KANSAS INSURANCE DEPARTMENT

Proposed Revisions to K.A.R. 40-4-41e

 

 

K.A.R. 40-4-41e. Utilization review organizations; staff requirements. Each utilization review organization shall have utilization review staff who are properly trained, qualified, supervised, and supported by written, clinically substantiated criteria and review procedures. (a)(1) For data collection, intake screening, and scripted clinical screening, the use of nonclinical administrative staff shall be limited to the following:

(A)       The performance of “review of service requirements requests” for completeness;

(B)       the collection and transfer of nonclinical data;

(C)       the acquisition of structured clinical data; and

(D)       any scripted clinical screening that does not require evaluation or interpretation of clinical information.

(2)    Nonclinical administrative staff performing the functions listed in paragraph paragraphs (a)(1)(A) through (D) shall meet the following conditions:

(A)        Be qualified and trained to perform “review of service requests”;

(B)        be supported by explicit instructions and scripts;

(C)      be trained in the principles and procedures of the collection and transfer of nonclinical data, the acquisition of structured clinical data, scripted clinical screening, and the maintenance of confidentiality of patient-specific information;

(D)        through an established process, promptly transfer a telephone call for review of services to an initial clinical reviewer if the review cannot be completed based on a formal script; and

(E)         be monitored by a licensed health professional while performing an administrative review.

(b)    The utilization review organization, when conducting an initial clinical review, shall perform the following:

(1)         Refer review of services that do not meet initial review criteria to peer clinical review;

(2)          restrict the performance of the initial clinical review to individuals who meet both of the following requirements:

(A)        Are health professionals; and

(B)        possess a current and valid professional license or certificate in the state or states in which they work. If the state in which they work does not require professional licensure, each of the individuals shall possess a current and valid professional license or certificate in another state or shall be certified by the national accrediting body appropriate to each individual's profession;

(3)         require initial clinical reviewers to be trained in the principles and procedures of utilization review; and

(4)         require initial clinical reviewers to be supported by a doctor of osteopathic medicine or a clinical director who has an unrestricted license to practice medicine.

(c)(1) The utilization review organization shall conduct peer clinical reviews for all cases in which a clinical determination to certify cannot be made by initial clinical review. Peer clinical reviews shall be conducted by health professionals who meet the following criteria:

(A)        Directly support the utilization review activity;

(B)        are oriented in the principles and procedures of utilization management and peer review;

(C)        are qualified to render a clinical opinion about the medical condition, procedures, and treatment under review; and

(D)       meet one of the following criteria:

(i)           Hold a current, unrestricted license in the same licensure category as that of the attending health care provider or other ordering provider; or

(ii)         for standard appeals, are in active practice.

(2)    The utilization review organization shall have a medical director or clinical director with professional postresidency experience in direct patient care who meets one of the following criteria:

(A)        Holds an unrestricted license to practice medicine; or

(B)        has a clinical specialty appropriate to the type of single service utilization management conducted. (Authorized by K.S.A. 40-103, and K.S.A. 1999 Supp. 40-22a04, and 40-22a11; implementing K.S.A. 1999 Supp. 40-22a04 and 40-22a11; effective, T-40-4-26-95, April 26, 1995; effective June 12, 1995; amended June 22, 2001; amended P-__________________.)