Current through Register Vol. 54, No. 38, September 21, 2024
(a) If a list of designated providers is
established, the employer shall provide a clearly written notice to an injured
employe of the employe's rights and duties under section 306(f.1)(1)(i) of the
act (77 P. S. §
531(1)(i)).
(b) The contents of the written notice shall,
at a minimum, contain the following conditions:
(1) The employe has the duty to obtain
treatment for work-related injuries and illnesses from one or more of the
designated health care providers for 90 days from the date of the first visit
to a designated provider.
(2) The
employe has the right to have all reasonable medical supplies and treatment
related to the injury paid for by the employer as long as treatment is obtained
from a designated provider during the 90-day period.
(3) The employe has the right, during this
90-day period, to switch from one health care provider on the list to another
provider on the list, and that all the treatment shall be paid for by the
employer.
(4) The employe has the
right to seek treatment from a referral provider if the employe is referred to
him by a designated provider, and the employer shall pay for the treatment
rendered by the referral provider.
(5) The employe has the right to seek
emergency medical treatment from any provider, but that subsequent nonemergency
treatment shall be by a designated provider for the remainder of the 90-day
period.
(6) The employee has the
right to seek treatment or medical consultation from a nondesignated provider
during the 90-day period, but that these services shall be at the employee's
expense for the applicable 90 days.
(7) The employee has the right to seek
treatment from any health care provider after the 90-day period has ended, and
that treatment shall be paid for by the employer, if it is reasonable and
necessary.
(8) The employee has the
duty to notify the employer of treatment by a nondesignated provider within 5
days of the first visit to that provider. The employer may not be required to
pay for treatment rendered by a nondesignated provider prior to receiving this
notification. However, the employer shall pay for these services once notified,
unless the treatment is found to be unreasonable by a URO, under Subchapter C
(relating to medical treatment review).
(9) The employee has the right to seek an
additional opinion from any health care provider of the employee's choice when
a designated provider prescribes invasive surgery for the employee. If the
additional opinion differs from the opinion of the designated provider and the
additional opinion provides a specific and detailed course of treatment, the
employee shall determine which course of treatment to follow. If the employee
opts to follow the course of treatment outlined by the additional opinion, the
treatment shall be performed by one of the health care providers on the
employer's designated list for 90 days from the date of the first visit to the
provider of the additional opinion.
(c) The written notice to an employee of the
employee's rights and duties under this section shall be provided at the time
the employee is hired and immediately after the injury, or as soon thereafter
as possible under the circumstances of the injury. If the employee's injuries
are so severe that emergency care is required, notice of the employee's rights
and duties shall be given as soon after the occurrence of the injury as is
practicable.
(d) The employer's
duty under subsection (a) shall be evidenced by the employee's written
acknowledgment of having been informed of and having understood the notice of
the employee's rights and duties. Any failure of the employer to provide and
evidence the notification relieves the employee from any duties specified in
the notice, and the employer remains liable for all treatment rendered to the
employee. However, an employee may not refuse to sign an acknowledgment to
avoid duties specified in the notice.
