PROVIDER NETWORK RULES for ALABAMA

Provider Selection
The employer/insurer chooses the treating provider without restriction.

Managed Care Options
There is no policy currently in effect that either explicitly prohibits or mandates managed care. There is an option of utilization review.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; generic worksite posters may be used.


PROVIDER NETWORK RULES for ALASKA

Provider Selection
The employee chooses the treating provider. The employee may not make more than one change in their choice of attending physician without the written consent of the employer

Managed Care Options
Employers/insurers may use managed care services that do not interfere with the employee's choice of physician.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for ARIZONA

Provider Selection
The employer can direct an injured employee to a physician for a one-time evaluation. After the initial visit, the injured worker chooses the treating provider. Self-insured employers choose the treating provider beyond the initial visit, and employees may not change doctors without written approval.


Managed Care Options
The use of managed care practices is permitted as long as they do not interfere with the employee's right to choose the treating provider in the case of employers who are not self- insured.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for ARKANSAS

Provider Selection
The employer/insurer chooses the treating provider without restriction.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; generic worksite posters may be used.

PROVIDER NETWORK RULES for ARKANSAS MCO


Provider Selection
The employer chooses the treating physician from among those associated with managed care entities (MCOs) certified by the commission

Provider Lists
Notice of choices must be given to employees. See Direction of Care law.



PROVIDER NETWORK RULES for CALIFORNIA

Provider Selection
Unless the employer has an MPN, or an HCO, the employer chooses the treating provider for the first 30 days from the date of injury. There after the employee chooses.


Pre-designation is only available if all of the following conditions are satisfied:

  1. The employer provides group health coverage;
  2. The physician is the employee's primary care physician (must be a licensed physician and surgeon) and has previously directed the medical treatment of the employee and who retains the employee's medical records, including his/her medical history.
  3. The physician agrees to be pre-designated.
  4. The employee notifies the employer in writing prior to the date of injury that he/she has a personal physician.
PROVIDER NETWORK RULES for CALIFORNIA HEALTH CARE ORGANIZATION (HCO)


Provider Selection
The employer chooses the treating provider.

If the employer has contracted with an HCO, the employee is precluded from selecting a physician of his or her choice unless they have "pre-designated" a physician prior to the injury occurring.

Depending on the employee benefits, once in the HCO, the HCO can manage an injured worker from 90-180 days.

Provider Lists
Provider lists and directories may be utilized.


PROVIDER NETWORK RULES FOR CALIFORNIA MPN


Provider Selection
The employer chooses the initial treating provider. The employee may choose a physician within the MPN after the first visit.

Provider Lists
Provider lists and directories may be utilized



PROVIDER NETWORK RULES for COLORADO

Provider Selection
The employer/insurer chooses the initial treating provider from a list of at least 2 physician provided by the employer.

Managed Care Options
Managed care is allowed, and defined as the provision of medical services through an insurer-chosen accredited provider network or a recognized managed care organization.

Provider Lists
Provider lists and directories may be utilized. There is a state-mandated posting panel. The employer has the right to direct the employee`s selection of initial medical provider for non-emergency treatment. The employer must provide a list of at least two physicians or corporate medical providers, or at least one physician and one corporate medical provider, from which the employee may choose a treating physician. The two providers must be at two distinct locations without common ownership. If there are not two providers as described within thirty miles of each other, the employer may designate two providers at the same location or with shared ownership. The employee should contact the employer`s designated representative before treating with providers obtained from this referral.


PROVIDER NETWORK RULES for CONNECTICUT

Provider Selection
The employer is responsible for furnishing the emergency medical treatment at an employer-designated office or facility. After this initial treatment, the employee may choose an attending physician from the list of approved practitioners.

The list presently includes all physicians, surgeons, podiatrists, optometrists, and dentists licensed to practice in Connecticut.

Managed Care Options
If an employer uses an approved medical care plan, then the employee must receive medical treatment from a participating medical practitioner. If a provider outside the Managed Care Plan is chosen, workers’ compensation benefits may be suspended.

