Medical services and supplies — Liability of employer — Definition

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  1. (a)

    1. (1) The employer shall promptly provide for an injured employee such medical, surgical, hospital, chiropractic, optometric, podiatric, and nursing services and medicine, crutches, ambulatory devices, artificial limbs, eyeglasses, contact lenses, hearing aids, and other apparatus as may be reasonably necessary in connection with the injury received by the employee.

    2. (2)

      1. (A) Rabies is a highly contagious and potentially deadly infectious disease, and exposure to rabies and the risk of infection is the direct result of an injury caused by the bite of a rabies-infected animal under this section.

      2. (B)

        1. (i) An employer shall promptly provide reasonably necessary medical treatment to an injured employee who is exposed to rabies as described in subdivision (a)(2)(A) of this section.

        2. (ii) As used in subdivision (a)(2)(B)(i) of this section, “reasonably necessary medical treatment” means without limitation any diagnostic and preventive measures prescribed for detection, diagnosis, and prevention of rabies.

  2. (b) If the employer fails to provide the medical services set out in subsection (a) of this section within a reasonable time after knowledge of the injury, the Workers' Compensation Commission may direct that the injured employee obtain the medical service at the expense of the employer, and any emergency treatment afforded the injured employee shall be at the expense of the employer. In no circumstance may an employee, his or her family, or dependents, be billed or charged for any portion of the cost of providing the benefits to which he or she is entitled under this chapter.

  3. (c) In order to help control the cost of medical benefits, the commission, on or before July 1, 1994, following a public hearing and with the assistance and cooperation of the State Insurance Department, is authorized and directed to establish appropriate rules to establish and implement a system of managed health care for the State of Arkansas.

  4. (d) For the purpose of establishing and implementing a system of managed health care, the commission is authorized to:

    1. (1) Develop rules for the certification of managed care entities to provide managed care to injured workers;

    2. (2) Develop rules for peer review, service utilization, and resolution of medical disputes;

    3. (3) Prohibit “balance billing” from the employee, employer, or carrier;

    4. (4)

      1. (A) Establish fees for medical services as provided in Workers' Compensation Commission Rule 30 and its amendments.

      2. (B) The commission shall make no distinction in approving fees from different classes of medical service providers or healthcare providers for provision of the same or essentially similar medical services or healthcare services as specified in this section; and

    5. (5)

      1. (A) Give the employer the right to choose the initial treating physician, with the injured employee having the right to petition the commission for a one-time-only change of physician to one who is associated with a managed care entity certified by the commission or is the regular treating physician of the employee who maintains the employee's medical records and with whom the employee has a bona fide doctor-patient relationship demonstrated by a history of regular treatment prior to the onset of the compensable injury, but only if the primary care physician agrees to refer the employee to a certified managed care entity for any specialized treatment, including physical therapy, and only if such primary care physician agrees to comply with all the rules, terms, and conditions regarding services performed by the managed care entity initially chosen by the employer.

      2. (B) A petition for change of physician shall be expedited by the commission.

  5. (e) Any section or subsection of this chapter notwithstanding, the injured employee shall have direct access to any optometric or ophthalmologic medical service provider who agrees to provide services under the rules, terms, and conditions regarding services performed by the managed care entity initially chosen by the employer for the treatment and management of eye injuries or conditions. Such optometric or ophthalmologic medical service provider shall be considered a certified provider by the commission.

  6. (f) The commission is authorized to promulgate any other rules as may be necessary to carry out the provisions of this section and its purpose of controlling medical costs through the establishment of a managed care system.


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