D.C. Mun. Regs. tit. 7, r. 7-122

Current through Register Vol. 71, No. 44, November 1, 2024

Rule 7-122 - MEDICAL BENEFITS AND SERVICES; GENERAL

122.1

Pursuant to Section 2303(a) of the Act (D.C. Official Code § 1-623.03(a) ), the District government shall furnish to an employee or claimant who is injured while in the performance of duty the services, appliances, or supplies prescribed or recommended by a qualified health professional whom the Program has admitted into its Panel of Healthcare Providers, except as provided in § 125.7 of this chapter.

122.2

Payment for services, appliances, or supplies pursuant to Section 2303 of the Act (D.C. Official Code § 1-623.03(a) ) shall only be made, where the services, appliances, or supplies are:

(a) Rendered for treatment of a condition that has been accepted as compensable under the Act by the Program or necessary for the Program to issue a compensability determination, and

(b) Ordered by a District of Columbia government medical officer or hospital, or a qualified health professional pursuant to the rules prescribed at § 124 of this chapter, subject to utilization review.

D.C. Mun. Regs. tit. 7, r. 7-122

Final Rulemaking published at 59 DCR 8766, 8789 (July 27, 2012); amended by Final Rulemaking published at 64 DCR 6325 (7/7/2017); amended by Final Rulemaking published at 66 DCR 4246 (4/5/2019)

Authority: Chief Risk Officer of the Office of Risk Management (ORM), Executive Office of the Mayor, pursuant to the authority set forth in section 2344 of the District of Columbia Government Merit Personnel Act of 1978 (CMPA), effective March 3, 1979 (D.C. Law 2-139; D.C. Official Code § 1-623.44 (2012 Supp.)); section 7 of Reorganization Plan No. 1 of 2003 for the Office of Risk Management, effective December 15, 2003; and Mayor's Order 2004-198, effective December 14, 2004