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312.200 Peer review committee -- Initiation of peer review -- Report of findings -Licensure of other persons performing peer review of chiropractic claims.
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The board shall appoint a peer review committee not to exceed five (5) doctors of
chiropractic licensed under this chapter, none of whom are in direct business
relationship with the provider, insurer, or patient whose case is being reviewed.
Members of the peer review committee shall serve at the pleasure of the board.
Peer review shall occur upon submission by a patient, the patient's representative,
insurer, or chiropractor, in accordance with the procedures and fees approved by the
board, of an inquiry about a treatment rendered to a patient by a chiropractor. The
peer review committee shall examine each inquiry submitted to it and shall report
its findings to the board and furnish copies of the findings to the patient,
chiropractor, and third-party payor. The findings of the peer review committee on
each inquiry reviewed may include a determination of whether or not the
chiropractor properly utilized services and rendered or ordered appropriate
treatment or services and whether or not the cost of the treatment was
unconscionable.
Other persons performing peer review of chiropractic claims shall be licensed by the
board and complete annually a board approved utilization review course, in addition
to the required annual education in KRS 312.175. Persons performing review
services under this subsection shall annually register with the board and pay a
registration fee not to exceed one hundred dollars ($100).
Effective: July 14, 1992
History: Amended 1992 Ky. Acts ch. 252, sec. 11, effective July 14, 1992. -- Created
1988 Ky. Acts ch. 426, sec. 2, effective July 15, 1988.
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