Section 92-01-02-29.6 - Footwear1. An injured employee shall obtain the primary health care provider's order of medical necessity supported by objective medical findings before the purchase of footwear may be approved by the organization. The primary health care provider's order must contain the following: b. Date of patient's face-to-face examination;c. Pertinent diagnosis or conditions that relate to the work injury and the necessity of footwear;d. Specific description of the type or brand or both of footwear being requested;e. Primary health care provider's signature; andf. Date of primary health care provider's signature.2. Medical documentation must provide the expected benefits and must explain the link to the physical injury necessitating the request.3. The organization will purchase one pair of footwear per claim and only during the acute rehabilitation phase.4. The organization shall pay a medical service provider for modifications to regular footwear purchased by an injured employee after a billing is received by the medical service provider if the modifications are due to the work injury and there is objective medical evidence to support the necessity of the modifications.5. Custom orthotic inserts and custom made medical orthotic shoes must be preapproved by the organization. There must be objective medical evidence to support custom orthotic inserts and custom made medical orthotic shoes are a necessity due to the work injury.6. The organization must approve the footwear prior to purchase. If the footwear is approved, the organization shall pay the medical service provider after a billing is received. The organization may not prepay an injured employee to purchase footwear and may not place orders for footwear for an injured employee.7. An appeal of a decision made by the organization under this section must be adjudicated pursuant to North Dakota Century Code section 65-02-20.N.D. Admin Code 92-01-02-29.6
Adopted by Administrative Rules Supplement 376, April 2020, effective 4/1/2020.Amended by Administrative Rules Supplement 2023-391, January 2024, effective 1/1/2024.General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-02-20, 65-05-07