"This network will help injured workers get the best possible care," commented Beth Dupre, assistant director for Insurance Services. "We want workers to return to good health and to work."
The proposed standards are modeled on those used by most health plans. To develop the standards, L&I worked closely with a special advisory group made up of worker, employer, and provider representatives from the Industrial Insurance Medical and Chiropractic Advisory Committees.
The medical provider network is part of historic legislation passed in 2011, Substitute Senate Bill 5801, which was enacted to improve workers' outcomes following injury. In addition to creating the network, the legislation expands access to the state's Centers of Occupational Health and Education (COHEs) and directs L&I to offer incentives to network providers who use best practices for occupational health.
When the final standards take effect in February 2012, L&I will begin enrolling providers in the new network. This first phase of network standards applies only to physicians, chiropractors, naturopathic physicians, doctors of podiatry, advanced registered nurse practitioners, physician assistants, dentists and optometrists.
Network standards will be added for other types of providers at a later date. Until then, other provider types can continue to treat injured workers without being part of the network.
Starting Jan. 1, 2013, injured workers only will be able to see a non-network provider for the initial visit. Workers must choose a network provider for ongoing care. L&I will help workers who need to transition their care to a network provider.
Complete information and a copy of the proposed rules are available at the Provider Network and COHE Expansion Web site.
Three hearings will be held to gather public comment on the proposed standards:
· Seattle, Dec. 8, 10 a.m., Conference Center at Seattle-Tacoma International Airport.
· Tumwater, Dec. 12, 5:30 p.m. L&I headquarters.
· Spokane Valley, Dec. 16, 10 a.m., CenterPlace Event Center
Written comments on the draft rules will be accepted until 5 p.m., Dec. 16, and should be submitted to Jami Lifka, via e-mail at [email protected]; mailed to the Department of Labor & Industries, PO Box 44321, Olympia, WA 98504-4321; or hand-delivered to L&I, 7273 Linderson Way SW, Tumwater, WA 98501.