reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT › Subchapter C - MEDICAL TREATMENT REVIEW › AUTHORIZATION OF UROs AND PROs › Section 127.668 - Suspension of assignments

Current through Register Vol. 54, No. 28, July 13, 2024
If the Bureau obtains information suggesting that a URO
						or PRO is not acting in accordance with the requirements of the act or this
						chapter, the Bureau may temporarily suspend the assignment of new reviews to
						the URO or PRO pending the outcome of an investigation. The suspension period
						may not exceed 60 days. The URO or PRO shall have the right to confer with the
						Chief of Medical Cost Containment Division.
This section cited in 34 Pa. Code §
													127.401 (relating to
						  purpose/review of medical
						  treatment).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT › Subchapter C - MEDICAL TREATMENT REVIEW › AUTHORIZATION OF UROs AND PROs › Section 127.669 - Revocation of authorizations

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Upon investigation and following a conference with the Chief of the Medical
					 Cost Containment Division, if the Bureau determines that a URO or PRO has
					 violated the requirements of the act or this chapter, it may revoke the
					 authorization of the URO or PRO to perform review functions under the act.
					 Revocation of a URO or PRO's authority to perform reviews will be in writing
					 and will advise the URO or PRO of its appeal rights.
(b) A URO or PRO whose authorization to
					 perform reviews under the act has been revoked by the Bureau shall have the
					 right to appeal the revocation within 30 days of the receipt of the Bureau's
					 initial determination in accordance with the hearing process set forth in
					 §
											127.670 (relating to
					 hearings).
This section cited in 34 Pa. Code §
													127.401 (relating to
						  purpose/review of medical
						  treatment).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT › Subchapter C - MEDICAL TREATMENT REVIEW › AUTHORIZATION OF UROs AND PROs › Section 127.670 - Hearings

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Director of
					 the Bureau will assign appeals to decisions regarding a URO and PRO's authority
					 to review medical treatment to a hearing officer who will schedule a de novo
					 hearing on the appeal from the initial decision. The URO/PRO will receive
					 reasonable notice of the hearing date, time and place.
(b) The hearing will be conducted in a manner
					 to provide the URO/PRO and the Bureau the opportunity to be heard. The hearing
					 officer will not be bound by strict rules of evidence. All relevant evidence of
					 reasonably probative value may be received into evidence. Reasonable
					 examination and cross-examination of witnesses will be permitted.
(c) Testimony will be recorded and a full
					 record kept of the proceeding. The Bureau and the URO/PRO will be provided the
					 opportunity to submit briefs addressing issues raised.
(d) The hearing officer will issue a written
					 adjudication within 90 days following the close of the record. The decision
					 will include all relevant findings and conclusions, and state the rationale for
					 the decision. The decision will be served upon the URO/PRO, the Bureau and
					 counsel of record. The decision will include a notification to the URO/PRO and
					 the Bureau of further appeal rights to the Commonwealth Court.
(e) The URO/PRO or the Bureau, aggrieved by a
					 hearing officer's adjudication, may file a further appeal to Commonwealth
					 Court.
This section cited in 34 Pa. Code §
													127.401 (relating to
						  purpose/review of medical treatment); 34 Pa. Code §
													127.653 (relating to decision on
						  application); and 34 Pa. Code §
													127.669 (relating to revocation of
						  authorizations).
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 127.751 - Employer's option to establish a list of designated health care providers

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Employers have
				  the option to establish a list of designated health care providers under
				  section 306(f.1)(1)(i) of the act (77 P. S. §
											531(1)(i)).
(b) If an employer has established a list of
				  providers which meets the requirements of the act and this subchapter, an
				  employe with a work-related injury or illness shall seek treatment with one of
				  the designated providers from the list. The employe shall continue to treat
				  with the same provider or another designated provider for 90 days from the date
				  of the first visit for the treatment of the work injury or illness.
(c) The employer may not require treatment
				  with any one specific provider on the list, nor may the employer restrict the
				  employe from switching from one designated provider to another designated
				  provider.
(d) An employe may not be
				  required to obtain emergency medical treatment from a listed provider. However,
				  once emergency conditions no longer exist, the injured employe shall treat with
				  a listed provider for the remainder of the 90-day period.
(e) If an employer's list of designated
				  providers fails to comport with the act and this subchapter, the employe shall
				  have the right to treat with a health care provider of the employe's choice
				  from the time of the initial visit.
(f) If an employer chooses not to establish a
				  list of designated providers, the employe shall have the right to seek medical
				  treatment from any provider from the time of the initial visit.
(g) If a designated provider prescribes
				  invasive surgery for the employe, the employe may seek an additional opinion
				  from any health care provider of the employe's choice. 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 employe shall
				  determine which course of treatment to follow. If the employe 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.
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 127.752 - Contents of list of designated health care providers

