312.200 Peer review committee -- Initiation of peer review -- Report of findings --

238 words·~1 min read·/ky/312-200

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Licensure of other persons performing peer review of chiropractic claims.

(1)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.

(2)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.

(3)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).