Establishment, revision and compliance with standards of care for provision of accident benefits.
1. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, adopt regulations establishing standards of care for the provision of accident benefits to employees who have suffered industrial injuries or occupational diseases. The standards must include, but are not limited to criteria and protocols to be used as minimal guides for evaluating and ensuring the quality of programs of treatment and for reviewing the:
(a) Utilization of diagnostic procedures and the provision of other medical services;
(b) Treatment and expected durations of industrial injuries and occupational diseases;
(c) Utilization of narcotic drugs and other forms of medication;
(d) Referral of patients to obtain a second opinion; and
(e) Provision of care by more than one provider of health care.
Ê The standards must be consistent with national or regional guidelines and must be specific to medicine for industrial injuries and occupational diseases.
2. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, periodically review and revise as necessary the standards established pursuant to subsection 1.
3. An insurer and each person who provides any accident benefit to an employee who has suffered an industrial injury or occupational disease shall comply with the regulations adopted pursuant to this section.
Last modified: February 25, 2006