Fourth Quarter 2020
By: Randy Schroer
In a compensable Kansas workers compensation claim, can a medical provider seek reimbursement from an employee?
No, in Kansas a medical provider cannot seek reimbursement from an employee in a workers’ compensation claim pursuant to KSA 44-510j(h) which expressly prohibits collection actions against a claimant during the pendency of the claim. There are procedures by which the medical providers can seek payment from the employee or employer which will be explored in the next newsletter.
In Kansas, KSA 44-510j(h) prohibits the medical provider from seeking reimbursement from the claimant until the claim is concluded. Specifically, the statute states:
No action shall be filed in any court by a health care provider or other provider of services under this act for the payment of an amount for medical services or materials provided under the workers compensation act and no other action to obtain or attempt to obtain or collect such payment shall be taken by a health care provider or other provider of services under this act, including employing any collection service, until after final adjudication of any claim for compensation for which an application for hearing is filed with the director under K.S.A. 44-534, and amendments thereto. In the case of any such action filed in a court prior to the date an application is filed under KSA. 44-534, and amendments thereto, no judgment may be entered in any such cause and the action shall be stayed until after the final adjudication of the claim. In the case of an action stayed hereunder, any award of compensation shall require any amounts payable for medical services or materials to be paid directly to the provider thereof plus an amount of interest at the rate provided by statute for judgments. No period of time under any statute of limitation, which applies to a cause of action barred under this subsection, shall commence or continue to run until final adjudication of the claim under the workers compensation act.
An Application for Hearing (renamed Application for Benefits) is the formal claim form filed by the employee with the Division of Workers’ Compensation. Final adjudication would be by Award following a final hearing or settlement approved by the Division. Providers have the alternative of pursuing a medical fee dispute claim directly against the employer or insurer under the procedures outlined in KSA 44-510j(a) through (g) and which will be discussed in more detail in the next newsletter.
In Kansas, we recommend that all valid and authorized medical bills be processed and paid according to the Kansas Fee Schedule with any disputed bills for unauthorized treatment held until conclusion of the claim for adjudication of liability.