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If an employer establishes a list of
				  designated health care providers, there shall be at least six providers on the
				  list.
(1) At least three of the providers on
				  the list shall be physicians.
(2)
				  No more than four of the providers on the list may be CCOs.
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 127.753 - Disclosure requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				  employer may not include on the list of designated health care providers a
				  physician or other health care provider who is employed, owned or controlled by
				  the employer or the employer's insurer, unless employment, ownership or control
				  is disclosed on the list.
(b) For
				  purposes of this section, "employer's insurer" means the insurer who is
				  responsible for paying workers' compensation under the terms of the
				  act.
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 127.754 - Prominence of list of designated providers

Current through Register Vol. 54, No. 28, July 13, 2024
If an employer chooses to establish a list of providers,
					 the list shall be posted in prominent and readily accessible places at the
					 worksite. These places include places used for treatment and first aid of
					 injured employes and employe informational bulletin boards.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter A - PRELIMINARY PROVISIONS › Section 129.1 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter provides definitions of terms used in this
					 chapter to allow for accurate understanding of commonly and frequently used
					 terminology.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.101 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter interprets the requirements of the act that
					 an insurer desiring to write workers' compensation insurance in this
					 Commonwealth shall maintain or provide adequate accident and illness prevention
					 services as a prerequisite for a license to write this insurance. Services
					 shall be adequate to furnish accident and illness prevention required by the
					 nature of the insurer's business or its policyholders' operations. This
					 subchapter also establishes the criteria that the Department will employ in
					 determining the adequacy of the services required to be maintained or provided
					 by an insurer.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.103 - Obligation of an insured employer/policyholder

Current through Register Vol. 54, No. 28, July 13, 2024
An insured employer/policyholder requesting accident and
					 illness prevention services as mandated by the act shall provide the necessary
					 information and access to the insurer to permit the insurer to fulfill its
					 requirements under the act.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.104 - Insurer's accident and illness prevention services providers requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Accident and
				  illness prevention services providers employed by or contracted with an insurer
				  to perform accident and illness prevention services shall meet the requirements
				  specified in Subchapter E (relating to accident and illness prevention services
				  providers requirements).
(b) The
				  Bureau may require that the insurer provide documentation or evidence to
				  support that the requirements for accident and illness prevention services
				  providers have been met by each individual providing accident and illness
				  prevention services, whether employed or under contract, based on the criteria
				  in Subchapter E.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.105 - Reporting requirements for applicants for licensure

Current through Register Vol. 54, No. 28, July 13, 2024
(a) As part of their application for a
				  certificate of authority submitted to the Insurance Department, applicants for
				  a license to write workers' compensation insurance shall provide information
				  concerning their accident and illness prevention services required under §
										129.102 (relating to accident and
				  illness prevention services requirements) using Form LIBC-211I,
Insurer's Initial Report of Accident and Illness Prevention
				  Services
.
(b) As part of
				  the process of licensing to write workers' compensation insurance in this
				  Commonwealth, the Insurance Department will forward to the Bureau the report in
				  subsection (a) for a determination of adequacy. The Bureau will provide a final
				  determination of adequate or inadequate to the Commissioner.
This section cited in 34 Pa. Code §
												129.107 (relating to report
						finds).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.106 - Reporting requirements for licensed insurers

Current through Register Vol. 54, No. 28, July 13, 2024
A licensed insurer shall, by June 1 of each year, provide
					 the Bureau with information concerning accident and illness prevention services
					 offered or provided to the insurer's policyholders during the preceding
					 calendar year. The information shall be provided using the AIPS report. In
					 addition, documentation required by other governmental regulatory agencies can
					 be used as supporting evidence of accident and illness prevention services.
					 Report information shall be subject to Bureau verification.
This section cited in 34 Pa. Code §
												129.107 (relating to report
						finds).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.107 - Report findings

