Bill Text: IA HF123 | 2021-2022 | 89th General Assembly | Introduced

Iowa House Bill 123 (Prior Session Legislation)

Introduced

Bill Title: A bill for an act relating to the choice of doctor to treat an injured employee under workers' compensation laws and including applicability date provisions.

Spectrum: Partisan Bill (Democrat 13-0)

Status: (Introduced - Dead) 2021-01-21 - Introduced, referred to Labor. H.J. 132. [HF123 Detail]

Download: Iowa-2021-HF123-Introduced.html

House File 123 - Introduced HOUSE FILE 123 BY HUNTER , OLSON , JACOBY , ANDERSON , KRESSIG , STAED , KONFRST , JAMES , MASCHER , BROWN-POWERS , GJERDE , EHLERT , and COHOON A BILL FOR An Act relating to the choice of doctor to treat an injured 1 employee under workers’ compensation laws and including 2 applicability date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1559YH (5) 89 je/rn

H.F. 123 Section 1. Section 85.27, subsection 4, Code 2021, is 1 amended to read as follows: 2 4. a. (1) For purposes of this section , the employer is 3 obliged to furnish reasonable services and supplies to treat an 4 injured employee, and has the right to choose the care unless 5 the employee has predesignated a physician as provided in 6 paragraph “b” . If the employer chooses the care, the employer 7 shall hold the employee harmless for the cost of care until the 8 employer notifies the employee that the employer is no longer 9 authorizing all or any part of the care and the reason for 10 the change in authorization. An employer is not liable for 11 the cost of care that the employer arranges in response to a 12 sudden emergency if the employee’s condition, for which care 13 was arranged, is not related to the employment. The treatment 14 must be offered promptly and be reasonably suited to treat the 15 injury without undue inconvenience to the employee. 16 (2) If the employee has reason to be dissatisfied with the 17 care offered, the employee should communicate the basis of 18 such dissatisfaction to the employer, in writing if requested, 19 following which the employer and the employee may agree to 20 alternate care reasonably suited to treat the injury. If the 21 employer and employee cannot agree on such alternate care, the 22 commissioner may, upon application and reasonable proofs proof 23 of the necessity therefor, allow and order other care. In an 24 emergency, the employee may choose the employee’s care at the 25 employer’s expense, provided the employer or the employer’s 26 agent cannot be reached immediately. 27 (3) An application made under this subsection paragraph 28 “a” shall be considered an original proceeding for purposes 29 of commencement and contested case proceedings under section 30 85.26 . The hearing shall be conducted pursuant to chapter 31 17A . Before a hearing is scheduled, the parties may choose 32 a telephone hearing , an audio-video conference hearing, or 33 an in-person hearing. A request for an in-person hearing 34 shall be approved unless the in-person hearing would be 35 -1- LSB 1559YH (5) 89 je/rn 1/ 6

H.F. 123 impractical because of the distance between the parties to the 1 hearing. The workers’ compensation commissioner shall issue a 2 decision within ten working days of receipt of an application 3 for alternate care made pursuant to a telephone hearing or 4 audio-video conference hearing or within fourteen working days 5 of receipt of an application for alternate care made pursuant 6 to an in-person hearing. The employer shall notify an injured 7 employee of the employee’s ability to contest the employer’s 8 choice of care pursuant to this subsection paragraph “a” . 9 b. (1) An injured employee has the right to choose care, 10 unless care needs to be provided at the job site in response to 11 a life-threatening emergency, if the employee has predesignated 12 a physician who is a primary care provider, who has previously 13 provided medical treatment to the employee and has retained 14 the employee’s medical records, to provide treatment for the 15 injury. Upon hire and periodically during employment, an 16 employer shall provide written notice, in a manner prescribed 17 by the workers’ compensation commissioner by rule, to all 18 employees who have not yet predesignated a physician of their 19 rights under this paragraph “b” to predesignate such a physician 20 for treatment of an injury. The employer or the employer’s 21 insurer shall not coerce or otherwise attempt to influence an 22 injured employee’s choice of a physician to provide care. An 23 employee shall, as soon as practicable, notify the employer of 24 an injury, and upon receiving such notice of an injury from an 25 employee, the employer shall again provide written notice to 26 that employee of the employee’s rights under this paragraph 27 “b” in a manner prescribed by the workers’ compensation 28 commissioner by rule. If an employer fails to notify employees 29 of their right to choose a physician as provided in this 30 paragraph “b” , the employee has the right to choose any 31 physician to provide treatment for the injury and the treatment 32 shall be considered care authorized under this section. 33 (2) For the purposes of this paragraph “b” , “physician” 34 includes an individual physician, a group of physicians, or 35 -2- LSB 1559YH (5) 89 je/rn 2/ 6

