2014 Kentucky Revised Statutes CHAPTER 342 - WORKERS' COMPENSATION 342.735 Additional authority for administrative regulations on expediting payment of temporary total disability benefits, use of managed care, and expediting payment for and resolution of disputes concerning medical benefits.
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342.735 Additional authority for administrative regulations on expediting
payment of temporary total disability benefits, use of managed care, and
expediting payment for and resolution of disputes concerning medical
benefits.
(1)
(2)
(3)
The commissioner shall promulgate administrative regulations to expedite the
payment of temporary total disability and medical expense benefits.
The commissioner may promulgate administrative regulations incorporating
managed care intended to reduce costs or to speed the delivery or payment of
medical services to employees receiving medical and related benefits under
this chapter.
The commissioner shall promulgate administrative regulations pursuant to KRS
Chapter 13A establishing an expedited method for resolving medical issues
prior to the filing of a claim with the Department of Workers' Claims. The
administrative regulations shall permit an employee or other interested party,
prior to the filing of a claim, to request a determination by an administrative law
judge on medical issues relating to the reasonableness or appropriateness of
the proposed medical care or relating to the obligation of the employer or the
employer's insurance carrier to make payment of contested medical bills.
However, the employee has the burden of proof to show the medical expenses
are related to the injury, reasonable and necessary prior to an application of
benefits being filed and before an award or order of benefits. Thereafter, the
burden is upon the employer. The respondent to the moving party shall be
given ten (10) days to answer a request for an expedited determination of
medical issues, and the administrative law judge shall issue a ruling within
seven (7) days thereafter. The interested parties shall be provided a form to
provide to the medical care provider and the completed form filed with the
department and served upon the respondent shall initiate the time for response
and determination.
Effective:July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1844, effective July 15, 2010. -Amended 2000 Ky. Acts ch. 514, sec. 32, effective July 14, 2000. -- Amended
1996 (1st Extra. Sess.) Ky. Acts ch. 1, sec. 67, effective December 12, 1996. -Amended 1994 Ky. Acts ch. 181, Part 5, sec. 21, effective April 4, 1994. -Created 1980 Ky. Acts ch. 104, sec. 17, effective July 15, 1980.
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