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Upon
				  receipt of a report required under §
										129.105 (relating to reporting
				  requirements applicants for licensure), the Bureau will review the report data,
				  make a final determination of the adequacy or inadequacy of services and
				  provide notification to the Commissioner and the insurer of its final
				  determination.
(b) Upon receipt of
				  a report required under §
										129.106 (relating to reporting
				  requirements for licensed insurers), the Bureau will review the report data and
				  make a final determination of adequacy or an initial determination of
				  inadequacy of services. An inadequate determination may result in an audit of
				  services before a final determination is made. The Bureau will provide
				  notification to the Commissioner and the insurer of its final
				  determination.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.108 - Recordkeeping requirements

Current through Register Vol. 54, No. 28, July 13, 2024
Insurers shall maintain records of accident and illness
					 prevention services by a policyholder for the most complete current calendar
					 year and 2 preceding consecutive calendar years which include:
(1) The dates of the requests for
				  services.
(2) The services
				  requested or problems presented.
(3) Reports from site inspections
				  performed.
(4) Other service
				  reports including proposed corrective actions.
(5) The dates on which services were provided
				  and the policyholder's responses to proposed corrective actions.
(6) The results of industrial hygiene and
				  health surveys and consultations.
(7) Accident and illness prevention training
				  conducted.
(8) Documentation
				  supporting the funds expended for the delivery of accident and illness
				  prevention services.
(9) Evidence
				  of the effectiveness and accomplishments of accident and illness prevention
				  services.
This section cited in 34 Pa. Code §
												129.111 (relating to site of
						audit).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.109 - Periodic audits of insurer's accident and illness prevention services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Bureau may
				  audit an insurer's accident and illness prevention services at least once every
				  2 years.
(b) The Bureau may audit
				  an insurer's accident and illness prevention services if the insurer fails to
				  file an AIPS by specified time frames or fails to meet the requirements of this
				  subchapter.
(c) The notice of the
				  audit will include the reasons for audit.
(d) At least 60-calendar days prior to an
				  audit, the Bureau will notify the insurer in writing of the date on which the
				  audit will occur.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.110 - Preaudit exchange of information

Current through Register Vol. 54, No. 28, July 13, 2024
(a) At least 45-calendar days prior to the
				  audit, the insurer shall provide the Bureau with:
(1) If not already submitted, a completed,
				  annual AIPS report for the most recently completed calendar year and, if
				  requested, the AIPS reports for the 2 preceding consecutive calendar years
				  including those of its affiliated companies, if applicable.
(2) A description of the type of accident and
				  illness prevention services provided during the last completed calendar year
				  and a list of current insured employers/policyholders specifying name and
				  premium size grouping which: received services; requested but did not receive
				  services; and have reported to the carrier that they have a certified workplace
				  safety committee.
(3) The name,
				  address, business telephone number, credentials, experience and status (whether
				  employed or contracted) of each person acting as an accident and illness
				  prevention services provider for the insurer.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.111 - Site of audit

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The audit of
				  the insurer's accident and illness prevention services will take place at the
				  insurer's main office in this Commonwealth unless otherwise agreed by the
				  Bureau and the insurer. If the insurer has no office in this Commonwealth, the
				  audit will take place at the Bureau's headquarters.
(b) At the site where the audit will occur,
				  the insurer shall provide the documentation required by §
										129.108 (relating to recordkeeping
				  requirements) and any other documentation chosen by the insurer supporting the
				  existence and adequacy of required services.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.112 - Written report of audit

Current through Register Vol. 54, No. 28, July 13, 2024
(a) After
				  the conclusion of the audit, the Bureau will issue a written report containing
				  its findings. The report will indicate whether the Bureau has issued a final
				  determination of adequate or an initial determination of inadequate with regard
				  to an insurer's accident and illness prevention services.
(b) The Bureau will notify the insurer of a
				  final determination of adequate.
(c) The Bureau will provide written
				  notification to the insurer of specific deficiencies and recommendations for
				  corrective action if it assigns an initial determination of inadequate. Within
				  60-calendar days from the date of the audit report, the insurer shall provide
				  written documentation that it has complied with the Bureau's recommendations.
				  If the insurer believes that it will take more than 60 days to implement the
				  recommendations, it shall file a plan of correction in accordance with §
										129.113 (relating to plan of
				  correction/reports of progress on correcting deficiencies). At the end of the
				  60-calendar day correction period, a final determination of adequate or
				  inadequate will be assigned. The insurer will receive notification of this
				  final determination. The Commissioner will receive notification of final
				  determinations of inadequate.
This section cited in 34 Pa. Code §
												129.113 (relating to plan of
						correction/reports of progress on correcting
						deficiencies).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.113 - Plan of correction/reports of progress on correcting deficiencies

