Rhode Island General Laws 28-30-22. Medical advisory board
(a) The chief judge of the workers’ compensation court, in consultation with the appropriate medical or professional association, shall appoint a medical advisory board that shall serve at the chief judge’s pleasure and consist of eleven (11) members in the following specialties: one orthopedic surgeon; one neurologist; one physiatrist; one chiropractor; one physical therapist; one internist; one psychiatrist or psychologist; and four (4) ad hoc physician members appointed at the discretion of the chief judge. Members of the board shall be reimbursed five hundred dollars ($500) per day served in the discharge of the board’s duties, not to exceed six thousand dollars ($6,000) per member in any year. The chief judge shall designate the chairperson of the board.
Terms Used In Rhode Island General Laws 28-30-22
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Chief judge: The judge who has primary responsibility for the administration of a court but also decides cases; chief judges are determined by seniority.
- Employee: means any person who has entered into the employment of or works under contract of service or apprenticeship with any employer, except that in the case of a city or town other than the city of Providence it shall only mean that class or those classes of employees as may be designated by a city, town, or regional school district in a manner provided in this chapter to receive compensation under chapters 29 — 38 of this title. See Rhode Island General Laws 28-29-2
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Injury: means and refers to personal injury to an employee arising out of and in the course of his or her employment, connected and referable to the employment. See Rhode Island General Laws 28-29-2
- Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
- Maximum medical improvement: means a point in time when any medically determinable physical or mental impairment as a result of injury has become stable and when no further treatment is reasonably expected to materially improve the condition. See Rhode Island General Laws 28-29-2
- person: may be construed to extend to and include co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6
- Physician: means medical doctor, surgeon, dentist, licensed psychologist, chiropractor, osteopath, podiatrist, or optometrist, as the case may be. See Rhode Island General Laws 28-29-2
(b) The chief judge is authorized, with the advice of the medical advisory board, to do the following:
(1)(i) Adopt and review protocols and standards of treatment for compensable injury, which shall address types, frequency, modality, duration, and termination of treatment, and types and frequency of diagnostic procedures;
(ii) Within thirty (30) days of its establishment, the medical advisory board shall prepare a recommended standard for the consideration and weighing by the court of medical evidence, including, but not limited to, medical test results, objective clinical findings, subjective complaints supported by tests for inconsistency, and purely subjective complaints, with the purposes of assuring treatment and compensation for legitimate, compensable injuries; reducing litigation, inefficiency, and delay in court proceedings; and deterring false or exaggerated claims of injury. The standards shall be applicable to proceedings before the workers’ compensation court, including specifically those to determine the nature and extent of injury and the achievement of maximum medical improvement, and shall be effective in all proceedings when adopted by the court;
(2) Approve and promulgate rules, regulations, and procedures concerning the appointment and qualifications of comprehensive, independent healthcare review teams that would be composed of any combination of one or more healthcare provider(s), rehabilitation expert(s), physical therapist(s), occupational therapist(s), psychologist(s), and vocational rehabilitation counselor(s);
(3) Approve and administer procedures to disqualify or disapprove medical service providers and maintain the approved provider list;
(4) Appoint an administrator of the medical advisory board;
(5) Approve and promulgate rules, regulations, and procedures concerning the appointment and qualifications of impartial medical examiners; and
(6) Annually review the performance of each comprehensive, independent healthcare review team and impartial medical examiner.
(c) The administrator of the medical advisory board is authorized and directed to establish terms and conditions for comprehensive, independent healthcare review teams and impartial medical examiners to apply for approval by the medical advisory board and to perform any other duties as directed by the board.
(d) Any reference to an impartial medical examiner in chapters 29 — 38 of this title shall be deemed to include the impartial medical examiners and comprehensive, independent healthcare review teams referred to in subsection (b) of this section.
(e)(1) Disqualification of medical-care providers. Every healthcare provider licensed in the state of Rhode Island shall be presumed to be qualified to provide healthcare services for injuries compensable under this title and may recover costs of treatment consistent with established fee and cost schedules. The administrator of the medical advisory board is thereafter authorized to disqualify and/or suspend any qualified provider based upon one or more of the following:
(i) The violation of the protocols and standards of care established by the medical advisory board;
(ii) The filing of affidavits that are untimely, inadequate, incomplete, or untruthful;
(iii) The provision of unnecessary and/or inappropriate treatment;
(iv) A pattern of violation and/or evasion of an approved fee schedule;
(v) The censure or discipline of the provider by the licensing body of the provider’s profession; or
(vi) The billing of, or pursuing collection efforts against, the employee for treatment or diagnostic tests causally related to an injury not deemed noncompensable by the workers’ compensation court.
(2) Upon disqualification or during suspension, the provider shall not be permitted to recover any costs or fees for treatment provided under this title. The appropriate body with professional disciplinary authority over the provider shall be notified of any such action. Appeal of disqualification or suspension shall be to the medical advisory board, with final review by the workers’ compensation court.
(3) If unnecessary or inappropriate treatment is provided by an entity affiliated with the treating physician, the administrator of the medical advisory board may increase the penalty for a violation.
(4) This section shall not prevent the recovery of reasonable costs for immediate emergency care rendered by a provider.
(f) As a guide to the interpretation and application of this section, the policy and intent of this legislature is declared to be that every person who suffers a compensable injury with resulting disability should be provided with high-quality medical care and the opportunity to return to gainful employment as soon as possible with minimal dependence on compensation awards.
History of Section.
P.L. 1992, ch. 31, § 4; P.L. 2000, ch. 109, § 33; P.L. 2001, ch. 256, § 2; P.L. 2001, ch. 355, § 2; P.L. 2015, ch. 104, § 1; P.L. 2015, ch. 116, § 1; P.L. 2016, ch. 470, § 1; P.L. 2016, ch. 473, § 1.