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AN ACT relating to healthcare charges. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
ď˘Section 1. KRS 216B.250 is amended to read as follows: 3
(1) [For purposes of this section, "paying patient" means persons receiving health care 4
services who pay directly for services rendered, patients with private health 5
insurance or health maintenance organization coverage, persons receiving Medicaid 6
or Medicaid benefits under Title XVIII and Title XIX of the Social Security Act and 7
persons receiving veteran's health care benefits. "Paying patient" does not include 8
medically indigent persons with no source of payment whatsoever. 9
(2)] (a) On or after January 1, 2023[When a copy of an itemized statement is 10
requested by any paying patient], each health facility shall furnish to the 11
patient within thirty (30) days of the patient's discharge or within seven 12
(7)[fifteen (15)] days of the patient's request, whichever is sooner[later], a 13
consolidated[one (1) copy free of charge of the] itemized statement detailing, 14
in plain language that is comprehensible to an ordinary layperson, the 15
specific nature of the charges or expenses for health care services received 16
by the patient at the health facility[of services rendered and charges incurred 17
by the patient]. 18
(b) The itemized statement required under paragraph (a) of this subsection: 19
1. May include technical terms in its description of billed charges to 20
describe the health care services if the technical terms are defined 21
using limited medical nomenclature as permitted under the 22
administrative regulations adopted pursuant to subsection (6) of this 23
section; and 24
2. Shall: 25
a. Not describe a billed charge using only medical billing codes or 26
general terms, including miscellaneous charges, supply charges, 27 UNOFFICIAL COPY 22 RS BR 1109
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or other charges; 1
b. List the specific health care services received, and expenses 2
incurred, by date and provider, enumerating in detail the 3
constituent components of the health care services received 4
within each department of the health facility and include unit 5
price data on rates charged by the health facility; 6
c. Identify each item as paid, assigned to a third-party payor, or 7
chargeable directly to the patient, and include the amount due 8
and the due date for any amount expected from the patient; 9
d. Not refer to drug code numbers without also including the 10
appropriate brand or generic name for each drug; 11
e. Include the health care services provided by any hospital-based 12
physicians and other health care providers who may not bill 13
separately; 14
f. Specifically identify physical, rehabilitative, occupational, or 15
speech therapy treatment by date, type, and length of treatment; 16
g. Conspicuously display the telephone number of the health 17
facility's patient liaison responsible for expediting the resolution 18
of any billing dispute between the patient, or the patient's 19
survivor or legal guardian under subsection (4) of this section; 20
and[A summary statement of services rendered and charges 21
incurred by the patient shall be included with the invoice sent by a 22
health facility to the patient. Each invoice shall indicate that an 23
itemized statement may be obtained upon request. The Cabinet for 24
Human Resources shall impose a civil fine of five hundred dollars 25
($500) for each violation by a health care facility for failure to 26
provide an itemized statement as required under this section.] 27 UNOFFICIAL COPY 22 RS BR 1109
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h. [(c) The itemized statement Shall] Be stamped "Kentucky 1
Revised Statutes prohibit the use of this statement for insurance 2
payment purposes where benefits have been assigned." 3
(c) After delivery of the itemized statement required under paragraph (a) of this 4
subsection, any subsequent statement provided to a patient, or to the 5
patient's survivor or legal guardian as appropriate, relating to the same 6
episode of care shall include all of the information required by paragraph 7
(b) of this subsection with any revisions clearly delineated. 8
(d) A health facility shall: 9
1. Not bill or otherwise charge a patient for the preparation of any 10
itemized statement required under this section; and 11
2. Transmit the itemized statement via secure e-mail, a secure online 12
portal, or upon request, by mail. 13
(2)[(3)] Each health facility shall post in a publicly visible place in their admission, 14
outpatient areas and, where applicable, emergency areas that a consolidated[an] 15
itemized statement is required to be provided under state law within the sooner of 16
the following: 17
(a) Thirty (30) days after the patient's discharge; or 18
(b) Seven (7) days after the health facility receives a written request[available to 19
any paying patient upon request]. 20
(3)[(4)] The itemized statement or statements rendered under subsection (2) of this 21
section shall be the record maintained by the health facility that details the charges 22
made for services rendered to patients and shall indicate whether an assignment of 23
benefits has been obtained. 24
(4)[(5)] Each health facility shall: 25
(a) Establish policies and procedures for reviewing and responding to questions 26
from a patient concerning the patient's itemized statement; and 27 UNOFFICIAL COPY 22 RS BR 1109
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(b) Designate and make available appropriate staff to provide a response to 1
questions from the patient concerning the patient's[, upon patient request, an 2
explanation of charges listed in the] itemized statement no later than seven 3
(7) days after the date the question was received. 4
(5)[(6)] If a health facility knows of a discrepancy in the total charges as reported in an 5
itemized statement and that which is reported to a third party payor, or at any time 6
that a health facility becomes aware of such a discrepancy, the health facility shall 7
provide the patient and third party payor with notification, an explanation, and[,] if 8
applicable, any reconciliation of the discrepancy in total charges. 9
(6) (a) The cabinet, in consultation with the commissioner of insurance, shall 10
promulgate administrative regulations establishing the requirements for 11
health facilities to develop and provide plain-language consolidated 12
itemized statements in accordance with this section. 13
(b) The administrative regulations promulgated pursuant to this subsection 14
shall, at a minimum, establish: 15
1. The required contents of the statements, which shall include the 16
patient's rights and payment obligations under the patient's health 17
insurance plan; and 18
2. Disclosure requirements specific to health facilities, including the 19
terms used to differentiate in-network and out-of-network services and 20
health care providers. 21
(7) The cabinet shall impose a civil fine of five hundred dollars ($500) for each 22
violation by a health care facility for failure to provide an itemized statement as 23
required under this section. 24