Opinion ID: 6340590
Heading Depth: 1
Heading Rank: 4

Heading: conclusion

Text: We need not precisely construe the term usual and customary or decide any preemption question without first having the Board's administrative fact-finding about EagleMed's billed charges and its application of the facts to the 2012 fee schedule. But we do hold the 2012 fee schedule requires billings for air ambulance services to be supportable by evidence that the charges are usual and customary. The Board's decision requiring Travelers to pay the billed amounts must be reversed because the decision is not 20 supported by substantial competent evidence in light of the record as a whole. See K.S.A. 77-621(c)(7), (d); Estate of Graber v. Dillon Companies, 309 Kan. 509, 513, 439 P.3d 291 (2019); Pener v. King, 305 Kan. 1199, 1205, 391 P.3d 27 (2017). The evidentiary record contains nothing showing these charges meet any permutation of the usual and customary standard. On remand, it will be necessary for the Board to provide guidance to the parties as to the evidence expected for the Board to make its determinations. In other words, the Board will need to tell the parties whether defining usual and customary charges can be done only as EagleMed suggests through the air carrier's sole perspective, or whether there is an alternative that better reflects both federal law and the statutory purposes for our workers compensation system. Judgment of the Court of Appeals is affirmed in part and reversed in part. Decision of the Workers Compensation Board is reversed, and the case is remanded with directions. WALL AND STANDRIDGE, JJ., not participating. PATRICK D. MCANANY, Senior Judge, assigned.1 MICHAEL J. MALONE, District Judge Retired, assigned.2 1 REPORTER'S NOTE: Senior Judge McAnany was appointed to hear case No. 117,903 vice Justice Wall under the authority vested in the Supreme Court by K.S.A. 20- 2616. 2 REPORTER'S NOTE: Retired District Judge Malone was appointed to hear case No. 117,903 vice Justice Standridge under the authority vested in the Supreme Court by K.S.A. 20-2616. 21