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205.623 Information on claims paid for insurance policyholders and dependents -- Use of data -- Confidentiality of information -- Prohibited fees.

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Page 1 of 1 205.623 Information on claims paid for insurance policyholders and dependents -- Use of data -- Confidentiality of information -- Prohibited fees. (1) All health insurers and administrators as defined under KRS Chapter 304 shall provide upon request to the Department for Medicaid Services, by electronic means <br>and in the format prescribed by the department, policy and coverage information <br>and claims paid data on Medicaid-eligible policyholders and dependents. Any <br>request from the department shall include a list of data elements that shall be <br>included on the electronic file from the insurer or administrator. (2) All health insurers and administrators as defined under KRS Chapter 304 shall provide upon request to the department, by electronic means and in the format <br>prescribed by the department, identifying information on all policyholders and <br>dependents to match with the Medicaid management information system to <br>determine which policyholders and dependents also participate in the Kentucky <br>Medical Assistance Program. The identifying information shall include the name, <br>address, date of birth, and Social Security number as these items appear in the <br>companies' files and as the department may require. (3) No health insurer or administrator shall be required to provide information under this section if doing so would violate any provision of federal law. (4) All information obtained by the department pursuant to this section shall be confidential and shall not be open for public inspection. (5) The department shall not be charged a fee by a third party for information requested under this section, nor shall the department be charged a fee by a third party for the <br>processing and adjudication of the department's claim for recovery, reclamation, or <br>validation of eligibility. Effective: July 15, 2008 <br>History: Amended 2008 Ky. Acts ch. 71, sec. 5, effective July 15, 2008. -- Amended 2005 Ky. Acts ch. 99, sec. 246, effective June 20, 2005. -- Amended 1998 Ky. Acts <br>ch. 426, sec. 204, effective July 15, 1998. -- Amended 1996 Ky. Acts ch. 353, sec. 5, <br>effective July 15, 1996. -- Created 1994 Ky. Acts ch. 506, sec. 5, effective July 15, <br>1994.