Section 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) 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. Effective:7/15/2010
Amended 2010, Ky. Acts ch. 24, sec. 1844, effective7/15/2010. --Amended 2000, Ky. Acts ch. 514, sec. 32, effective 7/14/2000. -- Amended 1996, (1st Extra. Sess.) Ky. Acts ch. 1, sec. 67, effective 12/12/1996. -- Amended 1994 Ky. Acts ch. 181, Part 5, sec. 21, effective 4/4/1994. -- Created 1980 Ky. Acts ch. 104, sec. 17, effective 7/15/1980.