Regulatory Compliance
Kentucky
CorVel has provided workers’ compensation management services to Kentucky employers for more than 30 years. Our approach is that all injured workers need quality healthcare and compassionate guidance from someone who is familiar with their case. CorVel provides personalized attention, along with the expertise needed to help speed return to work, while ensuring patients understand and follow treatment plans and get their questions answered quickly. All so that recovery can continue and life can get back on track.
Our comprehensive return to work program ensures collaboration and communication with all interested parties including the injured worker, employer, human resources, medical and safety teams, and healthcare providers. We use technology, compassionate case management for employees and cost containment measures, to give Kentucky employers a superior program.
Kentucky Regulatory Updates 4/11/2024
SB 367 – An Act Relating to Health Care to Provide For an All-Payer Claims Database and Making an Appropriation Therefor.
Issues: Workers’ Compensation (General)
Summary For 02/29/2024
This measure establishes an all-payer claims database.
It requires healthcare payers to provide healthcare claim data to the database within 3 months of it becoming operational. It includes the following entities in the definition of healthcare payers: Medicare, Medicaid, CHIP, workers’ compensation insurers and self-insurers/self insured groups, healthcare insurers and self-insurers/self insured groups, including employer organized associations, HMOs, limited health service organizations, nonprofit hospitals, medical-surgical, dental and health service corporations, administrators, pharmacy benefit managers, and other third parties not exempt under federal law. It allows assessment of civil penalties for violations of this requirement.
It requires submission of claims data on medical and hospital claims, including surgical, mental heal and substance use disorder, as well as rehabilitative services. It also requires submission of dental and pharmacy claims, and anything else designated under administrative regulation. It specifically excludes claims for primary care services.
It affords the database basic administrative considerations, including hiring an executive director and staff, appointing an advisory committee, and the ability to contract with entities, including other state’s APCDs. It requires compliance with HIPAA and other federal laws, and does not require individual consent to provide data to the database. It allows sharing data with payers, consumers, providers and state agencies in a manner that protects the privacy and security of health information. It forbids sale or commercial use of the data, as well as attempts to reidentify individuals using the data.
It requires federal waiver application within 90 days of taking effect, if determined to be necessary.
Most Recent Update:
03/01/2024 This measure has been referred to the Senate Appropriations & Revenue Committee. This measure awaits consideration in the committee.
Kentucky MCO
The Kentucky regulation 803KAR 25:110E (effective July 14, 1994) requires that all Managed Care Organizations (MCO) must be certified by the Director of Workers’ Compensation and recertified every two years.
We are here to help.
CorVel has been a certified Managed Care Organization (MCO) in Kentucky since 1995. Our provider management is compliant with Kentucky requirements that include grievance procedures, 24-hour toll free number, access to an after-hours clinic, and round the clock access to emergency care.
Learn more about CorVel’s comprehensive suite of workers’ compensation solutions, or you can contact a local representative for additional information.
Kentucky Services
- Directed channeling to top quality providers
- State-approved utilization management program
- Workers’ compensation claims administration and medical bill review
Kentucky Resources
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