Bill Text: IA HF97 | 2017-2018 | 87th General Assembly | Introduced

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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 12-0)

Status: (Introduced - Dead) 2017-01-31 - Subcommittee: Forristall, Hunter and Worthan. H.J. 166. [HF97 Detail]

Download: Iowa-2017-HF97-Introduced.html

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House File 97 - Introduced




                                 HOUSE FILE       
                                 BY  HUNTER, ABDUL=SAMAD,
                                     BENNETT, T. TAYLOR,
                                     KACENA, KEARNS,
                                     GASKILL, STAED,
                                     RUNNING=MARQUARDT,
                                     OLDSON, BROWN=POWERS,
                                     and GAINES

                                      A BILL FOR

  1 An Act relating to the choice of doctor to treat an injured
  2    employee under workers' compensation laws and including
  3    applicability date provisions.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1    Section 1.  Section 85.27, subsection 4, Code 2017, is
  1  2 amended to read as follows:
  1  3    4.a.  (1)  For purposes of this section, the employer is
  1  4 obliged to furnish reasonable services and supplies to treat an
  1  5 injured employee, and has the right to choose the care unless
  1  6 the employee has predesignated a physician as provided in
  1  7 paragraph "b". If the employer chooses the care, the employer
  1  8 shall hold the employee harmless for the cost of care until the
  1  9 employer notifies the employee that the employer is no longer
  1 10 authorizing all or any part of the care and the reason for
  1 11 the change in authorization. An employer is not liable for
  1 12 the cost of care that the employer arranges in response to a
  1 13 sudden emergency if the employee's condition, for which care
  1 14 was arranged, is not related to the employment. The treatment
  1 15 must be offered promptly and be reasonably suited to treat the
  1 16 injury without undue inconvenience to the employee.
  1 17    (2)  If the employee has reason to be dissatisfied with the
  1 18 care offered, the employee should communicate the basis of
  1 19 such dissatisfaction to the employer, in writing if requested,
  1 20 following which the employer and the employee may agree to
  1 21 alternate care reasonably suited to treat the injury. If the
  1 22 employer and employee cannot agree on such alternate care, the
  1 23 commissioner may, upon application and reasonable proofs proof
  1 24  of the necessity therefor, allow and order other care. In an
  1 25 emergency, the employee may choose the employee's care at the
  1 26 employer's expense, provided the employer or the employer's
  1 27 agent cannot be reached immediately.
  1 28    (3)  An application made under this subsection paragraph
  1 29 "a" shall be considered an original proceeding for purposes
  1 30 of commencement and contested case proceedings under section
  1 31 85.26. The hearing shall be conducted pursuant to chapter
  1 32 17A.  Before a hearing is scheduled, the parties may choose
  1 33 a telephone hearing, an audio=video conference hearing, or
  1 34 an in=person hearing. A request for an in=person hearing
  1 35 shall be approved unless the in=person hearing would be
  2  1 impractical because of the distance between the parties to the
  2  2 hearing. The workers' compensation commissioner shall issue a
  2  3 decision within ten working days of receipt of an application
  2  4 for alternate care made pursuant to a telephone hearing or
  2  5 audio=video conference hearing or within fourteen working days
  2  6 of receipt of an application for alternate care made pursuant
  2  7 to an in=person hearing. The employer shall notify an injured
  2  8 employee of the employee's ability to contest the employer's
  2  9 choice of care pursuant to this subsection paragraph "a".
  2 10    b.  (1)  An injured employee has the right to choose care,
  2 11 unless care needs to be provided at the job site in response to
  2 12 a life=threatening emergency, if the employee has predesignated
  2 13 a physician who is a primary care provider, who has previously
  2 14 provided medical treatment to the employee and has retained
  2 15 the employee's medical records, to provide treatment for the
  2 16 injury.  Upon hire and periodically during employment, an
  2 17 employer shall provide written notice to all employees who have
  2 18 not yet predesignated a physician, of their rights under this
  2 19 paragraph "b" to predesignate such a physician for treatment of
  2 20 an injury, in a manner prescribed by the workers' compensation
  2 21 commissioner by rule.  The employer or the employer's insurer
  2 22 shall not coerce or otherwise attempt to influence an injured
  2 23 employee's choice of a physician to provide care.  An employee
  2 24 shall, as soon as practicable, notify the employer of an
  2 25 injury, and upon receiving such notice of an injury from an
  2 26 employee, the employer shall again provide written notice to
