Kentucky Revised Statutes · § 304.17A-660 — Definitions for KRS 304.17A-660 to 304.17A-669

As used in KRS 304.17A-660 to 304.17A-669, unless the context requires otherwise:

(1) "Classification of benefits" means the classification of benefits set forth in 45 C.F.R. sec. 146.136(c)(2)(ii)(A);

(2) "Mental health condition" means any condition or disorder that involves mental illness or substance use disorder as defined in KRS 222.005 and that falls under any of the diagnostic categories listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders or that is listed in the mental disorders section of the most recent version of the International Classification of Disease;

(3) "Nonquantitative treatment limitation" means any limitation that is not expressed numerically but otherwise limits the scope or duration of benefits for treatment;

(4) "Terms or conditions" includes day or visit limits, episodes of care, any lifetime or annual payment limits, deductibles, copayments, prescription coverage, coinsurance, out-of-pocket limits, and any other cost-sharing requirements; and

(5) "Treatment of a mental health condition" includes but is not limited to any necessary outpatient, inpatient, residential, partial hospitalization, day treatment, emergency detoxification, or crisis stabilization services.