recognized certification or accreditation organization for all
utilization review where the date of the injury is at least
eighteen (18) calendar months after the publication of notice
under subclause (A).
(C) The department shall enter an agreement with the
selected nationally recognized certification or accreditation
organization to provide for the certification or accreditation
process for utilization review organizations and employes of
utilization review organizations, including the costs of any
audits required for the certification or accreditation process.
The department shall make reasonable attempts to negotiate a
reduction of the cost of the certification or accreditation
process. An entity approved as a utilization review organization
by the department prior to the effective date of this clause,
including a surviving association that results from the merger
of two or more utilization review organizations under 15 Pa.C.S.
Ch. 3 Subch. C (relating to merger), shall be eligible to
participate in the initial certification or accreditation
process at no cost to the entity. After January 1, 2020, an
entity approved as a utilization review organization shall be
eligible to participate in the process to renew its
certification or accreditation at no cost to the entity. An
entity for which the department has incurred costs under this
subclause shall reimburse the department for its costs related
to the most recent certification or accreditation for the
entity, if the entity does not successfully obtain the initial
or renewal certification or accreditation. The actual amount of
the cost to the department for the certification or
accreditation process under this subclause, not to exceed one
million five-hundred thousand dollars ($1,500,000) annually,
shall be transferred to the department from the Workers'
Compensation Administration Fund.
(D) The department shall conduct outreach to all entities
approved as utilization review organizations by the department
prior to the effective date of this clause. The outreach shall
include providing each entity with notice of the requirements of
this clause, guidance on how this clause will be enforced by the
department and information on how the entity may participate in
the required certification or accreditation process at no cost
under subclause (C).
Amend Bill, page 4, by inserting between lines 11 and 12
Section 3. Within eight months of the effective date of this
act, the Department of Labor and Industry shall propose
regulations to implement the amendment or addition of section
306(f.1)(3)(vi)(J) and (6)(ii) and (v) of the act.
Amend Bill, page 4, line 12, by striking out "3" and
inserting
2017/90SFR/HB0018A01754 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47