Pennsylvania lawmakers have proposed a change to the utilization review process in the state’s workers’ compensation system.
House Bill 881, introduced Tuesday, would amend the state Workers’ Compensation Act by mandating that utilization review requests in injured workers be assigned only to organizations that are nationally accredited to handle utilization review issues for workers’ comp programs.
If the bill becomes law, the specific nationally recognized accreditation or certification programs that will be required of organizations seeking approval to handle utilization reviews must be published via public notice within 30 days of the bill’s enactment.
Those organizations that do not have the appropriate certification or accreditation will be allowed to continue participating in utilization review for up to 1
8 months after the publication of the new notice as long as they “actively seek to achieve the chosen certification or accreditation” during that time frame, the measure states.Utilization review is a process in workers’ compensation claims where an impartial medical party can review the reasonableness or necessity of providing treatment to injured and ill workers who are collecting compensation benefits.
The bill was sent to Parliament’s Labor and Industry Committee for consideration.
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