Kentucky Statutes 304.17A-575 – Definitions for KRS 304.17A-575 to 304.17A-577
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As used in KRS § 304.17A-575 to KRS § 304.17A-577, unless the context requires otherwise:
(1) “Applicant” means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter 320 applying for credentialing;
(2) “Enrollee” means a person who is eligible to receive health care services under a managed care plan;
(3) “Managed care plan” means a health benefit plan that integrates the financing and delivery of appropriate health care services to enrollees by arrangements with participating providers who are selected to participate on the basis of explicit standards to furnish a comprehensive set of health care services and financial incentives for enrollees to use the participating providers and procedures provided for in the plan; and
(4) “Nonparticipating provider” means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter
320 that has not entered into an agreement with an insurer to provide health care services.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 85, sec. 47, effective July 15, 2010. — Created
2008 Ky. Acts ch. 169, sec. 1, effective July 15, 2008.
Legislative Research Commission Note (1/1/2017). During codification of 2016 Ky.
Acts ch. 143, KRS § 304.17A-578 was repealed and reenacted as a new section of KRS Chapter 304.17A, which was given the number KRS § 304.17A-578. A conforming correction was required to be made to the language preceding subsection (1) of this statute to reflect removal of KRS § 304.17A-578 from the statutory range “KRS § 304.17A-575 to KRS § 304.17A-578″ and changing the reference to read “KRS
304.17A-575 to 304.17A-577.”
(1) “Applicant” means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter 320 applying for credentialing;
Terms Used In Kentucky Statutes 304.17A-575
- Insurer: means any insurance company. See Kentucky Statutes 304.17A-005
- Managed care: means systems or techniques generally used by third-party payors or their agents to affect access to and control payment for health care services and that integrate the financing and delivery of appropriate health care services to covered persons by arrangements with participating providers who are selected to participate on the basis of explicit standards for furnishing a comprehensive set of health care services and financial incentives for covered persons using the participating providers and procedures provided for in the plan. See Kentucky Statutes 304.17A-005
- Statute: A law passed by a legislature.
(2) “Enrollee” means a person who is eligible to receive health care services under a managed care plan;
(3) “Managed care plan” means a health benefit plan that integrates the financing and delivery of appropriate health care services to enrollees by arrangements with participating providers who are selected to participate on the basis of explicit standards to furnish a comprehensive set of health care services and financial incentives for enrollees to use the participating providers and procedures provided for in the plan; and
(4) “Nonparticipating provider” means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter
320 that has not entered into an agreement with an insurer to provide health care services.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 85, sec. 47, effective July 15, 2010. — Created
2008 Ky. Acts ch. 169, sec. 1, effective July 15, 2008.
Legislative Research Commission Note (1/1/2017). During codification of 2016 Ky.
Acts ch. 143, KRS § 304.17A-578 was repealed and reenacted as a new section of KRS Chapter 304.17A, which was given the number KRS § 304.17A-578. A conforming correction was required to be made to the language preceding subsection (1) of this statute to reflect removal of KRS § 304.17A-578 from the statutory range “KRS § 304.17A-575 to KRS § 304.17A-578″ and changing the reference to read “KRS
304.17A-575 to 304.17A-577.”