Provider Lists
Provider lists and directories may be utilized. Posting of a provider listing (panel) is required under a State Certified Managed Care Plan. StrataCare generic posting may be used.


PROVIDER NETWORK RULES for DELAWARE

Provider Selection
The employee chooses the treating provider without restriction.

Managed Care Options
Use of any managed care techniques must not interfere with the employees' rights regarding choice of physician.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for DISTRICT OF COLUMBIA

Provider Selection
The employee may select any licensed treating provider.

Managed Care Options
Insurers and employers are permitted to provide managed care type services including case management and utilization review. The employee still maintains choice of provider.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for FLORIDA

Provider Selection
The employer/insurer chooses the treating provider for situations other than managed care, or gives the injured employee a choice from the carrier's list of providers. If an employer or insurer participates in the Florida MCA, the injured worker can choose a provider from an approved list.

Managed Care Options
Treatment must be provided through managed care arrangements (MCA). In MCA, the injured employee chooses a designated physician gatekeeper (medical care coordinator) within the MCA’s network of providers. MCC must be M.D. or D.O.

Provider Lists
There is a State-mandated posting. The StrataCare generic posting may be used in conjunction with the state poster.


PROVIDER NETWORK RULES for GEORGIA

Provider Selection
The employee chooses a provider from a panel selected by the employer/insurer. The employer/insurer may choose listed providers without restriction. The employee may see providers not on the list if the employer/insurer authorizes them.

For employees whose insurers and/or employers have contracted with a certified managed care organization, initial choice of physician is limited to providers within the network.

Provider Lists
Panel state. GA form WC-P1 to be used to post panel. Legislation requires an orthopedic surgeon on the posted panel; it restricts industrial clinics to two, and requires a minority physician where feasible. The panel providers must not be associated (a group, professional association, or professional corporation counts as one provider). There must be a minimum of six providers on the panel unless an exception has been granted. The employer/insurer may choose listed providers without restriction.

Work Site Posters
Must be printed on pink colored cardstock paper, 8x14 in. size. A state-mandated MCO posting is available – GA WC-P3.


PROVIDER NETWORK RULES for HAWAII

Provider Selection
The employee chooses the treating provider.

Managed Care Options
Employers and insurers may provide such services if they do not deny the employee's right to choose the treating physician.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for IDAHO

Provider Selection
The employer/insurer can designate a particular provider or provider network for its injured workers (must be disclosed at time of hire and applied uniformly). However, when no provider is designated, the employee chooses the provider.

Managed Care Options
Employers/insurers may provide managed care services and generally must disclose the provider networks at the time of hire in order to direct care.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for ILLINOIS

Provider Selection
General Rule: The employee may choose a provider for initial care either from the employer’s posted panel of providers or a provider not included on the employer’s panel. 820 ILCS 305/8. First aid and emergency care are not considered an initial choice of provider. http://www.iwcc.il.gov.

Managed Care Options
General Rule: The employee may elect to change providers one time at the employee's own discretion. A subsequent change of treating provider is subject to employer or insurer approval. Referrals to specialists are not considered a change in treating physician. http://www.iwcc.il.gov.

Provider Lists
Panels and Directories are allowed, subject to the approval of the Illinois Workers' Compensation Commission. There is no state-mandated panel form.


PROVDER NETWORK RULES FOR ILLINOIS – PPP


Provider Selection
The employee chooses the treating provider from a list of network providers.

Managed Care Options
An employer may use a preferred provider program (PPP) approved by the Illinois Department of Insurance.

Provider Lists
Provider lists and directories are allowed.




PROVIDER NETWORK RULES for INDIANA

Provider Selection
The employer/insurer chooses the treating provider.

Managed Care Options
Insurers/employers may provide or contract with managed care and/or utilization review services.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for IOWA

Provider Selection
The employer/insurer chooses the treating provider.

Managed Care Options
Insurers/employers may provide such services, as they deem necessary including contracting with managed care organizations. Employees can petition the commissioner for alternate medical care.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for KANSAS

Provider Selection
The employer/insurer chooses the treating provider.