  2 27 that employee of the employee's rights under this paragraph
  2 28 "b" in a manner prescribed by the workers' compensation
  2 29 commissioner by rule.  If an employer fails to notify employees
  2 30 of their right to choose a physician as provided in this
  2 31 paragraph "b", the employee has the right to choose any
  2 32 physician to provide treatment for the injury and the treatment
  2 33 shall be considered care authorized under this section.
  2 34    (2)  For the purposes of this paragraph "b", "physician"
  2 35  includes an individual physician, a group of physicians, or
  3  1 a clinic.  For the purposes of this paragraph "b", "primary
  3  2 care provider" means an employee's personal physician who is
  3  3 licensed to practice medicine and surgery, osteopathic medicine
  3  4 and surgery, or osteopathy in this state or in another state
  3  5 and provides primary care and who is a family or general
  3  6 practitioner, a pediatrician, an internist, an obstetrician,
  3  7 or a gynecologist.  A physician who practices in another
  3  8 state shall not be predesignated by an employee unless the
  3  9 physician's office is located within sixty miles of where
  3 10 the employee is employed or was injured unless the workers'
  3 11 compensation commissioner allows otherwise.  A physician chosen
  3 12 by an injured employee to provide treatment is authorized to
  3 13 arrange for any consultation, surgical consultation, referral,
  3 14 emergency care, or other specialized medical services as the
  3 15 physician deems necessary to treat the injury.  The employer
  3 16 shall pay for all such care, unless the workers' compensation
  3 17 commissioner determines otherwise.
  3 18    (3)  If the employer has reason to be dissatisfied with the
  3 19 care chosen by the employee, the employer should communicate
  3 20 the basis of such dissatisfaction to the employee, in writing
  3 21 if requested, following which the employee and the employer may
  3 22 agree to alternate care reasonably suited to treat the injury.
  3 23 If the employee and employer cannot agree on such alternate
  3 24 care, the commissioner may, upon application and reasonable
  3 25 proof of the necessity therefor, allow and order other care.
  3 26    (4)  An application made under this paragraph "b" shall be
  3 27 considered an original proceeding for purposes of commencement
  3 28 and contested case proceedings under section 85.26.  The
  3 29 hearing shall be conducted pursuant to chapter 17A.  Before
  3 30 a hearing is scheduled, the parties may choose a telephone
  3 31 hearing, an audio=video conference hearing, or an in=person
  3 32 hearing.  A request for an in=person hearing shall be approved
  3 33 unless the in=person hearing would be impractical because of
  3 34 the distance between the parties to the hearing.  The workers'
  3 35 compensation commissioner shall issue a decision within ten
  4  1 working days of receipt of an application for alternate care
  4  2 made pursuant to a telephone hearing or audio=video conference
  4  3 hearing or within fourteen working days of receipt of an
  4  4 application for alternate care made pursuant to an in=person
  4  5 hearing.
  4  6    Sec. 2.  Section 85.39, Code 2017, is amended to read as
  4  7 follows:
  4  8    85.39  Examination of injured employees.
  4  9    1.  a.  After an injury, the employee, if requested by the
  4 10 employer, shall submit for examination at some reasonable
  4 11 time and place and as often as reasonably requested, to a
  4 12 physician or physicians authorized to practice under the laws
  4 13 of this state or another state, without cost to the employee;
  4 14 but if the employee requests, the employee, at the employee's
  4 15 own cost, is entitled to have a physician or physicians
  4 16 of the employee's own selection present to participate in
  4 17 the examination. If an employee is required to leave work
  4 18 for which the employee is being paid wages to attend the
  4 19 requested examination, the employee shall be compensated at
  4 20 the employee's regular rate for the time the employee is
  4 21 required to leave work, and the employee shall be furnished
  4 22 transportation to and from the place of examination, or the
  4 23 employer may elect to pay the employee the reasonable cost of
  4 24 the transportation. The refusal of the employee to submit
  4 25 to the examination shall suspend the employee's right to any
  4 26 compensation for the period of the refusal. Compensation shall
  4 27 not be payable for the period of suspension.
  4 28    b.  If an evaluation of permanent disability has been made by
  4 29 a physician retained by the employer and the employee believes
  4 30 this evaluation to be too low, the employee shall, upon
  4 31 application to the commissioner and upon delivery of a copy of
  4 32 the application to the employer and its insurance carrier, be
  4 33 reimbursed by the employer the reasonable fee for a subsequent
  4 34 examination by a physician of the employee's own choice, and
  4 35 reasonably necessary transportation expenses incurred for the
  5  1 examination. The physician chosen by the employee has the
