N.H. Admin. Code § Lab 704.04

Current through Register No. 36, September 5, 2024
Section Lab 704.04 - Carriers, Self-Insurers and their Representatives
(a) The carrier or self-insurer providing benefits under RSA 281-A shall have the responsibility to:
(1) Determine the causal relationship between the injury and the employee's employment;
(2) Review and authorize or deny payment of all related medical expenses within 30 days of its receipt of the billing;
(3) Issue any denials for treatment or benefits presented as associated with the employee's injuries;
(4) Request and schedule any independent medical examinations in accordance with Lab 506.01(g);
(5) Pay for an independent medical examination allowed to the injured employee under the provisions or RSA 281-A:38-a, and Lab 705.03; and
(6) Pay only for charges for care rendered by the health care providers within the network approved by the commissioner, except for treatment outside the network specifically authorized or directed by RSA 281-A:23-a, I(b), or by these rules.
(b) Any carrier, or self-insured employer or employer group, or third party administrator that provided or paid or gave direction and guidance to injury management facilitators who worked with their injured workers prior to July 1, 2011, may continue to operate in that manner. Such injury management facilitators shall be certified in accordance with Lab 703.01(n).

N.H. Admin. Code § Lab 704.04

#5788, eff 2-17-94, EXPIRED: 2-17-00

New. #7212, INTERIM, eff 3-2-00, EXPIRED: 6-30-00

New. #7338, eff 8-2-00; ss by #9217, eff 8-1-08; amd by #10038, eff 12-1-11

Amended by Volume XXXVI Number 45, Filed November 10, 2016, Proposed by #12013, Effective 10/25/2016, Expires 12/25/2026.