The Department of Labor & Industries is seeking input from the public on draft rules for implementing portions of the workers’ comp medical network that will launch in 2013. Specifically, the rules cover injured workers’ visits to non-network providers — what L&I can pay for and who can decide to reopen a claim.
“After the network launches, injured workers can see a non-network provider only for an initial visit,” said Beth Dupre, Assistant Director for Insurance Services. “After that they must transfer to a network provider. Since providers outside our network cannot receive payment after the first treatment, we’re eager to find a way to make the transition to network providers as smooth as possible for everyone.”
The proposed rules were developed in consultation with a special advisory group made up of worker, employer, and provider representatives from the Industrial Insurance Medical and Chiropractic Advisory Committees.
To gather public comment on the proposed rules, one hearing will be held in Tumwater, on Feb. 23, 12 p.m., L&I Headquarters at 7273 Linderson Way SW.
Written comments on the draft rules will be accepted until 5 p.m., Feb. 23. Submit written comments to Jami Lifka at:
Later this month, L&I will begin enrolling providers who want to join the new network. During 2012, enrollment will be open to physicians, chiropractors, naturopathic physicians, podiatric doctors, advanced registered nurse practitioners, physician assistants, dentists, and optometrists who practice in Washington State. Other provider types and out-of-state providers can continue treating injured workers until they are invited to join the network at a later date.
The medical provider network is part of historic legislation passed in 2011, Substitute Senate Bill 5801, to improve workers’ outcomes following injury. In addition to creating the network, the legislation expands access to the state’s Centers of Occupational Health and Education (COHEs) and directs L&I to offer incentives to network providers who use best practices for occupational health.
Complete information and a copy of the proposed rules are available at the Provider Network and COHE Expansion website.