Managed Care Options
Insurers/employers may use such services including negotiating rates, and contracting with managed care organizations.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for KENTUCKY

Provider Selection
The employee chooses the treating provider.


Managed Care Options
Where an employer has contracted with an approved managed care plan, employees must choose one of the providers within the plan unless emergency care is needed.

Provider Lists
When no managed care contracts (MCP) exist, provider lists and directories may be utilized. Where there is a managed care plan, there is a state-mandated panel. The StrataCare generic posting may be used in conjunction with the state poster.


PROVIDER NETWORK RULES for LOUISIANA

Provider Selection
The employee chooses the treating provider without restriction.

Managed Care Options
Managed care is authorized. The employer/insurer has the right to contract with special groups of providers but cannot force an employee to use them.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for MAINE

Provider Selection
The employer has the right to select a health care provider for the initial 10 days of medical care. After 10 days the employee may select a provider and provide the employer with the name and a statement of intention to treat with that provider.

Managed Care Options
There are no regulations by the WCB regarding managed care plans; however employers/insurers may provide such services that do not interfere with the provider choice provisions.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for MARYLAND

Provider Selection
The employee chooses the treating provider.

Managed Care Options
Employers/insurers may provide managed care services that do not interfere with the employee's choice of physician.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for MASSACHUSETTS

Provider Selection
The employee may select a treating health care professional. However, when a preferred provider arrangement (PPA) exists, the employer may select the provider for the first scheduled appointment.

Managed Care Options
Insurers, employers, and health care providers may enter into a preferred provider arrangement (PPA) for workers' compensation.

Provider Lists
Provider lists and directories may be utilized. The list of names of providers in the PPA within an employee’s geographic region shall be posted prominently at the worksite.


PROVIDER NETWORK RULES for MICHIGAN

Provider Selection
The employer/insurer has the right to select the treating provider for the first 28 days following the beginning of medical care. After 28 days from inception of medical care the employee may select a physician of his or her own choice.

Managed Care Options
Employers may contract with others to provide care at less than the fee schedule would pay in aggregate to manage their health care costs.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for MINNESOTA

Provider Selection
The employee chooses the treating provider without restriction unless the employer or insurer has contracted with a certified managed care plan.

Within a certified plan the employee must select from the plan providers. However, the employee in a managed care plan may continue to treat with a doctor outside the plan with whom the employee has an established treating relationship.

Managed Care Options
Employers/insurers may contract with one or more plans. If multiple plans exist, employee is allowed to choose plan.

Provider Lists
There is a state-mandated posting for the certified managed care program. The StrataCare generic posting may be used in conjunction with the state poster.


As long as employees are covered by a managed care plan, a posted notice must be displayed which includes the following information:

  1. Employer has enrolled with a MCP to provide all necessary medical treatment for workers’ compensation injuries. An employee with an injury prior to enrollment may continue treatment with a non-participating provider until he changes doctors.
  2. Contact person and phone number of employer and MCP who can answer questions about managed care.
  3. Employee may receive treatment from MD, Chiropractor, Podiatrist, Osteopath or dentist if the treatment is available within community and is appropriate for the injury.
  4. Toll-free 24-hour phone number of MCP that informs employees of available services.
  5. Employee is required to receive services from a health care provider who is a member of the MCP unless (1) emergency, (2) outside mileage parameters and (3) documented history of treatment before injury.



PROVIDER NETWORK RULES for MISSISSIPPI

Provider Selection
The employer must furnish the employee with a list of providers, however the employee may choose any treating provider. The employee's choice is limited to one provider and specialists to whom he is referred by that provider.

Also, referrals by the chosen physician are limited to one specialist and, except in emergencies, any additional referral must receive prior approval from the employer/insurer or the Workers' Compensation Commission.

Managed Care Options
Employers/insurers may contract with managed care organizations or use other managed care techniques that do not prohibit an employee from choosing the treating provider.

