(A) The bureau of workers' compensation shall audit the programs of employers who elect to pay compensation directly in the following situations:
(1) Audits shall be conducted by the bureau on a random basis.
(2) In addition, the bureau shall make such audits whenever the bureau has grounds for believing that an employer is not in full compliance with the rules of the commission and bureau or the provisions of Chapter 4123. of the Revised Code.
(3) Upon request from the self-insured review panel or the self-insuring employers evaluation board.
(B) Such audits shall include the employer's methods of furnishing medical, surgical, nursing and hospital attention services, medicines and funeral expenses; the employer's payment of compensation or benefits to claimants and dependents and whether this is being done in a proper and timely manner; whether the employer has promptly filed all reports required under the rules of the commission and bureau and the provisions of Chapter 4123. of the Revised Code. Such audits may also be used to evaluate whether the employer is providing medical examinations and evaluations in a timely manner; and whether the employer has harassed, dismissed or otherwise disciplined employees who have filed complaints against such employer with the bureau of workers' compensation.
(C) The bureau shall report its findings on such audits to the employer, the self-insured review panel, or the self-insuring employers evaluation board, where the panel or board had requested the audit, and shall evaluate such findings and take such action as is indicated.
Five Year Review (FYR) Dates: 05/31/2017 and 06/01/2022
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4123.05
Rule Amplifies: 4123.35, 4123.352
Prior Effective Dates: 1/2/78, 5/9/90, 12/17/01, 10/30/06