Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT › Subchapter D - EMPLOYER LIST OF DESIGNATED PROVIDERS › Section 127.755 - Required notice of employe rights and duties

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a list of designated providers is
				  established, the employer shall provide a clearly written notice to an injured
				  employe of the employe's rights and duties under section 306(f.1)(1)(i) of the
				  act (77 P. S. §
											531(1)(i)).
(b) The contents of the written notice shall,
				  at a minimum, contain the following conditions:
(1) The employe has the duty to obtain
				  treatment for work-related injuries and illnesses from one or more of the
				  designated health care providers for 90 days from the date of the first visit
				  to a designated provider.
(2) The
				  employe has the right to have all reasonable medical supplies and treatment
				  related to the injury paid for by the employer as long as treatment is obtained
				  from a designated provider during the 90-day period.
(3) The employe has the right, during this
				  90-day period, to switch from one health care provider on the list to another
				  provider on the list, and that all the treatment shall be paid for by the
				  employer.
(4) The employe has the
				  right to seek treatment from a referral provider if the employe is referred to
				  him by a designated provider, and the employer shall pay for the treatment
				  rendered by the referral provider.
(5) The employe has the right to seek
				  emergency medical treatment from any provider, but that subsequent nonemergency
				  treatment shall be by a designated provider for the remainder of the 90-day
				  period.
(6) The employee has the
				  right to seek treatment or medical consultation from a nondesignated provider
				  during the 90-day period, but that these services shall be at the employee's
				  expense for the applicable 90 days.
(7) The employee has the right to seek
				  treatment from any health care provider after the 90-day period has ended, and
				  that treatment shall be paid for by the employer, if it is reasonable and
				  necessary.
(8) The employee has the
				  duty to notify the employer of treatment by a nondesignated provider within 5
				  days of the first visit to that provider. The employer may not be required to
				  pay for treatment rendered by a nondesignated provider prior to receiving this
				  notification. However, the employer shall pay for these services once notified,
				  unless the treatment is found to be unreasonable by a URO, under Subchapter C
				  (relating to medical treatment review).
(9) The employee has the right to seek an
				  additional opinion from any health care provider of the employee's choice when
				  a designated provider prescribes invasive surgery for the employee. If the
				  additional opinion differs from the opinion of the designated provider and the
				  additional opinion provides a specific and detailed course of treatment, the
				  employee shall determine which course of treatment to follow. If the employee
				  opts to follow the course of treatment outlined by the additional opinion, the
				  treatment shall be performed by one of the health care providers on the
				  employer's designated list for 90 days from the date of the first visit to the
				  provider of the additional opinion.