Current through Register Vol. 54, No. 28, July 13, 2024
An insurer shall file a plan of correction to implement
					 audit report recommendations referenced in §
										129.112(c)
					 (relating to written report of audit) for any deficiency requiring more than 60
					 days to correct. The plan shall include a timetable for correction acceptable
					 to the Bureau. Progress reports shall be filed by the insurer detailing
					 corrective actions at the end of each 30-day period of the correction plan
					 period. The Bureau may audit the insurer's accident and illness prevention
					 services if the insurer fails to file progress reports, implement
					 recommendations, or provide acceptable documentation of corrective actions. At
					 the end of the correction plan period, a final determination of adequate or
					 inadequate will be made, and the insurer will be notified of the determination.
					 The Commissioner will be notified of final determinations of
					 inadequate.
This section cited in 34 Pa. Code §
												129.112 (relating to written
						report of audit).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter B - INSURER'S ACCIDENT AND ILLNESS PREVENTION SERVICES › Section 129.114 - Contesting final determinations

Current through Register Vol. 54, No. 28, July 13, 2024
An insurer may contest a final determination of inadequate
					 under Subchapter G (relating to hearings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.401 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter interprets the requirements of the act that
					 an individual self-insured employer shall maintain an adequate accident and
					 illness prevention program as a prerequisite for retention of its self-insured
					 status. The subchapter establishes the criteria that the Bureau will employ in
					 determining the adequacy of the accident and illness prevention program
					 required to be maintained by an individual self-insured
					 employer.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.403 - Individual self-insured employer's accident and illness prevention services providers requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  Accident and illness prevention services providers employed by an individual
				  self-insured employer or serving through a contract to perform accident and
				  illness prevention services shall meet the requirements in Subchapter E
				  (relating to accident and illness prevention services providers
				  requirement).
(b) The Bureau may
				  require that the individual self-insured employer provide documentation or
				  evidence to support that the requirements for accident and illness prevention
				  services providers have been met by each individual providing accident and
				  illness prevention services, whether employed or under contract, based on the
				  criteria in Subchapter E.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.404 - Reporting requirements for applicants for individual self-insurance status

Current through Register Vol. 54, No. 28, July 13, 2024
(a) As part of
				  its application for individual self-insurance status submitted to the Bureau,
				  an applicant for individual self-insurance status shall provide the Bureau with
				  detailed information on its accident and illness prevention program as required
				  under §
										129.402 (relating to program
				  requirements) using form LIBC-221E,
Initial Report of Accident and
				  Illness Prevention Program
.
(b) As part of the process of granting
				  individual self-insurance status, the Bureau will use this information to
				  determine whether to grant individual self-insurance status.
This section cited in 34 Pa. Code §
												129.406 (relating to report
						findings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.405 - Reporting requirements for individual self-insured employers

Current through Register Vol. 54, No. 28, July 13, 2024
(a) At the time of
				  reapplication for renewal of self-insurance status, an individual self-insured
				  employer shall, as required under section 815 of the act (77 P. S. §
											1036.15), provide the Bureau with detailed
				  information on its accident and illness prevention program using the AIPPS
				  report, for the last complete fiscal year preceding the date of the renewal
				  application.
(b) In addition,
				  documentation required by other governmental regulatory agencies can be used as
				  supporting evidence of accident and illness prevention programs.
(c) Report information shall be subject to
				  Bureau verification.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.406 - Report findings

Current through Register Vol. 54, No. 28, July 13, 2024
Upon receipt of a report required under §
										129.404 (relating to reporting
					 requirements for individual self-insurance status employers), the Bureau will
					 review the report data and make a final determination of adequacy or an initial
					 determination of inadequacy of programs. An inadequate determination may result
					 in an audit of services before a final determination is made. The Bureau will
					 provide notification to the employer of its final
					 determination.
This section cited in 34 Pa. Code §
												129.410 (relating to site of
						audit).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.407 - Recordkeeping requirements

