THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY GERGELY, W. KELLER, CALTAGIRONE, GEORGE, HORNAMAN, KOTIK, KULA, McGEEHAN, MURPHY, M. O'BRIEN, SCHMOTZER, STABACK AND JOSEPHS, OCTOBER 17, 2012

REFERRED TO COMMITTEE ON LABOR AND INDUSTRY, OCTOBER 17, 2012  

AN ACT

Amending the act of June 2, 1915 (P.L.736, No.338), entitled, as

reenacted and amended, "An act defining the liability of an

employer to pay damages for injuries received by an employe

in the course of employment; establishing an elective

schedule of compensation; providing procedure for the

determination of liability and compensation thereunder; and

prescribing penalties," in liability and compensation,

further providing for the schedule of compensation.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 306(f.1)(1) of the act of June 2, 1915

(P.L.736, No.338), known as the Workers' Compensation Act,

reenacted and amended June 21, 1939 (P.L.520, No.281) and

amended June 24, 1996 (P.L.350, No.57), is amended to read:

Section 306.  The following schedule of compensation is

hereby established:

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(f.1)  (1)  (i)  The employer shall provide payment in

accordance with this section for reasonable surgical and medical

services, services rendered by physicians or other health care

providers, including an additional opinion when invasive surgery

may be necessary, medicines and supplies, as and when needed.

Provided an employer establishes a list of at least six

designated health care providers, no more than four of whom may

be a coordinated care organization and no fewer than three of

whom shall be physicians, the employe shall be required to visit

one of the physicians or other health care providers so

designated and shall continue to visit the same or another

designated physician or health care provider for a period of

[ninety (90)] thirty (30) days from the date of the first visit:

Provided, however, That the employer shall not include on the

list a physician or other health care provider who is employed,

owned or controlled by the employer or the employer's insurer

unless employment, ownership or control is disclosed on the

list. Should invasive surgery for an employe be prescribed by a

physician or other health care provider so designated by the

employer, the employe shall be permitted to receive an

additional opinion from any health care provider of the

employe's own choice. If the additional opinion differs from the

opinion provided by the physician or health care provider so

designated by the employer, the employe shall determine which

course of treatment to follow: Provided, That the second opinion

provides a specific and detailed course of treatment. If the

employe chooses to follow the procedures designated in the

second opinion, such procedures shall be performed by one of the

physicians or other health care providers so designated by the

employer for a period of [ninety (90)] thirty (30) days from the

date of the visit to the physician or other health care provider

of the employe's own choice. Should the employe not comply with

the foregoing, the employer will be relieved from liability for

the payment for the services rendered during such applicable

period. It shall be the duty of the employer to provide a

clearly written notification of the employe's rights and duties

under this section to the employe. The employer shall further

ensure that the employe has been informed and that he

understands these rights and duties. This duty shall be

evidenced only by the employe's written acknowledgment of having

been informed and having understood his rights and duties. Any

failure of the employer to provide and evidence such

notification shall relieve the employe from any notification

duty owed, notwithstanding any provision of this act to the

contrary, and the employer shall remain liable for all rendered

treatment. Subsequent treatment may be provided by any health

care provider of the employe's own choice. Any employe who, next

following termination of the applicable period, is provided

treatment from a nondesignated health care provider shall notify

the employer within five (5) days of the first visit to said

health care provider. Failure to so notify the employer will

relieve the employer from liability for the payment for the

services rendered prior to appropriate notice if such services

are determined pursuant to paragraph (6) to have been

unreasonable or unnecessary.

(ii)  In addition to the above service, the employer shall

provide payment for medicines and supplies, hospital treatment,

services and supplies and orthopedic appliances, and prostheses

in accordance with this section. Whenever an employe shall have

suffered the loss of a limb, part of a limb, or an eye, the

employer shall also provide for an artificial limb or eye or

other prostheses of a type and kind recommended by the doctor

attending such employe in connection with such injury and any

replacements for an artificial limb or eye which the employe may

require at any time thereafter, together with such continued

medical care as may be prescribed by the doctor attending such

employe in connection with such injury as well as such training

as may be required in the proper use of such prostheses. The

provisions of this section shall apply to injuries whether or

not loss of earning power occurs. If hospital confinement is

required, the employe shall be entitled to semiprivate

accommodations, but, if no such facilities are available,

regardless of the patient's condition, the employer, not the

patient, shall be liable for the additional costs for the

facilities in a private room.

(iii)  Nothing in this section shall prohibit an insurer or

an employer from contracting with any individual, partnership,

association or corporation to provide case management and

coordination of services with regard to injured employes.

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Section 2.  The amendment of section 306(f.1)(1) of the act

shall apply to injuries occurring on or after the effective date

of this section.

Section 3.  This act shall take effect in 30 days.