Title 201 | Chapter 021 | Regulation 075
PREVIOUS VERSION
The previous document that this document is based upon is available.
201 KAR 21:075.Peer review committee procedures and fees.
Section 1.
Peer Review Committee.(1)
The board shall appoint a Peer Review committee of up to five (5) members. All members of the peer review committee may serve a three (3) year term.(a)
Each member of the Peer Review committee shall serve until their successor is appointed and qualified.(b)
Appointments to fill vacancies shall be for the unexpired term.(c)
Applicants for appointment to the Peer Review committee shall make application on the same form utilized by applicants for appointment to the board, except filed with the board and not the Governor's office, and shall include a cover letter stating that the application is for the Peer Review Committee.(2)
Members of the Peer Review committee shall be doctors of chiropractic of integrity and ability who at the time of their appointment have been actual residents of the Commonwealth of Kentucky for at least two (2) years next preceding their appointment, and have been engaged in the actual practice of chiropractic for at least five (5) years next preceding their appointment.(3)
Any member of the peer review committee shall not hold an elected position in any state organization or association relating to or consisting of licensees of this board or the practice of chiropractic.(4)
(a)
Beginning on March 1, 2021, the longest-serving member on the Peer Review committee shall be replaced by a member with a three (3) year appointment.(b)
In 2022, the next longest-serving member of the Peer Review committee shall be replaced by a member with a three (3) year appointment.(c)
In 2023, the next longest-serving member on the Peer Review committee shall be replaced by a member with a three (3) year appointment.(d)
In 2024, the next longest-serving member shall be replaced by a member with a three-year appointment.(e)
Thereafter, each appointee to the Peer Review committee shall be appointed to a three (3) year term.(f)
This subsection shall not prohibit any member of the peer review committee from serving consecutive terms.Section 2.
Procedures and Fees of Peer Review Committee.(1)
Peer review shall not take place until the patient has submitted a release permitting photocopies of the applicable treatment or billing records prepared by the chiropractor in the regular course of business.(a)
Treatment records shall not be released for peer review without the patient's authorization.(b)
The acceptance of, or the request for, payment by a chiropractor shall constitute the consent of the chiropractor to the submission of all necessary records and other information concerning the treatment or the cost to the peer review committee.(2)
(a)
Each claim shall be assigned to an individual member of the committee who shall review the submitted records and response from the charged party and report his findings to the full committee, which shall review the findings and either adopt those findings or modify them as determined by majority vote.(b)
A copy of the findings shall be forwarded to the board, the patient, the chiropractor, and insurer or other third party payor.(3)
(a)
The peer review committee shall elect a chair.(b)
The committee may recommend for the board's approval a contract with or employment of third parties to perform administrative functions or to aid in obtaining records necessary for appropriate review of claims.(c)
1.
The peer review committee shall recommend to the board that a complaint be filed against a chiropractor if it appears from the review of a claim that reasonable cause exists to believe that the chiropractor has violated any portion of KRS Chapter 312 or 201 KAR Chapter 21 for which a chiropractor may be disciplined.2.
The peer review committee shall transmit all complaint information the committee possesses to the board.(4)
(a)
A chiropractor, insurer, or other third party payor requesting review shall submit with the request a service fee of fifty (50) dollars payable to "B.C.E. Peer Review."(b)
An additional fee shall be charged for claims requiring more than one (1) hour of review by the committee calculated at fifty (50) dollars per hour, which sum shall be due prior to the delivery of committee findings to all parties.(c)
All fees shall be paid by the chiropractor, insurer, or other third party payor requesting the review.(5)
Each member of the peer review committee shall comply with the requirements and standards established in 201 KAR 21:095.Section 3.
Annual Report.(1)
An annual summary of the findings of the peer review committee shall be prepared by the committee and submitted to the board.(2)
The report shall be made available to interested persons upon request and upon payment of the cost of reproduction.(3)
A report or summary submitted to the public by the board shall not disclose the name or identity of any patient without the patient's consent.HISTORY: (16 Ky.R. 94; Am. 345; 535; eff. 10-8-1989; 40 Ky.R. 1417; 2123; eff. 3-20-2014; 47 Ky.R. 789, 1380; eff, 2-4-2021; 49 Ky.R. 1983; eff. 9-27-2023.)
DR. JAMES ENGLAND, Chair
APPROVED BY AGENCY: March 13, 2023
FILED WITH LRC: March 14, 2023 at 1:15 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on May 25, 2023 at 12:00 noon EST in Room 127CW, The Mayo-Underwood Building, 500 Mero Street, Frankfort, Kentucky 40601. All attendees shall comply with all Executive Orders relating to the State of Emergency as may be in effect on the date of the public hearing, which may be found at: https://governor.ky.gov/covid-19. Members of the public may utilize the following link to attend the meeting by video conference: Join from PC, Mac, Linux, iOS or Android: https://us06web.zoom.us/j/82428127008?pwd=blg4a3hSZVkvTnFtUnpMWDFaNkY5QT09 // Password: 059844 // Or Telephone: Dial: USA 713 353 0212; USA 8888227517 (US Toll Free) // Conference code: 446599. Individuals interested in attending this hearing shall notify this agency in writing by May 20, 2023, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until 11:59 pm on May 31, 2023. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Clayton Patrick, General Counsel, Department of Professional Licensing, 500 Mero Street 237 CW, phone (502) 782-0562 (office), fax (502) 564-4818, email Clayton.Patrick@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Clayton Patrick
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation establishes peer review committee procedures and fees.
