personal Care Homes Operation and Services, 902 Ky. Admin. Regs. 20:036 Personal Care Homes Operation and Services
Prohibition Against Limiting Disclosure of Options, Ky. Rev. Stat. Ann. § 304.17A-530 Prohibition Against Limiting Disclosure to Patient of Medical Condition or Treatment Options
Release of Public Data Sets for Health Care Discharge Data, 900 Ky. Admin. Regs. 7:040 Release of Public Data Sets for Health Care Discharge Data
Requirements for HMOs Providing Hospital Benefit Coverage, Ky. Rev. Stat. Ann. § 304.28-225 Requirements for HMOs Providing Hospital Benefit Coverage
Rural Health Clinics Operations and Services, 902 Ky. Admin. Regs. 20:145 Rural Health Clinics Operations and Services
Standards Governing Scientific Misconduct, 900 Ky. Admin. Regs. 1:080 Standards Governing Scientific Misconduct
Transfer of Patients to Other Facilities, 908 Ky. Admin. Regs. 3:040 Transfer of Patients to Other Facilities. 
Payment reform initiatives Direct Payment of Hospital, Medical Services, Ky. Rev. Stat. Ann. § 304.18-040 Direct payment of hospital/medical services.   
New coordinated systems of care (ACOs, Patient Centered Medical Homes/Health homes) (Cross reference with Quality Measurement) Eligibility for Coverage Under Kentucky Access, Ky. Rev. Stat. Ann. § 304.17B-015 Eligibility for Coverage Under Kentucky Access
Health Benefit Plan Not Required to Include State Benefits, Ky. Rev. Stat. Ann. § 304.17A-252 Health Benefit Plan Not Required to Include State Benefits
HMO Medicare Supplement Coverage for Persons Not Eligible, Ky. Rev. Stat. Ann. § 304.38-205 HMO Medicare Supplement Coverage for Persons Not Eligible
HMOs as Insurers to Offer Home Health Care Coverage, Ky. Rev. Stat. Ann. § 304.38-210 HMOs as Insurers to Offer Home Health Care Coverage
Kentucky Health Information Exchange Participation, 900 Ky. Admin. Regs. 9:010 Kentucky Health Information Exchange Participation
Medicaid Adverse Action and Condition for Recipients, 907 Ky. Admin. Regs. 20:060 Medicaid Adverse Action and Condition for Recipients
Nursing Facilities Operation and Services, 902 Ky. Admin. Regs. 20:300 Nursing Facilities Operation and Services
Protocol for Treatment of Drug Overdose, Ky. Rev. Stat. Ann. § 216B.402 Protocol for Treatment of Drug Overdose
Requirements for Transfer of Risk to Provider, Ky. Rev. Stat. Ann. § 304.38-075 Requirements for Transfer of Risk to Provider
Validation and Complaint Investigation Procedures for Deemed Hospitals, 906 Ky. Admin. Regs. 1:140 Validation and Complaint Investigation Procedures for Deemed Hospitals
Discharge instructions/Required follow-up. Long Term Care Transfer and Discharge Rights, 900 Ky. Admin. Regs. 2:050 Long Term Care Transfer and Discharge Rights
Patient authorization requirements (to provide health information to another individual) Ombudsman Complaint Review Responsibilities, 920 Ky. Admin. Regs. 1:030 Ombudsman Complaint Review Responsibilities
Treatment planning when using interdisciplinary team (including assessments, plan of care, discharge/transfer planning Transfer of Patients to Other Facilities, 908 Ky. Admin. Regs. 3:040 Transfer of Patients to Other Facilities. 
Click on the individual state law in the table above to see our summary of the individual law.


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