Provider Lists
Provider lists and/or directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for MISSOURI

Provider Selection
Except in an emergency, the employer has the right to select the treating provider. The employer must authorize all treatment. In an emergency the employee may be treated by the closest emergency room for the initial visit.

Managed Care Options
Employees subject to a managed care network cannot choose a provider outside of the plan.

Provider Lists
Provider lists and directories may be utilized. There is a state-mandated posting. The StrataCare generic posting may be used in conjunction with the state poster.


PROVIDER NETWORK RULES for MONTANA

Provider Selection
An employee chooses the treating physician, but if subject to a certified managed care plan, the MCO designates the treating physician.

Managed Care Options
Montana insurers may contract with certified MCOs. Insurers may contract with multiple MCO’s and allow the employees to choose an MCO.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting unless there is a certified plan.

A minimum of five treating physicians with at least three of the following specialties is required: Orthopedics, Surgery, Neurology or Neurosurgery, Osteopathy, Family Practice or Internal Medicine, and Occupational or Physical Medicine.


PROVIDER NETWORK RULES for NEBRASKA

Provider Selection
Generally the employee selects the physician from a list provided by the employer. The employee can designate a provider who has treated the employee or a family member in the past (even if subject to a managed care contract).

If no employer notice was given, then the employee may make an initial selection of any physician, regardless of prior treatment.

Managed Care Options
Employees may choose among plans if multiple plans exist.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting unless within a certified plan.


PROVIDER NETWORK RULES for NEVADA

Provider Selection
The employer can direct medical care only if the employer is enrolled in an MCO.


Managed Care Options
A self-insured employer or employer's insurer may enter into a contract with an MCO.


Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for NEW HAMPSHIRE

Provider Selection
The employee chooses the treating provider without restriction unless covered under a managed care contract. If subject to managed care, the employee must choose a provider within the plan.

Managed Care Options
MCOs may restrict access within the network pending the primary physician's direction. Employers or insurers are required to contract with a single state-approved plan only.

Provider Lists
Provider lists and directories may be utilized. Employees subject to MCO plan must be given a choice of two providers, including vocational rehabilitation providers.


PROVIDER NETWORK RULES for NEW JERSEY

Provider Selection
Except in an emergency the employer/insurer has the right to select the treating provider. In an emergency the employee is not restricted to the employer/insurer's choice.

Additional Regulations
MCOs must ensure that employees will be directed to appropriate care and provide medical case management services based on established treatment protocols.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting. StrataCare generic posting may be used.


PROVIDER NETWORK RULES for NEW MEXICO

Provider Selection
The employer/insurer has the option to control provider choice either during the first 60 days following the injury or, if the employee makes the initial choice, after this initial 60-day period.

Managed Care Options
Payers may use managed care services that do not conflict with choice of provider rules.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; StrataCare generic posting may be used.


PROVIDER NETWORK RULES for NEW YORK

Provider Selection
Unless in a certified program the employee must select the treating provider from an extensive list of authorized providers developed by the Workers' Compensation Board (WCB).

An employee may waive the right to select an authorized provider and enter a carrier – or employer-sponsored network if the injured worker signs form C 3.1 at the time of injury.

Managed Care Options
Certified PPO program: Employees have restricted choice of provider - employees working within certified counties are required to treat with a PPO provider for up to 30 days after the initial treatment by a PPO provider.

Provider Lists
Provider lists and directories may be utilized in all counties. Any employee postings provided by the employer or insurer related to the utilization of an employer or insurer recommended network or health care provider must clearly indicate that such utilization is voluntary.


PROVIDER NETWORK RULES FOR NEW YORK ROC


Provider Selection
The employee chooses the treating provider, but the employer may recommend a designated network or healthcare provider to an injured employee.

Provider Lists
Panels, lists and directories are allowed, and must clearly indicate the using network providers is purely voluntary.


PROVIDER NETWORK RULES FOR NEW YORK PPO


Provider Selection
The employee chooses the treating provider from a network list. After 30 days post initial treatment, the employee may seek treatment from a state authorized provider of his or her choice

Provider Lists
Lists and directories are allowed.




