PRINTER'S NO. 512
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
467
Session of
2015
INTRODUCED BY HICKERNELL, BAKER, CUTLER, DUNBAR, GRELL, GROVE,
JAMES, KAUFFMAN, MENTZER, METCALFE, MILLARD, PICKETT AND
SAYLOR, FEBRUARY 12, 2015
REFERRED TO COMMITTEE ON LABOR AND INDUSTRY, FEBRUARY 12, 2015
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 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:
* * *
(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
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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] none 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) days from the date of the first visit: Provided,
however, That an employer may also establish a list of one or
more designated coordinated care organizations for treatment of
employes, and if such list is established, the employe shall
only treat with a provider or providers who are participants in
one of those organizations for the duration of the injury; and
further Provided, 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
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physicians or other health care providers so designated by the
employer for a period of ninety (90) 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
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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.
* * *
Section 2. The amendment of section 306(f.1)(1) of the act
shall apply to injuries which occur on or after the effective
date of this act.
Section 3. This act shall take effect in 60 days.
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