  5  2 right to confer with and obtain from the employer=retained
  5  3 physician sufficient history of the injury to make a proper
  5  4 examination.
  5  5    2.  If the employee has chosen a physician to provide care
  5  6 as provided in section 85.27, subsection 4, paragraph "b", when
  5  7 it is medically indicated that no significant improvement from
  5  8 an injury is anticipated, the employee may obtain a medical
  5  9 opinion from the employee's physician, at the employer's
  5 10 expense, regarding the extent of the employee's permanent
  5 11 disability.  If the employee obtains such an evaluation and the
  5 12 employer believes this evaluation of permanent disability to be
  5 13 too high, the employer may arrange for a medical examination of
  5 14 the injured employee by a physician of the employer's choice
  5 15 for the purpose of obtaining a medical opinion regarding the
  5 16 extent of the employee's permanent disability.  If an employee
  5 17 is required to leave work for which the employee is being paid
  5 18 wages to attend an examination under this subsection, the
  5 19 employee shall be compensated at the employee's regular rate
  5 20 for the time the employee is required to leave work, and the
  5 21 employee shall be furnished transportation to and from the
  5 22 place of examination, or the employer may elect to pay the
  5 23 employee the reasonable cost of transportation.  The physician
  5 24 chosen by the employer to conduct the examination has the right
  5 25 to confer with and obtain from any physician who has treated
  5 26 the injured employee sufficient history of the injury to make
  5 27 a proper examination.  The refusal by the employee to submit
  5 28 to the examination shall suspend the employee's right to any
  5 29 compensation for the period of the refusal.  Compensation shall
  5 30 not be payable for the period of suspension.
  5 31    Sec. 3.  APPLICABILITY.  This Act applies to injuries
  5 32 occurring on or after January 1, 2018.
  5 33                           EXPLANATION
  5 34 The inclusion of this explanation does not constitute agreement with
  5 35 the explanation's substance by the members of the general assembly.
  6  1 This bill relates to the choice of a physician to treat an
  6  2 injured employee under the state's workers' compensation laws.
  6  3 The bill allows the employer to choose care unless the employee
  6  4 has predesignated a physician as provided in the bill.
  6  5    The bill gives an employee the right to predesignate a
  6  6 physician who is a primary care provider, who has previously
  6  7 provided treatment to the employee and has retained the
  6  8 employee's medical records, to provide treatment for a
  6  9 work=related injury.  The employer is required to provide
  6 10 written notice to employees of this right upon hire, and
  6 11 periodically during employment, and upon receiving notice of
  6 12 an injury from an employee who has not yet predesignated a
  6 13 physician of their right to do so, in a manner prescribed by
  6 14 the workers' compensation commissioner.  An employer or an
  6 15 employer's insurer shall not coerce or otherwise attempt to
  6 16 influence an injured employee's choice of a physician.
  6 17    If the employer fails to provide such notification, an
  6 18 injured employee has the right to choose any physician to
  6 19 provide treatment for the work=related injury and that
  6 20 treatment shall be considered authorized care.
  6 21    If the employer or employee is dissatisfied with the care
  6 22 chosen by the other party, the dissatisfied party is required
  6 23 to communicate the basis of dissatisfaction to the other
  6 24 party in writing and the parties may agree to alternate care
  6 25 reasonably suited to treat the injury.  If the parties cannot
  6 26 agree to such alternate care, the dissatisfied party may make
  6 27 an application for alternate care to the commissioner.
  6 28    An application for alternate care is an original proceeding
  6 29 and is treated as a contested case.  A party may request that
  6 30 the hearing be held in person, by telephone, or by audio=video
  6 31 conference.  The commissioner is required to issue a decision
  6 32 within 10 working days of receipt of an application made
  6 33 pursuant to a telephone hearing or audio=video conference
  6 34 hearing and within 14 days of an in=person hearing.
  6 35    Code section 85.39 is amended to provide that if the
  7  1 employee has chosen care, when it is medically indicated that
  7  2 no significant improvement from an injury is anticipated, the
  7  3 employee may obtain a medical opinion regarding the extent
  7  4 of the employee's permanent disability from the employee's
  7  5 physician.  If the employer believes that the evaluation of
  7  6 permanent disability obtained by the employee is too high, the
  7  7 employer has the right to obtain another medical opinion from a
  7  8 physician of the employer's choosing.
  7  9    The bill applies to injuries occurring on or after January
  7 10 1, 2018.
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