PROVIDER NETWORK RULES for NORTH CAROLINA

Provider Selection
The employer/insurer chooses the treating provider. If the employer/insurer does not direct, the employee can choose the provider or facility. The employee may choose in an emergency, but must notify the employer.

Managed Care Options
In the case of employees subject to MCOs, the employee can change physicians once within the MCO's panel.

Provider Lists
Provider lists and directories may be utilized. Form 17 is the state-mandated informational posting. StrataCare generic posting may also be used in conjunction with Form 17.


PROVIDER NETWORK RULES for NORTH DAKOTA

Provider Selection
The employee has unrestricted choice of the treating provider, unless the employer is with an agency-approved risk management program.

Employers with an agency-approved risk management program are allowed to select designated providers to treat injured workers. Employees may opt out prior to sustaining a work injury.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES for OHIO

Provider Selection
For self-insureds, employee chooses from a BWC certified provider pool.

For self-insureds who are members of the qualified health plan (QHP), employees may be restricted to choosing a provider within that program. QHP’s must be certified by the state.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; StrataCare generic posting may be used.


PROVIDER NETWORK RULES for OKLAHOMA

Provider Selection
The employer selects the treating physician unless it is an emergency or the employer fails or refuses to provide care within the statutory time frame. If covered by a certified workplace medical plan (CWMP), the employee must choose a plan provider or a physician who has maintained the medical records of the employee or a member of their immediate family.

Managed Care Options
The employer or the insurer may contract with a CWMP. A managed care plan must provide aggressive case management for injured employees and a program for early return to work in order to be certified.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; StrataCare generic posting may be used.


PROVIDER NETWORK RULES for OREGON

Provider Selection
Employee chooses without restriction unless a contract with a managed care organization (MCO) exists. Where an MCO contract exists the injured worker must choose a panel provider unless the MCO approves a non-panel provider, or a “come-along provider” who provides care subject to the MCO terms. A come-along provider is a primary care provider who is not in the MCO, and who continues to treat the worker when the worker becomes enrolled in the MCO.

Managed Care Options
The state certifies MCO’s. Only insurers and self-insureds may contract with an MCO. Additionally, they may also contract with more than one MCO in the state. Employees may choose between MCOs at the time of enrollment.

Provider Lists
Provider lists and directories may be utilized. For an MCO, there is a state-mandated posting, which is distributed by the Managed Care partner. Panels must include a minimum of one attending physician for every 1,000 workers covered.


PROVIDER NETWORK RULES for PENNSYLVANIA

Provider Selection
Employer/insurer may direct for the first 90 days of treatment after the first visit, by use of a panel posting. If there is no list, the employee can select the treating provider.

Provider Lists
Provider lists and directories may be utilized. There is a state-mandated posting (Panel).

  1. The panel must include at least six designated providers. Four may be coordinated care organizations (CCO) or hospitals/facilities, and no fewer than three must be physicians.
  2. The list must include the specialty of the provider.
  3. If the list includes a CCO, the employer may not individually list any provider participating in that CCO if those individually listed providers are bound by the terms of the CCO for treatment.
  4. Employer must provider written notice to all injured employees of their rights.



PROVIDER NETWORK RULES for RHODE ISLAND

Provider Selection
The employee can choose the first treating provider without restriction. Treatment provided at an emergency room after the accident or by a physician under contract with the employer does not count as the first medical care provider.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting.


PROVIDER NETWORK RULES FOR RHODE ISLAND PPN


Provider Selection
The employee can choose the first treating provider. If the insurer/self-insured employer has a PPN, any change by the employee shall only be to a provider listed in the approved PPN.

Provider Lists
Provider lists and directories may be utilized. There is no state mandated posting.


PROVIDER NETWORK RULES for SOUTH CAROLINA

Provider Selection
The employer/insurer chooses the treating provider.

Managed Care Options
Managed care is not mandated, however, programs (provider networks, medical case management, utilization review, etc.) can be implemented.

