Sec. 31-279. Notice of availability of compensation. Uniform system for determination of degree of physical impairment. Employer-sponsored plan for medical care and treatment. Indemnification of medic
Sec. 31-279. Notice of availability of compensation. Uniform system for determination of degree of physical impairment. Employer-sponsored plan for medical
care and treatment. Indemnification of medical advisory panel members. (a) The
chairman of the Workers' Compensation Commission shall adopt regulations, in accordance with the provisions of chapter 54, specifying the minimum information to be contained in a notice of the availability of compensation which shall be posted in the workplace by each employer subject to the provisions of this chapter pursuant to subsection
(f) of section 31-284.
(b) The chairman of the Workers' Compensation Commission shall, not later than
July 1, 1991, adopt regulations, in accordance with chapter 54, to create a uniform system
to be used by medical professionals in determining the degree of physical impairment
of persons receiving compensation under this chapter.
(c) (1) Any employer or any insurer acting on behalf of an employer, may establish
a plan, subject to the approval of the chairman of the Workers' Compensation Commission under subsection (d) of this section, for the provision of medical care that the
employer provides for treatment of any injury or illness under this chapter. Each plan
shall contain such information as the chairman shall require, including, but not limited to:
(A) A listing of all persons who will provide services under the plan, along with
appropriate evidence that each person listed has met any licensing, certification or registration requirement necessary for the person to legally provide the service in this state;
(B) A listing of all pharmacies that will provide services under the plan, to which
the employer, any insurer acting on behalf of the employer, or any other entity acting
on behalf of the employer or insurer shall make direct payments for any prescription
drug prescribed by a physician participating in the plan;
(C) A designation of the times, places and manners in which the services will be
provided;
(D) A description of how the quality and quantity of medical care will be managed; and
(E) Such other provisions as the employer and the employees may agree to, subject
to the approval of the chairman.
(2) The election by an employee covered by a plan established under this subsection
to obtain medical care and treatment from a provider of medical services who is not
listed in the plan shall suspend the employee's right to compensation, subject to the
order of the commissioner.
(d) Each plan established under subsection (c) of this section shall be submitted to
the chairman for his approval at least one hundred twenty days before the proposed
effective date of the plan and each approved plan, along with any proposed changes
therein, shall be resubmitted to the chairman every two years thereafter for reapproval.
The chairman shall approve or disapprove such plans on the basis of standards established by the chairman in consultation with a medical advisory panel appointed by the
chairman. Such standards shall include, but not be limited to: (1) The ability of the plan
to provide all medical and health care services that may be required under this chapter
in a manner that is timely, effective and convenient for the employees; (2) the inclusion
in the plan of all categories of medical service and of an adequate number of providers
of each type of medical service in accessible locations to ensure that employees are
given an adequate choice of providers; (3) the provision in the plan for appropriate
financial incentives to reduce service costs and utilization without a reduction in the
quality of service; (4) the inclusion in the plan of fee screening, peer review, service
utilization review and dispute resolution procedures designed to prevent inappropriate
or excessive treatment; and (5) the inclusion in the plan of a procedure by which information on medical and health care service costs and utilization will be reported to the
chairman in order for him to determine the effectiveness of the plan.
(e) Any person who serves as a member of the medical advisory panel, appointed
by the chairman of the Workers' Compensation Commission pursuant to subsection
(d) of this section, shall be deemed to be a state officer or employee for purposes of
indemnification and defense under section 5-141d.
(1949 Rev., S. 7437; September, 1957, P.A. 11, S. 13; 1958 Rev., S. 31-143; 1961, P.A. 491, S. 5; 1967, P.A. 842, S.
2; 1969, P.A. 556, S. 3; P.A. 90-116, S. 1; P.A. 91-32, S. 4, 41; 91-339, S. 5, 55; P.A. 93-228, S. 3, 35; P.A. 95-240; P.A.
01-85, S. 1, 3.)
History: 1961 act entirely replaced previous provisions; 1967 act added provisions re commissioners' duties to maintain
approved list of practicing physicians, surgeons and dentists, etc.; 1969 act added podiatrists to approved list; P.A. 90-116
added provision concerning regulations creating a uniform system for determination of the degree of physical impairment;
P.A. 91-32 added provisions re notice of availability of compensation and made technical changes; P.A. 91-339 deleted
provisions re adoption of rules by the commissioners, designated provisions re notice of availability of compensation as
Subsec. (a) and authorized the chairman to adopt regulations governing, deleted provisions re list of physicians, surgeons,
podiatrists and dentists, designated provisions re uniform system for determination of degree of physical impairment as
Subsec. (b) and authorized the chairman to adopt regulations governing, deleted provisions re annual report of commissioner
to the governor and added Subsecs. (c) to (e), inclusive, re employer-sponsored plans for medical care and treatment; P.A.
93-228 amended Subsec. (c) to delete requirement that employer-sponsored plans for medical care and treatment by
employers with fifty or more employees include designation of labor-management safety committee and to prohibit employees from receiving compensation for treatment outside such plans, deleting provisions which had specified conditions
permitting care and treatment by outside providers and deleted Subsec. (e) re compensation for treatment by practitioners
not listed in employer-sponsored plans, effective July 1, 1993; P.A. 95-240 added Subsec. (e) re indemnification of members
of the medical advisory panel; P.A. 01-85 amended Subsec. (c) by dividing existing provisions into Subdivs. (1)(A) and
(1)(C) to (E) and Subdiv. (2), adding Subdiv. (1)(B) re direct payments to pharmacies and making technical changes,
effective January 1, 2002.
Cited. 219 C. 439.
Cited. 29 CA 249.