Current through Register Vol. 54, No. 28, July 13, 2024
Individual self-insured employers shall maintain records of
					 accident and illness prevention program services for the most complete fiscal
					 year and 2 preceding consecutive fiscal years which include:
(1) Number and dates of surveys
				  conducted.
(2) Proposed corrective
				  actions and their disposition.
(3)
				  Training programs conducted.
(4)
				  Consultations held.
(5) Analyses of
				  accident causes.
(6) Industrial
				  hygiene services provided.
(7)
				  Industrial health services provided.
(8) Qualified service providers utilized to
				  provide program services whether contracted or employed.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.408 - Periodic audits of individual self-insured employer's accident and illness prevention program

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Bureau
				  may audit an individual self-insured employer's accident and illness prevention
				  program at least once every 2 years.
(b) A combined audit may be conducted for
				  affiliated companies of an individual self-insured employer if the same
				  facilities, accident and illness prevention program, and accident and illness
				  prevention services providers are used by each of the companies.
(c) The Bureau may audit an individual
				  self-insured employer's accident and illness prevention program if the
				  individual self-insured employer fails to file an AIPPS by specified time
				  frames or fails to meet the requirements of this subchapter.
(d) The notice of the audit will include the
				  reasons for audit.
(e) At least 60
				  calendar days prior to an audit, the Bureau will notify the individual
				  self-insured employer in writing of the date on which the audit will
				  occur.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.409 - Preaudit exchange of information

Current through Register Vol. 54, No. 28, July 13, 2024
(a) At least 45-calendar days prior to the
				  audit, the individual self-insured employer shall provide the Bureau with:
(1) If not already submitted, a completed
				  annual AIPPS report for the most recently completed fiscal year and, if
				  requested, the AIPPS reports for the 2 preceding consecutive fiscal years
				  including those of its affiliated companies, if applicable.
(2) The name, address and telephone number of
				  the contact person.
(3) A
				  description of the types of accident and illness prevention program services
				  provided during the last completed fiscal year.
(4) The name, address, business telephone
				  number, credentials, experience and status (whether employed or contracted) of
				  each person acting as an accident and illness prevention services provider for
				  the individual self-insured employer.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.410 - Site of audit

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The audit of
				  the individual self-insured employer's accident and illness prevention program
				  will take place at the employer's main office in this Commonwealth unless
				  otherwise agreed by the Bureau and the employer. If the individual self-insured
				  employer has no office in this Commonwealth, the audit will take place at the
				  Bureau's headquarters.
(b) At the
				  site where the audit will occur, the individual self-insured employer shall
				  provide the documentation required by §
										129.406 (relating to report
				  findings) and any other documentation chosen by the employer supporting the
				  existence and adequacy of required program elements.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.411 - Written report of audit

Current through Register Vol. 54, No. 28, July 13, 2024
(a) After
				  the conclusion of the audit, the Bureau will issue a written report containing
				  its findings. The report will indicate whether the Bureau has issued a final
				  determination of adequate or an initial determination of inadequate with regard
				  to an individual self-insured employer's accident and illness prevention
				  program.
(b) The Bureau will notify
				  the individual self-insured employer of a final determination of
				  adequate.
(c) The Bureau will
				  provide written notification to the individual self-insured employer of
				  specific deficiencies and recommendations for corrective action if it assigns
				  an initial determination of inadequate. Within 60 calendar days from the date
				  of the audit report, the individual self-insured employer shall provide written
				  documentation that it has complied with the Bureau's recommendations. If the
				  individual self-insured employer believes that it will take more than 60 days
				  to implement the recommendations, it shall file a plan of correction in
				  accordance with §
										129.412 (relating to plan of
				  correction/reports of progress on correcting deficiencies). At the end of the
				  60 calendar day correction period, a final determination of adequate or
				  inadequate will be assigned. The individual self-insured employer will receive
				  notification of this final determination.
This section cited in 34 Pa. Code §
												129.412 (relating to plan of
						correction/reports of progress on correcting
						deficiencies).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.412 - Plan of correction/reports of progress on correcting deficiencies

