HB 517 Summary

• Allows the Workers' Compensation Administrator to implement presumptively authorized medical services and make immediate payment for specified medical conditions and first-fill prescription drugs prior to final claim determination, with disallowed claims charged to the surplus fund rather than the employer.

• Requires claimants who refuse or unreasonably delay rehabilitation services, medical examinations, vocational evaluations, or ordered medical treatment without good cause to forfeit compensation and benefits during the period of refusal and prohibits the refusal period from tolling jurisdiction time frames.

• Modifies the health partnership program to allow managed care organization vendor contracts for two-year periods with recertification options, permits integration with bureau staff for potential internal administration, and establishes provider panel standards based on access, quality, and cost.

• Extends freedom of choice limitations to the 46th day after injury or treatment beginning date, allowing the Administrator to require copayments for out-of-plan providers and establish data reporting requirements to measure outcomes and savings of managed care organizations.

• Creates provisions for reimbursement from third-party payers when the Administrator has paid benefits for ultimately noncompensable injuries and clarifies employer reimbursement procedures when workers' compensation claims are later determined compensable.