An employee who is otherwise covered by a certified managed
care plan is not required to receive services under a managed care plan until
the employer gives the employee notice of items A to E. For employees enrolled
after November 30, 1993, this individual notice must be given at the time of
enrollment. The notice must also be offered to an employee when the employer
receives notice of an injury. In addition, the employer must post a notice of
items A to E at a prominent location on the employer's premises. The posted
notice shall remain posted as long as the employees are covered by the managed
care plan. The posted and individual notices must include the information in
items A to E:
A. that the employer has
enrolled with the specified managed care plan to provide all necessary medical
treatment for workers' compensation injuries. An employee with an injury prior
to enrollment may continue to receive treatment from a nonparticipating
provider until the employee changes doctors. The notice to employees must
specify the effective date of the managed care plan, which must be later than
the date the notice is posted;
B.
the contact person and telephone number of the employer and the managed care
plan who can answer questions about managed care;
C. that the employee may receive treatment
from a medical doctor, chiropractor, podiatrist, osteopath, or dentist, if the
treatment is available within the community and is appropriate for the injury
or illness;
D. how the employee can
access care under the managed care plan and the toll-free 24-hour telephone
number of the managed care plan that informs employees of available
services;
E. that the employee is
required to receive services from a health care provider who is a member of the
managed care plan, except in the following circumstances:
(1) if the employee has established a
documented history of treatment before the injury with a health care provider
who maintains the employee's medical records under the requirements in part
5218.0500, subparts 1 and 2, except that if the employee changes doctors it
must be to a doctor within the managed care plan;
(2) in an emergency; and
(3) if the employee's place of employment and
residence are beyond the mileage parameters set forth in part 5218.0100,
subpart 1, item F, subitem (7); and
F. the St. Paul, Duluth, and toll-free
telephone numbers of the Department of Labor and Industry for
questions.