H.F. 123 a clinic. For the purposes of this paragraph “b” , “primary 1 care provider” means an employee’s personal physician who is 2 licensed to practice medicine and surgery, osteopathic medicine 3 and surgery, or osteopathy in this state or in another state 4 and provides primary care and who is a family or general 5 practitioner, a pediatrician, an internist, an obstetrician, 6 or a gynecologist. A physician who practices in another 7 state shall not be predesignated by an employee unless the 8 physician’s office is located within sixty miles of where 9 the employee is employed or was injured unless the workers’ 10 compensation commissioner allows otherwise. A physician chosen 11 by an injured employee to provide treatment is authorized to 12 arrange for any consultation, surgical consultation, referral, 13 emergency care, or other specialized medical services as the 14 physician deems necessary to treat the injury. The employer 15 shall pay for all such care, unless the workers’ compensation 16 commissioner determines otherwise. 17 (3) If the employer has reason to be dissatisfied with the 18 care chosen by the employee, the employer should communicate 19 the basis of such dissatisfaction to the employee, in writing 20 if requested, following which the employee and the employer may 21 agree to alternate care reasonably suited to treat the injury. 22 If the employee and employer cannot agree on such alternate 23 care, the commissioner may, upon application and reasonable 24 proof of the necessity therefor, allow and order other care. 25 (4) An application made under this paragraph “b” shall be 26 considered an original proceeding for purposes of commencement 27 and contested case proceedings under section 85.26. The 28 hearing shall be conducted pursuant to chapter 17A. Before 29 a hearing is scheduled, the parties may choose a telephone 30 hearing, an audio-video conference hearing, or an in-person 31 hearing. A request for an in-person hearing shall be approved 32 unless the in-person hearing would be impractical because of 33 the distance between the parties to the hearing. The workers’ 34 compensation commissioner shall issue a decision within ten 35 -3- LSB 1559YH (5) 89 je/rn 3/ 6

H.F. 123 working days of receipt of an application for alternate care 1 made pursuant to a telephone hearing or audio-video conference 2 hearing or within fourteen working days of receipt of an 3 application for alternate care made pursuant to an in-person 4 hearing. 5 Sec. 2. Section 85.39, Code 2021, is amended by adding the 6 following new subsection: 7 NEW SUBSECTION . 3. If the employee has chosen a physician 8 to provide care as provided in section 85.27, subsection 9 4, paragraph “b” , when it is medically indicated that no 10 significant improvement from an injury is anticipated, the 11 employee may obtain a medical opinion from the employee’s 12 physician, at the employer’s expense, regarding the extent of 13 the employee’s permanent disability. If the employee obtains 14 such an evaluation and the employer believes this evaluation 15 of permanent disability to be too high, the employer may 16 arrange for a medical examination of the injured employee by a 17 physician of the employer’s choice for the purpose of obtaining 18 a medical opinion regarding the extent of the employee’s 19 permanent disability. If an employee is required to leave 20 work for which the employee is being paid wages to attend 21 an examination under this subsection, the employee shall be 22 compensated at the employee’s regular rate for the time the 23 employee is required to leave work, and the employee shall be 24 furnished transportation to and from the place of examination, 25 or the employer may elect to pay the employee the reasonable 26 cost of transportation. The physician chosen by the employer 27 to conduct the examination has the right to confer with and 28 obtain from any physician who has treated the injured employee 29 sufficient history of the injury to make a proper examination. 30 The refusal by the employee to submit to the examination shall 31 suspend the employee’s right to any compensation for the period 32 of the refusal. Compensation shall not be payable for the 33 period of suspension. 34 Sec. 3. APPLICABILITY. This Act applies to injuries 35 -4- LSB 1559YH (5) 89 je/rn 4/ 6

H.F. 123 occurring on or after January 1, 2022. 1 EXPLANATION 2 The inclusion of this explanation does not constitute agreement with 3 the explanation’s substance by the members of the general assembly. 4 This bill relates to the choice of a physician to treat an 5 injured employee under the state’s workers’ compensation laws. 6 The bill allows the employer to choose care unless the employee 7 has predesignated a physician as provided in the bill. 8 The bill gives an employee the right to predesignate a 9 physician who is a primary care provider, who has previously 10 provided treatment to the employee and has retained the 11 employee’s medical records, to provide treatment for a 12 work-related injury. The employer is required to provide 13 written notice to employees of this right upon hire, and 14 periodically during employment, and upon receiving notice of 15 an injury from an employee who has not yet predesignated a 16 physician of their right to do so, in a manner prescribed by 17 the workers’ compensation commissioner. An employer or an 18 employer’s insurer shall not coerce or otherwise attempt to 19 influence an injured employee’s choice of a physician. 20 If the employer fails to provide such notification, an 21 injured employee has the right to choose any physician to 22 provide treatment for the work-related injury and that 23 treatment shall be considered authorized care. 24 If the employer or employee is dissatisfied with the care 25 chosen by the other party, the dissatisfied party is required 26 to communicate the basis of dissatisfaction to the other 27 party in writing and the parties may agree to alternate care 28 reasonably suited to treat the injury. If the parties cannot 29 agree to such alternate care, the dissatisfied party may make 30 an application for alternate care to the commissioner. 31 An application for alternate care is an original proceeding 32 and is treated as a contested case. A party may request that 33 the hearing be held in person, by telephone, or by audio-video 34 conference. The commissioner is required to issue a decision 35 -5- LSB 1559YH (5) 89 je/rn 5/ 6

H.F. 123 within 10 working days of receipt of an application made 1 pursuant to a telephone hearing or audio-video conference 2 hearing and within 14 days of an in-person hearing. 3 The bill provides that if the employee has chosen care, when 4 it is medically indicated that no significant improvement from 5 an injury is anticipated, the employee may obtain a medical 6 opinion regarding the extent of the employee’s permanent 7 disability from the employee’s physician. If the employer 8 believes that the evaluation of permanent disability obtained 9 by the employee is too high, the employer has the right 10 to obtain another medical opinion from a physician of the 11 employer’s choosing. 12 The bill applies to injuries occurring on or after January 13 1, 2022. 14 -6- LSB 1559YH (5) 89 je/rn 6/ 6