4123-6-02.2 Provider access to the HPP - provider credentialing criteria.

 

The Ohio Bureau of Workers' Compensation (BWC) will hold a public hearing on Thursday, May 22, 2003, at 10:00 a.m., Training Room G, 3rd Floor, 30 West Spring Street, Columbus, Ohio 43215, to consider the following:

 

(1)  Amendment of the following rules of the BWC for the purpose as shown below:

 

4123-6-02.2       Provider access to the HPP - provider credentialing and recredentialing criteria. Minimum  criteria  for  certifying/recertifying  two  new  provider  types  have  been  added:  1)  Athletic trainers must be licensed by the Ohio occupational therapy, physical therapy, and athletic trainer board;  and  2)  non-physician acupuncturists must have a certificate of registration from the Ohio state medical board.

In addition, criteria for certifying/recertifying several existing provider types have been modified: 1) durable medical equipment supplier (excluding  orthotics,  prosthetics  and  pedorthics)  must  have state vendors license, Medicare certification, or joint commission on accreditation of healthcare organization (JCAHO) accreditation; 2) radiology services (freestanding) must have state licensing, registration or accreditation and (mobile) must have either state, county or city  registration,  or Medicare or Medicaid certification; and 3) vocational rehabilitation case management inters must enroll with BWC as an intern, and qualify to take one of the examinations to achieve one of the following: certification for occupational health nursing (COHN(S)), certified rehabilitation counselor (CRC), or certified disability management specialist (CDMS), certified vocational evaluator (CVE), certified rehabilitation nurse (CRRN), or certified case manager (CCM). The rule also provides that HPP certification as a vocational rehabilitation case management intern is for a period of 4 years, and may not be renewed.

 

4123-6-02.21      Provider access to the HPP - chronic pain program requirements.

The proposed changes to this rule modify the minimum criteria for certification of a chronic pain management program as follows: 1) all components of the program, with the exception of aquatic therapy, must be provided at a single facility; 2) the program medical director must be a bureau certified medical doctor or doctor of osteopathy who has American Board of Medical Specialties or American Osteopathy Association board certification in one of the specialties specified in the rule; and 3) program medical staff must be bureau certified medical doctors or doctors of osteopathy who have American Board of Medical Specialties or  American  Osteopathy  Association  board certification or who have successfully completed a recognized residency or fellowship for a specialty listed below within the past three years and have eligibility for certification and are pursuing board certification in one of the specialties specified in the rule.

 

4123-7-14          Acupuncture.

The proposed changes to this rule provide as follows: 1) services provided by non-physician acupuncturists must be prescribed by medical doctors or doctors of osteopathy who have completed a course of study in acupuncture under the administration of an approved college of medicine or osteopathic medicine; and 2) a registered non-physician acupuncturist shall perform acupuncture under the general supervision of the injured worker's prescribing physician.

 

4123-6-31          Payment for acupuncture.

The proposed changes to this rule provide as follows: 1) services provided by non-physician acupuncturists must be prescribed by medical doctors or doctors of osteopathy who have completed a course of study in acupuncture under the administration of an approved college of medicine or osteopathic medicine; and 2) a registered non-physician acupuncturist shall perform acupuncture under the general supervision of the injured worker's prescribing physician.

 

4123-16-19          Self-insured construction projects.

These rules are being proposed to ensure that claims incurred in the course of, and arising out of, employment by a contractor or subcontractor participating in  a  Public  School  Employer Construction wrap-up project are administered timely and  properly  and  also  to  ensure  that  the Public School Employer is fiscally capable of administering the program.

The proposed rules specifically state the Public School Employer must employ a knowledgeable self-insured program administrator, an ombudsperson, and a safety professional. Public School Employer must identify its administrative plan to ensure that timely calculation and distribution of benefits is made.  In addition, a Public School Employer that is granted the privilege to self insure a

 

construction project will be required to proved its financial strength, as well as provide security in the amount of 125% of the expected losses of the project.

The full and complete text of the proposed rules is available at the Register of Ohio (http://www.registerofohio.state.oh.us) and is on file in the office of the Secretary of State (180 East Broad Street, 15th Floor, Columbus, Ohio), the Legislative Service Commission (77 South High Street, 9th Floor, Columbus, Ohio), the office of the Joint Committee on Agency Rule Review (77 South High  Street, Concourse Level, Columbus, Ohio), the Bureau of Workers'  Compensation,  Legal  Operations  (30  West Spring Street, 26th Floor, Columbus, Ohio), the Bureau of Workers' Compensation (30 West Spring Street, Columbus, Ohio, 1st Floor, Hearing Rooms), and all service offices of the Bureau.

All interested parties will be given an opportunity to be heard. Any interested party unable to attend the public hearing may submit written comments to the undersigned prior to the public hearing.

THE OHIO BUREAU OF WORKERS' COMPENSATION

Tom Sico

Director, Legal Operations

Bureau of Workers' Compensation 30 West Spring Street, L-26 Columbus, Ohio 43215-2256

[phone]

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