Current through Register Vol. 54, No. 28, July 13, 2024
An individual self-insured employer shall file a plan of
					 correction to implement audit report recommendations referenced in §
										129.411(c)
					 (relating to written report of audit) for any deficiency requiring more than 60
					 days to correct. The plan shall include a timetable for correction acceptable
					 to the Bureau. Progress reports shall be filed by the individual self-insured
					 employer detailing corrective actions at the end of each 30-day period of the
					 correction plan period. The Bureau may audit an individual self-insured
					 employer's accident and illness prevention program if an individual
					 self-insured employer fails to file progress reports, implement recommendations
					 or provide acceptable documentation of corrective actions. At the end of the
					 correction plan period, a final determination of adequate or inadequate will be
					 made, and the individual self-insured employer will be notified of the
					 determination.
This section cited in 34 Pa. Code §
												129.411 (relating to written
						report of audit).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter C - INDIVIDUAL SELF-INSURED EMPLOYER'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.413 - Contesting final determinations

Current through Register Vol. 54, No. 28, July 13, 2024
An individual self-insured employer may contest a final
					 determination of inadequate under Subchapter G (relating to
					 hearings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.451 - Purpose

Current through Register Vol. 54, No. 28, July 13, 2024
This subchapter establishes the criteria that the Bureau
					 will employ in determining the adequacy of the accident and illness prevention
					 program required by a group self-insurance fund under the act as a prerequisite
					 for retention of group self-insurance fund status.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.452 - Program requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A group
				  self-insurance fund shall maintain or provide an adequate accident and illness
				  prevention program and maintain records for this program for the 3 most current
				  fiscal years. The program shall contain the following elements:
(1) A safety policy statement.
(2) A designated accident and illness
				  prevention program coordinator.
(3)
				  An assignment of responsibilities for implementing and evaluating the accident
				  and illness prevention program.
(4)
				  Program goals and objectives.
(5)
				  Mechanisms for employee involvement, which may include establishment of a
				  workplace safety committee including a safety committee as described in
				  Subchapter F (relating to workplace safety committees).
(6) Employee accident and illness prevention
				  suggestion and communications programs.
(7) Methods for accident investigation,
				  reporting and recordkeeping.
(8)
				  Methods for determining and evaluating program effectiveness. These may
				  include:
(i) Comparison of the group
				  self-insurance fund incidence rate as derived using the OSHA/BLS formula to the
				  current, published OSHA/BLS industry-wide rate.
(ii) Comparison of the group self-insurance
				  fund injury and illness rates determined by means of a formula prescribed by
				  the Bureau to current, published Statewide rates by industry.
(iii) Experience modification
				  factor.
(iv) Loss ratio.
(v) Other methods used by group
				  self-insurance funds deemed appropriate by the Bureau.
(9) Protocols or standard operating
				  procedures, when applicable, to the workplace and worksite environments for:
(i) Electrical and machine
				  safeguarding.
(ii) Personal
				  protective equipment.
(iii) Hearing
				  and sight conservation.
(iv)
				  Lockout/tagout procedures.
(v)
				  Hazardous materials handling, storage and disposal procedures.
(vi) Confined space entry
				  procedures.
(vii) Fire prevention
				  and control practices.
(viii)
				  Substance abuse awareness and prevention policies and programs.
(ix) Control of exposure to bloodborne
				  pathogens.
(x) Preoperational
				  process reviews.
(xi) Other
				  protocols or standard operating procedures appropriate for members' workplace
				  and worksite operations.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.453 - Group self-insurance fund accident and illness prevention services providers requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  Accident and illness prevention services providers employed by a group
				  self-insurance fund or serving through a contract to perform accident and
				  illness prevention services shall meet the requirements specified in Subchapter
				  E (relating to accident and illness prevention services providers
				  requirements).
(b) The Bureau may
				  require the group self-insurance fund to provide documentation or evidence to
				  support that the requirements for accident and illness prevention services
				  providers have been met by each individual providing accident and illness
				  prevention services, whether employed or under contract, based on the criteria
				  in Subchapter E.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.454 - Reporting requirements for applicants for group self-insurance fund status

