Kentucky Statutes 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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(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).
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.
(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.
Terms Used In Kentucky Statutes 312.200
- Board: means the Kentucky State Board of Chiropractic Examiners. See Kentucky Statutes 312.015
- chiropractic: means the science of diagnosing and adjusting or manipulating the subluxations of the articulations of the human spine and its adjacent tissues. See Kentucky Statutes 312.015
- chiropractor: means one qualified by experience and training and licensed by the board to diagnose his patients and to treat those of his patients diagnosed as having diseases or disorders relating to subluxations of the articulations of the human spine and its adjacent tissues by indicated adjustment or manipulation of those subluxations and by applying methods of treatment designed to augment those adjustments or manipulation. See Kentucky Statutes 312.015
- Peer review: means an evaluation, based upon generally accepted standards, by a peer review committee established in KRS §. See Kentucky Statutes 312.015
- Treatment: when used in a criminal justice context, means targeted interventions
that focus on criminal risk factors in order to reduce the likelihood of criminal behavior. See Kentucky Statutes 446.010
(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).
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.