Workers whose doctors are already in the network, or whose applications to join are being processed, do not need to take any action. But injured workers whose doctors have not yet applied to join should encourage their doctors to do so.
Any workers with an open claim will need to move to a doctor in the network no later than Jan. 1, 2013. L&I will help workers covered by the state workers’ comp plan who have trouble finding a new medical provider. Workers whose claims are managed by their self-insured employers or third-party administrators should contact those companies directly.
Those providers required to be in the network include: physicians, chiropractors, naturopathic physicians, doctors of podiatry, advanced registered nurse practitioners, physician assistants, dentists and optometrists.
Workers can continue to see out-of-state providers and other providers not on this list, until those practices are asked to join the network.
The coming change is important not just for injured workers, but for medical providers as well. That’s because those providers who are not in the network won’t be paid for treating injured workers, except for the initial office or emergency room visit when a claim is filed.
L&I invites all of the provider types listed above to apply to its open network. All qualified providers who meet network requirements are being accepted.
In addition to the network, the 2011 reform legislation expands access to the state’s Centers of Occupational Health (COHEs) and directs L&I to offer incentives to providers that use best practices for occupational health. These reforms are expected to save $218 million over the next four years.