House Bill 478

Last Action posted in committee
Title AN ACT relating to insurance.
Bill Documents Bill
Bill Request Number 1561
Sponsor J. Gooch Jr.
Summary of Original Version 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.
Index Headings of Original Version Insurance, Motor Vehicle - No-fault, claims for medical expenses
Motor Vehicles - No-fault insurance, claims for medical expenses


  • introduced in House
  • to Banking & Insurance (H)
  • posted in committee

Last updated: 8/28/2019 8:09 AM (EDT)