(b) The necessity of this administrative regulation:
This administrative regulation is required by KRS 312.019.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation establishes peer review committee procedures and fees.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This regulation assists in the effective administration of KRS Chapter 312 by carrying out the legislative mandate for the board to establish regulations for the practice of chiropractic.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment will make a technical correction to conform to KRS 312.200 relating to the number of members who can be appointed to the peer review committee.
(b) The necessity of the amendment to this administrative regulation:
The amendment is necessary to make technical corrections to be consistent with KRS 312.200.
(c) How the amendment conforms to the content of the authorizing statutes:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation makes a technical correction regarding the peer review committee.
(d) How the amendment will assist in the effective administration of the statutes:
See 2(c) above.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This amendment to the administrative regulation will have no affect other than to make a technical correction to be consistent with KRS 312.200.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
No additional actions will be needed.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
No cost.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
There are no affected parties by the amendment.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
None. This administrative regulation does not create a cost for the administrative body
(b) On a continuing basis:
None. This administrative regulation does not create a cost for the administrative body
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Kentucky Board of Chiropractic Examiners is self-funded through the fees paid by licensees. No additional funding is necessary for the implementation and enforcement of this administrative regulation.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increases in fees or funding is necessary to implement the amendment to this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This regulation does not establish any fees.
(9) TIERING: Is tiering applied?
Tiering is not applicable because similarly situated licensees are treated similarly under this administrative regulation.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Board of Chiropractic Examiners.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 312.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This regulation will not generate revenue for state or local government. This regulation will not generate revenue for state or local government.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None.
(c) How much will it cost to administer this program for the first year?
There are no additional costs to administer this program.
(d) How much will it cost to administer this program for subsequent years?
There will be no additional cost to the agency.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None.
(c) How much will it cost the regulated entities for the first year?
There is no cost associated with this administrative regulation.
(d) How much will it cost the regulated entities for subsequent years?
There is no cost associate with this administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
None
Expenditures (+/-):
None
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)]. This administrative regulation will not have a major economic impact.
201 KAR 21:075.Peer review committee procedures and fees.
Section 1.
Peer Review Committee.(1)
The board shall appoint a Peer Review committee of up to five (5)(a)
Each member of the Peer Review committee shall serve until their successor is appointed and qualified.(b)
Appointments to fill vacancies shall be for the unexpired term.(c)
Applicants for appointment to the Peer Review committee shall make application on the same form utilized by applicants for appointment to the board, except filed with the board and not the Governor's office, and shall include a cover letter stating that the application is for the Peer Review Committee.(2)
Members of the Peer Review committee shall be doctors of chiropractic of integrity and ability who at the time of their appointment have been actual residents of the Commonwealth of Kentucky for at least two (2) years next preceding their appointment, and have been engaged in the actual practice of chiropractic for at least five (5) years next preceding their appointment.(3)
Any member of the peer review committee shall not hold an elected position in any state organization or association relating to or consisting of licensees of this board or the practice of chiropractic.(4)
(a)
Beginning on March 1, 2021, the longest-serving member on the Peer Review committee shall be replaced by a member with a three (3) year appointment.(b)
In 2022, the next longest-serving member of the Peer Review committee shall be replaced by a member with a three (3) year appointment.(c)
In 2023, the next longest-serving member on the Peer Review committee shall be replaced by a member with a three (3) year appointment.(d)
In 2024, the next longest-serving member shall be replaced by a member with a three-year appointment.(e)
Thereafter, each appointee to the Peer Review committee shall be appointed to a three (3) year term.(f)
This subsection shall not prohibit any member of the peer review committee from serving consecutive terms.Section 2.
Procedures and Fees of Peer Review Committee.(1)
Peer review shall not take place until the patient has submitted a release permitting photocopies of the applicable treatment or billing records prepared by the chiropractor in the regular course of business.(a)
Treatment records shall not be released for peer review without the patient's authorization.(b)
The acceptance of, or the request for, payment by a chiropractor shall constitute the consent of the chiropractor to the submission of all necessary records and other information concerning the treatment or the cost to the peer review committee.(2)
(a)
Each claim shall be assigned to an individual member of the committee who shall review the submitted records and response from the charged party and report his findings to the full committee, which shall review the findings and either adopt those findings or modify them as determined by majority vote.(b)
A copy of the findings shall be forwarded to the board, the patient, the chiropractor, and insurer or other third party payor.(3)
(a)
The peer review committee shall elect a chair.(b)
The committee may recommend for the board's approval a contract with or employment of third parties to perform administrative functions or to aid in obtaining records necessary for appropriate review of claims.(c)
1.
