HB 478 (BR 1561) - J. Gooch Jr.
AN ACT relating to insurance.
Amend KRS 304.39-020 to provide under the definition of "medical expense" when a medical bill shall not be presumed reasonable; define "emergency care"; amend KRS 304.39-210 to require medical expense benefits for providers of emergency care to be paid by the reparation obligor directly to persons supplying products, services, or accommodations to the claimant; provide that basic reparations benefits be paid without regard to fault and be primary except for benefits payable under a workers' compensation law; require a provider of services for medical expenses, other than medical expenses billed by a hospital or other provider for emergency care or inpatient services rendered at a hospital, to submit claims to a reparation obligor within 45 days from the date the services are provided; amend KRS 304.39-241 to provide exception for emergency care services where the reparation obligor pays the provider directly; amend KRS 304.39-270 to permit a reparation obligor to require a person to submit to a mental or physical examination by a health care provider licensed in Kentucky; require the reparation obligor to pay for the costs of the examination; create new sections of Subtitle 39 of KRS Chapter 304 to permit a reparation obligor to submit a claim for an independent review of reparation benefits to determine if the medical expenses furnished to a reparation insured are medically necessary or reasonable; permit a reparation obligor to contract with a private review agent to perform independent reviews of medical expenses; restrict disclosure of medical records or other confidential medical information; require written notice of decisions to the reparation insureds and providers; define "adverse determination"; require every reparation obligor to have an appeals process to be utilized by the reparation obligor; permit the appeals process to be initiated by the reparation insured or a provider acting on the insured's behalf.
Feb 6-introduced in House
Feb 7-to Banking & Insurance (H)
Feb 27-posted in committee
