First Regular Session Sixty-fifth General Assembly STATE OF COLORADO INTRODUCED LLS NO. 05-0521.01 Christy Chase HOUSE BILL 05-1018 HOUSE SPONSORSHIP Carroll M., SENATE SPONSORSHIP Takis, House Committees Senate Committees Business Affairs and Labor A BILL FOR AN ACT Concerning the ability of an injured worker under the "Colorado Workers' Compensation Act" to select the medical professional who will attend the worker. Bill Summary (Note: This summary applies to this bill as introduced and does not necessarily reflect any amendments that may be subsequently adopted.) Amends the workers' compensation statutes to allow an injured worker, rather than an employer or insurer, to select the licensed medical professional who will provide medical care to the worker. Defines "licensed medical professional" as a medical provider licensed under the "Colorado Medical Practice Act". Makes conforming amendments. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. 8-43-404, Colorado Revised Statutes, is amended to read: 8-43-404. Employee selection of medical provider - examination - refusal - personal responsibility - medical providers to testify and furnish results. (1) In all cases of injury, the injured employee shall have the right to select the licensed medical professional who attends the injured employee. If in case of injury the right to compensation under articles 40 to 47 of this title exists in favor of an injured employee, upon the written request of the employee's employer or the insurer carrying such risk, the employee shall from time to time submit to an independent medical examination by a physician or surgeon licensed medical professional or to a vocational evaluation, which shall be provided and paid for by the employer or insurer. and The employee shall likewise submit to an independent medical examination from time to time by any regular physician licensed medical professional selected and paid for by the division. As used in this section, "licensed medical professional" or "medical professional" means a medical provider licensed under the "Colorado Medical Practice Act", article 36 of title 12, C.R.S. (2) The employee shall be entitled to have a physician licensed medical professional, provided and paid for by the employee, present at any such independent medical examination If an employee is examined by a chiropractor at the request of the employer, the employee shall be entitled to have a chiropractor provided and paid for by the employee present at any such examination required pursuant to subsection (1) of this section. The employee shall also be entitled to receive from the examining physician or chiropractor licensed medical professional a copy of any report which said physician or chiropractor that the medical professional makes to the employer, insurer, or division upon said examination, said copy to and the copy shall be furnished to the employee at the same time it is furnished to the employer, insurer, or division. The employee shall also be entitled to receive reports from any physician selected by the employer to treat said employee upon the same terms and conditions and at the same time the reports are furnished by the physician to the employer. The employer shall be entitled to receive reports from any physician or chiropractor licensed medical professional selected by the employee to treat or examine said the employee in connection with such the injury upon on the same terms and at the same time the reports are furnished by the physician or chiropractor medical professional to the employee. (3) So long as the employee, after written request by the employer or insurer, refuses to submit to an independent medical examination or vocational evaluation or in any way obstructs the same examination or evaluation, all right to collect, or to begin or maintain any proceeding for the collection of, compensation shall be suspended. If the employee refuses to submit to such the examination or evaluation after direction by the director or any agent, referee, or administrative law judge of the division appointed pursuant to section 8-43-208 (1) or in any way obstructs the same examination or evaluation, all right to weekly indemnity which that accrues and becomes payable during the period of such refusal or obstruction shall be barred. If any employee persists in any unsanitary or injurious practice which that tends to imperil or retard recovery or refuses to submit to such medical or surgical treatment or vocational evaluation as that is reasonably essential to promote recovery, the director shall have the discretion to reduce or suspend the compensation of any such the injured employee. (4) Any physician or chiropractor licensed medical professional who makes or is present at any such examination may be required to testify as to the results thereof of the examination. The division may require any physician or chiropractor licensed medical professional having attended an employee in a professional capacity may be required to testify before the division. when it so directs. A physician or chiropractor will licensed medical professional shall not be required to disclose confidential communications that are imparted to said physician or chiropractor the medical professional for the purpose of treatment and which that are unnecessary to a proper understanding of the case. (5) (a) In all cases of injury, the employer or insurer has the right in the first instance to select the physician who attends said injured employee. If the services of a physician are not tendered at the time of injury, the employee shall have the right to select a physician or chiropractor. Upon written request to the insurance carrier or employer's authorized representative if self-insured, the employee may procure written permission to have a personal physician or chiropractor attend said employee. If such permission is neither granted nor refused within twenty days, the employer or insurance carrier shall be deemed to have waived any objection thereto. Objection shall be in writing and shall be deposited in the United States mail or hand delivered to the employee within said twenty days. Upon the proper showing to the division, the employee may procure its permission at any time to have a physician of the employee's selection attend said employee, and in any nonsurgical case the employee, with such permission, in lieu of medical aid, may procure any nonmedical treatment recognized by the laws of this state as legal, the practitioner administering such treatment to receive such fees therefor under the medical provisions of articles 40 to 47 of this title as may be fixed by the division. (b) Any private insurer or self-insured employer acting as its own insurance carrier as provided in section 8-44-201 providing workers' compensation coverage shall pay for chiropractic medical care as provided in paragraph (a) of this subsection (5) provided to the injured employee by a licensed medical professional. (6) Application or prosecution of a claim for benefits shall be a waiver of any privilege concerning communications relating to all medical issues raised by the claim, for the purposes of a utilization review conducted pursuant to section 8-43-501. (7) An employer or insurer shall not be liable for treatment provided pursuant to article 41 of title 12, C.R.S., unless such treatment has been prescribed by an authorized the injured employee's treating physician medical professional or a person to whom the injured employee has been referred by the treating medical professional. (8) Upon request by an employee who has not reached maximum medical improvement and whose authorized treating physician is not level II accredited, an insurer or self-insured employer shall select a level II accredited physician as the authorized treating physician. SECTION 2. Repeal. 8-43-501 (2) (c), Colorado Revised Statutes, is repealed as follows: 8-43-501. Utilization review process - legislative declaration - cash fund. (2) (c) A claimant may request a utilization review pursuant to this section if the claimant has been refused a request pursuant to section 8-43-404 (5) to have a personal physician or chiropractor attend the claimant. A claimant requesting a utilization review pursuant to this paragraph (c) shall file the request on forms promulgated by the director by rule and shall pay the fee required by paragraph (a) of this subsection (2). SECTION 3. 25-1-1202 (1) (b), Colorado Revised Statutes, is amended to read: 25-1-1202. Index of statutory sections regarding medical record confidentiality and health information. (1) Statutory provisions concerning policies, procedures, and references to the release, sharing, and use of medical records and health information include the following: (b) Section 8-43-404, C.R.S., concerning examinations by a physician or chiropractor licensed medical professional for the purposes of workers' compensation; SECTION 4. Applicability. This act shall apply to injuries occurring on or after the effective date of this act. SECTION 5. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.