Changes Would Create Medical Director Position, Review UR Rules

The Kentucky Department of Workers’ Claims is holding a hearing in May on proposed rules that would create a medical director position within the agency to monitor the fee schedule, treatment guidelines and formulary, and adjudicate disputes over the appropriateness of medical services provided to injured workers and the accuracy of provider payments. Rules the department proposed would also re-evaluate the utilization review and medical bill audit processes. Under the proposed rules, an employee or provider could appeal an adverse UR decision to the newly created medical director...