Current through Register Vol. 54, No. 28, July 13, 2024
(a) As part of
				  its application for group self-insurance fund status submitted to the Bureau,
				  an applicant for self-insurance fund status shall provide the Bureau with
				  detailed information on its accident and illness prevention program that will
				  be offered or provided to group self-insurance fund members as required under
				  §
										129.452 (relating to program
				  requirements) using form LIBC-231G, Initial Report of Accident and Illness
				  Prevention Program Status.
(b) As
				  part of the process of granting group self-insurance fund status, the Bureau
				  will use this information to determine whether to grant group self-insurance
				  fund status.
This section cited in 34 Pa. Code §
												129.456 (relating to Board
						findings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.455 - Reporting requirements for group self-insurance funds

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A group self-insurance fund shall provide
				  the Bureau with detailed information on its accident and illness prevention
				  program using the AIPPS report along with the annual report to the Bureau
				  required under section 815 of the act (77 P. S. §
											1036.15).
(b) A group self-insurance fund shall also
				  provide information describing the established methods used to identify
				  individual group self-insurance fund members requiring accident and illness
				  prevention services. A group self-insurance fund shall also provide data
				  describing accident and illness prevention services efforts for the identified
				  members and the effectiveness of these efforts in improving injury and illness
				  rates.
(c) In addition,
				  documentation required by other governmental regulatory agencies can be used as
				  supporting evidence of accident and illness prevention programs.
(d) Report information shall be subject to
				  Bureau verification.
This section cited in 34 Pa. Code §
												129.456 (relating to report
						findings).
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.456 - Report findings

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Upon
				  receipt of a report required under §
										129.454 (relating to reporting
				  requirements applicants for group self-insurance fund status), the Bureau will
				  review the report data and make a final determination of the adequacy or
				  inadequacy of programs and provide notification to the group self-insurance
				  fund applicant.
(b) Upon receipt of
				  a report required under §
										129.455 (relating to reporting
				  requirements for group self-insurance funds), the Bureau will review the report
				  data and make a final determination of adequacy or an initial determination of
				  inadequacy of programs. An inadequate determination may result in an audit of
				  programs before a final determination is made. The Bureau will provide
				  notification to the group self-insurance fund of its final
				  determination.
Pennsylvania Code › Title 34 - LABOR AND INDUSTRY › Part VIII - Bureau of Workers' Compensation › Chapter 129 - WORKERS' COMPENSATION HEALTH AND SAFETY › Subchapter D - GROUP SELF-INSURANCE FUND'S ACCIDENT AND ILLNESS PREVENTION PROGRAMS › Section 129.457 - Service requirements

Current through Register Vol. 54, No. 28, July 13, 2024
A group self-insurance fund shall maintain or provide
					 through its own or contracted accident and illness prevention services
					 providers the following accident and illness prevention services to
					 members:
(1) Onsite surveys to
				  identify existing or potential accident and illness hazards or safety program
				  deficiencies. If through a survey and analysis of survey results it is
				  determined that the hazards or deficiencies are present, corrective actions
				  shall be proposed to the group self-insurance fund member concerning the
				  abatement of hazards or program deficiencies identified in the surveys. If one
				  or more imminent danger situations or program deficiencies are identified, the
				  group self-insurance fund shall inquire as to the corrective actions the group
				  self-insurance fund member has taken and propose further corrective actions if
				  necessary.
(2) Analyses of the
				  causes of accidents and illnesses at the members' worksites.
(3) Providing or proposing corrective actions
				  in the area of industrial hygiene services as requested by the group
				  self-insurance fund member or as determined by the group self-insurance fund to
				  meet the group self-insurance fund members' operational requirements, for
				  example, air quality testing.
(4)
				  Providing or proposing corrective actions in the area of industrial health
				  services as requested by the group self-insurance fund member or as determined
				  by the group self-insurance fund to meet the group self-insurance fund members'
				  operational requirements, for example, health screenings or substance abuse
				  awareness and prevention training policies and programs.
(5) Accident and illness prevention training
				  programs which may include training for safety committee members as outlined
				  under Subchapter F (relating to workplace safety committees).
(6) Consultations regarding specific safety
				  and health problems and hazard abatement programs and techniques.
(7) Review of planned or newly introduced
				  industrial materials, processes, equipment, layouts and techniques to identify
				  potential hazards and to recommend methods to mitigate any hazards
				  identified.