4123-6-06.3 Employee access to the HPP -- application of rules to claims.

(A) The rules of this chapter of the Administrative Code shall apply to all claims with the date of injury on or after October 20, 1993. The employee’s medical care and treatment and return to work services in such claims shall be managed under the HPP by the employer’s MCO as provided in the rules of this chapter.

(B) Notwithstanding rule 4123-6-06.2 of the Administrative Code, if the employee’s date of injury is prior to October 20, 1993 and the employee’s physician of record is a non-bureau certified provider, the employee may continue treatment with that non-bureau certified provider. The employer’s MCO shall manage the medical care and treatment and return to work services in the claim and shall manage medical payment for the provider.

(C) In all claims with a date of injury prior to October 20, 1993, and not withstanding paragraph (B) of this rule, if the employee changes the physician of record for any reason, the employee shall select a bureau certified provider as a physician of record and the claim is thereafter governed by all of the HPP rules of this chapter. If the employee selects a physician of record who is a non-bureau certified provider, payment for the provider shall be governed 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