Provider Lists
Provider lists and directories may be utilized. There is a state-mandated posting. The StrataCare generic posting may also be used in conjunction with this.


PROVIDER NETWORK RULES for SOUTH DAKOTA

Provider Selection
Employees choose from members of the managed care program (CMP). However, employees may choose a provider outside of the plan if they notify the plan of the selection of a nonparticipating provider before treatment. CMPs may be denied certification or have certification revoked or suspended if they restrict access within the CMP to any medical provider.

Managed Care Options
All employees are to be covered under a state certified managed care plan.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; generic worksite posters may be used.


PROVIDER NETWORK RULES for TENNESSEE

Provider Selection
The employee chooses the treating provider from a list developed by the employer/insurer.

Provider Lists
Provider lists and directories may be utilized. There is a state-mandated posting (Panel) - Form C-42. The panel must include three or more providers, with no more than four physicians affiliated in a practice.


PROVIDER NETWORK RULES for TEXAS

Provider Selection
The employee is entitled to initial choice of a doctor from the Texas Workers' Compensation Commission's approved doctor list.

Provider Lists
TDI maintains an online listing of doctors licensed to practice in Texas through the TXCOMP Provider system. This listing can be used by employees to select treating doctors and other system participants.


PROVIDER NETWORK RULES FOR TEXAS HCN


Provider Selection
The employee chooses the treating provider from a list of network providers.

Provider Lists
Provider lists and directories may be used. There is no state-mandated positing.


PROVIDER NETWORK RULES for UTAH

Provider Selection
The employee chooses the treating provider from a network list if a preferred program is used by the employer/insurer. If there is no preferred provider program, the employee has free choice of health care providers.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting, StrataCare generic posting may be used in conjunction with this.


PROVIDER NETWORK RULES for VERMONT

Provider Selection
The employer/insurer has the right to choose the initial treating provider.


Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting; StrataCare generic posting may be used.


PROVIDER NETWORK RULES for VIRGINIA

Provider Selection
The employee must select a provider from a list developed by the employer/insurer. If no panel is offered, the employee may choose the provider.

Provider Lists
Panel State. Provider lists and directories may be utilized. There is a state-mandated posting, (Form VWC1). The panel must include three or more providers (per specialty listed). If no poster is provided, the employee may choose the provider.


PROVIDER NETWORK RULES for WASHINGTON

Provider Selection
The employee is free to choose the initial treating provider from the provider network established by the Department of Labor and Industries. An injured worker may receive care from a non-network provider only for an initial office or emergency room visit.

Provider Lists
Provider lists and directories may be utilized. There is no state-mandated posting. No postings are permitted.


PROVIDER NETWORK RULES for WEST VIRGINIA

Provider Selection
If the employer does not provide a managed care plan or program, the employee chooses the initial treating provider without restriction.

Provider Lists
There is no state-mandated posting. Postings may be informational but cannot direct employees to providers.


PROVIDER NETWORK RULES FOR WEST VIRGINIA MHCP


Provider Selection
The employee chooses the treating doctor from within the plan providers.

Provider Lists
Provider lists and directories may be utilized.


PROVIDER NETWORK RULES for WISCONSIN

Provider Selection
General Rule: The employee has the right to select the initial treating provider. In case of emergency, the employer may arrange for treatment without tendering a choice. After the emergency has passed, the employee may choose any treating provider. Any further choice shall be by mutual agreement. Wis. Stat. § 102.42 (2) (a) Referrals to specialists are not considered a change in treating physician.

Provider Lists
Panels and Directories are allowed. There is no state-mandated panel form. If panels are used, such postings must contain language making it clear that use of the providers listed is voluntary and choosing not to use a listed provider would not affect the employee’s benefits under the workers’ comp laws.


PROVIDER NETWORK RULES for WYOMING

Provider Selection
The employee can designate the treating provider, but the employer or the fund may select another provider for a second opinion without restriction.

Provider Lists
There is no state-mandated posting.