4123-6-04.2 MCO scope of services -- management of medical treatment of provider selected by employee.

(A) An employee may select a bureau certified provider. If the MCO selected by or assigned to the employee’s employer has elected to retain a provider panel, the employee may select an MCO panel provider. In either case, the MCO shall manage the medical treatment of all workers’ compensation related injuries or diseases incurred by the employee for that employer.

(B) An employee may select a provider who is not a bureau certified provider. In such case, the MCO for the employee’s employer shall manage only the initial or emergency care to the employee; further treatment shall not be authorized except as provided by rule 4123-6-12 of the Administrative Code.

R.C. 119.032 review dates: 10/27/2004 and 03/01/2009

Promulgated Under: 119.03

Statutory Authority: 4121.12, 4121.30, 4121.31, 4123.05

Rule Amplifies: 4121.121, 4121.44, 4121.441, 4123.66

Prior Effective Dates: 2/16/96, 1/1/01