342.735 Additional authority for administrative regulations on expediting payment

284 words·~1 min read·/ky/342-735

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

of temporary total disability benefits, use of managed care, and expediting

payment for and resolution of disputes concerning medical benefits.

(1)The commissioner shall promulgate administrative regulations to expedite the

payment of temporary total disability and medical expense benefits.

(2)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.

(3)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.