§ 28-30-22 - Medical advisory board.
SECTION 28-30-22
§ 28-30-22 Medical advisory board. –(a) The chief judge of the workers' compensation court, in consultation withthe appropriate medical or professional association, shall appoint a medicaladvisory board which shall serve at the chief judge's pleasure and consist ofeleven (11) members in the following specialties: one orthopedic surgeon; oneneurologist; one neurosurgeon; one physiatrist; one chiropractor; one physicaltherapist; one internist; one psychiatrist or psychologist; and three (3) adhoc physician members appointed at the discretion of the chief judge. Membersof the board shall be reimbursed three hundred dollars ($300) per day served inthe discharge of the board's duties, not to exceed six thousand dollars($6,000) per member in any year. The chief judge shall designate thechairperson of the board.
(b) The chief judge is authorized, with the advice of themedical advisory board, to do the following:
(1) Adopt and review protocols and standards of treatment forcompensable injury, which shall address types, frequency, modality, duration,and termination of treatment, and types and frequency of diagnostic procedures.
(ii) Within thirty (30) days of its establishment, themedical advisory board shall prepare a recommended standard for theconsideration and weighing by the court of medical evidence, including, but notlimited to, medical test results, objective clinical findings, subjectivecomplaints supported by tests for inconsistency, and purely subjectivecomplaints, with the purposes of assuring treatment and compensation forlegitimate compensable injuries, reducing litigation, inefficiency, and delayin court proceedings, and deterring false or exaggerated claims of injury. Thestandards shall be applicable to proceedings before the workers' compensationcourt, including specifically those to determine the nature and extent ofinjury and the achievement of maximum medical improvement, and shall beeffective in all proceedings when adopted by the court.
(2) Approve and promulgate rules, regulations, and proceduresconcerning the appointment and qualifications of comprehensive independenthealth care review teams which would be composed of any combination of one ormore health care provider(s), rehabilitation expert(s), physical therapist(s),occupational therapist(s), psychologist(s), and vocational rehabilitationcounselor(s).
(3) Approve and administer procedures to disqualify ordisapprove 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 proceduresconcerning the appointment and qualifications of impartial medical examiners.
(6) Annually review the performance of each comprehensiveindependent health care review team and impartial medical examiner.
(c) The administrator of the medical advisory board isauthorized and directed to establish terms and conditions for comprehensiveindependent health care review teams and impartial medical examiners to applyfor approval by the medical advisory board and to perform any other duties asdirected by the board.
(d) Any reference to an impartial medical examiner inchapters 29 – 38 of this title shall be deemed to include the impartialmedical examiners and comprehensive independent health care review teamsreferred to in subsection (b) of this section.
(e) Disqualification of medical care providers. Everyhealth care provider licensed in the state of Rhode Island shall be presumed tobe qualified to provide health care services for injuries compensable underthis title, and may recover costs of treatment consistent with established feeand cost schedules. The administrator of the medical advisory board isthereafter authorized to disqualify and/or suspend any qualified provider basedupon one or more of the following:
(i) The violation of the protocols and standards of careestablished by the medical advisory board;
(ii) The filing of affidavits that are untimely, inadequate,incomplete, or untruthful;
(iii) The provision of unnecessary and/or inappropriatetreatment;
(iv) A pattern of violation and/or evasion of an approved feeschedule;
(v) The censure or discipline of the provider by thelicensing 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 injurynot deemed non-compensable by the workers' compensation court.
(2) Upon disqualification or during suspension, the providershall not be permitted to recover any costs or fees for treatment providedunder this title. The appropriate body with professional disciplinary authorityover the provider shall be notified of any such action. Appeal ofdisqualification or suspension shall be to the medical advisory board, withfinal review by the workers' compensation court.
(3) If unnecessary or inappropriate treatment is provided byan entity affiliated with the treating physician, the administrator of themedical advisory board may increase the penalty for a violation.
(4) This section shall not prevent the recovery of reasonablecosts for immediate emergency care rendered by a provider.
(f) As a guide to the interpretation and application of thissection, the policy and intent of this legislature is declared to be that everyperson who suffers a compensable injury with resulting disability should beprovided with high quality medical care and the opportunity to return togainful employment as soon as possible with minimal dependence on compensationawards.