Pennsylvania Code
Title 34 - LABOR AND INDUSTRY
Part VIII - Bureau of Workers' Compensation
Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT
Subchapter C - MEDICAL TREATMENT REVIEW
UR-GENERAL REQUIREMENTS
Section 127.401 - Purpose/review of medical treatment
Current through Register Vol. 54, No. 38, September 21, 2024
(a) Section 306(f.1)(6) of the act (77 P. S. § 531(6)) provides a UR process, intended as an impartial review of the reasonableness or necessity of medical treatment rendered to, or proposed for, work-related injuries and illnesses.
(b) UR of medical treatment shall be conducted only by those organizations authorized as UROs by the Secretary, under the process in §§ 127.651-127.670 (relating to authorization of UROs and PROs).
(c) UR may be requested by or on behalf of the employer, insurer or employe.
(d) A party, including a health care provider, aggrieved by the UR determination, may file a petition for review of UR, to be heard and decided by a workers' compensation judge.
This section cited in 34 Pa. Code § 127.404 (relating to prospective, concurrent and retrospective review).