2016 -- H 7666

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LC004739

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2016

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A N   A C T

RELATING TO LABOR AND LABOR RELATIONS -- WORKERS' COMPENSATION

MEDICAL ADVISORY BOARD

     Introduced By: Representatives Keable, and McKiernan

     Date Introduced: February 24, 2016

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 28-30-22 of the General Laws in Chapter 28-30 entitled "Workers'

Compensation Court" is hereby amended to read as follows:

     28-30-22. Medical advisory board. -- (a) The chief judge of the workers' compensation

court, in consultation with the appropriate medical or professional association, shall appoint a

medical advisory board that shall serve at the chief judge's pleasure and consist of eleven (11)

twelve (12) members in the following specialties: one orthopedic surgeon; one neurologist; one

physiatrist; one doctor of acupuncture and Oriental medicine; one chiropractor; one physical

therapist; one internist; one psychiatrist or psychologist; and four (4) ad hoc physician members

appointed at the discretion of the chief judge. Members of the board shall be reimbursed three

hundred dollars ($300) per day served in the discharge of the board's duties, not to exceed six

thousand dollars ($6,000) per member in any year. The chief judge shall designate the

chairperson of the board.

      (b) The chief judge is authorized, with the advice of the medical advisory board, to do

the following:

      (1) (i) Adopt and review protocols and standards of treatment for compensable injury,

which shall address types, frequency, modality, duration, and termination of treatment, and types

and frequency of diagnostic procedures; provided, however, that for the treatment of moderate to

severe low back pain, neck pain, chronic trigger points/myofascial pain, and osteoarthrosis of the

knee and hip, patient choice shall be followed in the selection of non-prescription treatment

therapies within the scope of practice of a health professional licensed by the department of

health and they shall not require the exhaustion or failure of other treatment methods as a

prerequisite.

      (ii) Within thirty (30) days of its establishment, the medical advisory board shall prepare

a recommended standard for the consideration and weighing by the court of medical evidence,

including, but not limited to, medical test results, objective clinical findings, subjective

complaints supported by tests for inconsistency, and purely subjective complaints, with the

purposes of assuring treatment and compensation for legitimate compensable injuries; reducing

litigation, inefficiency, and delay in court proceedings; and deterring false or exaggerated claims

of injury. The standards shall be applicable to proceedings before the workers' compensation

court, including specifically those to determine the nature and extent of injury and the

achievement of maximum medical improvement, and shall be effective in all proceedings when

adopted by the court.

      (2) Approve and promulgate rules, regulations, and procedures concerning the

appointment and qualifications of comprehensive, independent health care review teams that

would be composed of any combination of one or more health care provider(s), rehabilitation

expert(s), physical therapist(s), occupational therapist(s), psychologist(s), and vocational

rehabilitation counselor(s).

      (3) Approve and administer procedures to disqualify or disapprove medical service

providers and maintain the approved provider list.

      (4) Appoint an administrator of the medical advisory board.

      (5) Approve and promulgate rules, regulations, and procedures concerning the

appointment and qualifications of impartial medical examiners.

      (6) Annually review the performance of each comprehensive, independent health care

review team and impartial medical examiner.

      (c) The administrator of the medical advisory board is authorized and directed to

establish terms and conditions for comprehensive, independent health care review teams and

impartial medical examiners to apply for approval by the medical advisory board and to perform

any other duties as directed by the board.

      (d) Any reference to an impartial medical examiner in chapters 29 -- 38 of this title shall

be deemed to include the impartial medical examiners and comprehensive, independent health

care review teams referred to in subsection (b) of this section.

      (e) (1) Disqualification of medical care providers. - Every health care provider licensed

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in the state of Rhode Island shall be presumed to be qualified to provide health care services for

injuries compensable under this title and may recover costs of treatment consistent with

established fee and cost schedules. The administrator of the medical advisory board is thereafter

authorized to disqualify and/or suspend any qualified provider based upon one or more of the

following:

      (i) The violation of the protocols and standards of care established by the medical

advisory board;

      (ii) The filing of affidavits that are untimely, inadequate, incomplete, or untruthful;

      (iii) The provision of unnecessary and/or inappropriate treatment;

      (iv) A pattern of violation and/or evasion of an approved fee schedule;

      (v) The censure or discipline of the provider by the licensing body of the provider's

profession;

      (vi) The billing of, or pursuing collection efforts against, the employee for treatment or

diagnostic tests causally related to an injury not deemed non-compensable by the workers'

compensation court.

      (2) Upon disqualification or during suspension, the provider shall not be permitted to

recover any costs or fees for treatment provided under this title. The appropriate body with

professional disciplinary authority over the provider shall be notified of any such action. Appeal

of disqualification or suspension shall be to the medical advisory board, with final review by the

workers' compensation court.

      (3) If unnecessary or inappropriate treatment is provided by an entity affiliated with the

treating physician, the administrator of the medical advisory board may increase the penalty for a

violation.

      (4) This section shall not prevent the recovery of reasonable costs for immediate

emergency care rendered by a provider.

      (f) As a guide to the interpretation and application of this section, the policy and intent of

this legislature is declared to be that every person who suffers a compensable injury with

resulting disability should be provided with high-quality medical care and the opportunity to

return to gainful employment as soon as possible with minimal dependence on compensation

awards.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO LABOR AND LABOR RELATIONS -- WORKERS' COMPENSATION

MEDICAL ADVISORY BOARD

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     This act would add a doctor of acupuncture and Oriental medicine to the medical

advisory board at the workers' compensation court, and would respect patient choice in the

selection of treatment therapies for certain conditions.

     This act would take effect upon passage.

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