1691 AMH .... REIN 42





HB 1691 - H AMD 0121 WITHDRAWN 3-18-03

By Representative Chandler

 

Beginning on page 1, line 11, strike all of subsection (1) of section 1 and insert the following:

"The ability of the department to manage industrial insurance health services becomes more difficult as the number or providers and scopes of practice are expanded. The integrity of the industrial insurance program of this state depends in large part upon the provision of quality health and vocational services and care to workers covered under this title. Medically unnecessary or inappropriate health and vocational services delay the recovery process, have grave potential for further injury to workers, and escalate the cost of the industrial insurance program at great unfairness to both workers and employers of this state. Therefore, the director or the director's designee shall accomplish the following objectives.

(1) The director shall supervise the providing of prompt and efficient care and treatment, including ((care)) services provided by physician assistants governed by the provisions of chapters 18.57A and 18.71A RCW, acting under a supervising physician, ((and)) including chiropractic care, and including care provided by licensed advanced registered nurse practitioners, to workers injured during the course of their employment at the least cost consistent with promptness and efficiency, without discrimination or favoritism, and with as great uniformity as the various and diverse surrounding circumstances and locations of industries will permit and to that end shall, from time to time, establish and adopt and supervise the administration of printed forms, rules, regulations, and practices for the furnishing of such care and treatment: PROVIDED, That the department may adopt rules that prescribe limits on the number or type of treatments, tests, or procedures provided to injured workers by licensed advanced registered nurse practitioners, based upon the most current medical and scientific evidence or the likelihood that such treatments, tests, or procedures are curative or rehabilitative, that is, that they are substantially likely to improve the worker's functional abilities, particularly related to return to work: PROVIDED FURTHER, That the medical coverage decisions of the department do not constitute a "rule" as used in RCW 34.05.010(16), nor are such decisions subject to the rule-making provisions of chapter 34.05 RCW except that criteria for establishing medical coverage decisions shall be adopted by rule after consultation with the workers' compensation advisory committee established in RCW 51.04.110: PROVIDED FURTHER, That the department may recommend to an injured worker particular health care services and providers where specialized treatment is indicated or where cost effective payment levels or rates are obtained by the department: AND PROVIDED FURTHER, That the department may enter into contracts for goods and services including, but not limited to, durable medical equipment so long as statewide access to quality service is maintained for injured workers."

 

On page 18, after line 24, insert the following:

"A licensed advanced registered nurse practitioner provider may appeal any action, decision, or order by the director or the director's authorized representative under this section. Proceedings during the appeal shall be as prescribed in this title. Any order terminating or suspending a licensed advanced registered nurse practitioner provider's eligibility to render services to industrially injured workers pursuant to this section shall become effective thirty days after the date the department order is communicated to the provider. An appeal by a provider shall not act as a stay of the action unless the board or court, for good cause shown, orders otherwise."



 

EFFECT: Gives the Department of Labor and Industries greater authority to oversee the utilization of health care services provided by licensed advanced registered nurse practitioners and to discipline participating licensed advanced registered nurse practitioner providers.