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).
- 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.
- The list must include the specialty of the provider.
- 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.
- Employer must provider written notice to all injured employees of their rights.