The peer review committee shall recommend to the board that a complaint be filed against a chiropractor if it appears from the review of a claim that reasonable cause exists to believe that the chiropractor has violated any portion of KRS Chapter 312 or 201 KAR Chapter 21 for which a chiropractor may be disciplined.2.
The peer review committee shall transmit all complaint information the committee possesses to the board.(4)
(a)
A chiropractor, insurer, or other third party payor requesting review shall submit with the request a service fee of fifty (50) dollars payable to "B.C.E. Peer Review."(b)
An additional fee shall be charged for claims requiring more than one (1) hour of review by the committee calculated at fifty (50) dollars per hour, which sum shall be due prior to the delivery of committee findings to all parties.(c)
All fees shall be paid by the chiropractor, insurer, or other third party payor requesting the review.(5)
Each member of the peer review committee shall comply with the requirements and standards established in 201 KAR 21:095.Section 3.
Annual Report.(1)
An annual summary of the findings of the peer review committee shall be prepared by the committee and submitted to the board.(2)
The report shall be made available to interested persons upon request and upon payment of the cost of reproduction.(3)
A report or summary submitted to the public by the board shall not disclose the name or identity of any patient without the patient's consent.HISTORY: (16 Ky.R. 94; Am. 345; 535; eff. 10-8-1989; 40 Ky.R. 1417; 2123; eff. 3-20-2014; 47 Ky.R. 789, 1380; eff, 2-4-2021; 49 Ky.R. 1983; eff. 9-27-2023.)
DR. JAMES ENGLAND, Chair
APPROVED BY AGENCY: March 13, 2023
FILED WITH LRC: March 14, 2023 at 1:15 p.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on May 25, 2023 at 12:00 noon EST in Room 127CW, The Mayo-Underwood Building, 500 Mero Street, Frankfort, Kentucky 40601. All attendees shall comply with all Executive Orders relating to the State of Emergency as may be in effect on the date of the public hearing, which may be found at: https://governor.ky.gov/covid-19. Members of the public may utilize the following link to attend the meeting by video conference: Join from PC, Mac, Linux, iOS or Android: https://us06web.zoom.us/j/82428127008?pwd=blg4a3hSZVkvTnFtUnpMWDFaNkY5QT09 // Password: 059844 // Or Telephone: Dial: USA 713 353 0212; USA 8888227517 (US Toll Free) // Conference code: 446599. Individuals interested in attending this hearing shall notify this agency in writing by May 20, 2023, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who attends will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on this proposed administrative regulation until 11:59 pm on May 31, 2023. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to the contact person. Pursuant to KRS 13A.280(8), copies of the statement of consideration and, if applicable, the amended after comments version of the administrative regulation shall be made available upon request.
CONTACT PERSON: Clayton Patrick, General Counsel, Department of Professional Licensing, 500 Mero Street 237 CW, phone (502) 782-0562 (office), fax (502) 564-4818, email Clayton.Patrick@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Clayton Patrick
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation establishes peer review committee procedures and fees.
(b) The necessity of this administrative regulation:
This administrative regulation is required by KRS 312.019.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation establishes peer review committee procedures and fees.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This regulation assists in the effective administration of KRS Chapter 312 by carrying out the legislative mandate for the board to establish regulations for the practice of chiropractic.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment will make a technical correction to conform to KRS 312.200 relating to the number of members who can be appointed to the peer review committee.
(b) The necessity of the amendment to this administrative regulation:
The amendment is necessary to make technical corrections to be consistent with KRS 312.200.
(c) How the amendment conforms to the content of the authorizing statutes:
KRS 312.019(9) authorizes the Kentucky Board of Chiropractic Examiners to promulgate administrative regulations consistent with KRS Chapter 312, regulating the practice of chiropractic. This administrative regulation makes a technical correction regarding the peer review committee.
(d) How the amendment will assist in the effective administration of the statutes:
See 2(c) above.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This amendment to the administrative regulation will have no affect other than to make a technical correction to be consistent with KRS 312.200.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
No additional actions will be needed.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
No cost.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
There are no affected parties by the amendment.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
None. This administrative regulation does not create a cost for the administrative body
(b) On a continuing basis:
None. This administrative regulation does not create a cost for the administrative body
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
The Kentucky Board of Chiropractic Examiners is self-funded through the fees paid by licensees. No additional funding is necessary for the implementation and enforcement of this administrative regulation.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increases in fees or funding is necessary to implement the amendment to this administrative regulation.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This regulation does not establish any fees.
(9) TIERING: Is tiering applied?
Tiering is not applicable because similarly situated licensees are treated similarly under this administrative regulation.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Board of Chiropractic Examiners.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 312.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This regulation will not generate revenue for state or local government. This regulation will not generate revenue for state or local government.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None.
(c) How much will it cost to administer this program for the first year?
There are no additional costs to administer this program.
(d) How much will it cost to administer this program for subsequent years?
There will be no additional cost to the agency.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None.
(c) How much will it cost the regulated entities for the first year?
There is no cost associated with this administrative regulation.
(d) How much will it cost the regulated entities for subsequent years?
There is no cost associate with this administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
None
Expenditures (+/-):
None
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)]. This administrative regulation will not have a major economic impact.