C.R.S. Section 8-43-503
Utilization review of health-care providers


(1)

The general assembly hereby finds and determines that health-care providers that provide medical care or health-care services that are not reasonably necessary or not reasonably appropriate according to accepted professional standards should not be allowed to provide such services to workers’ compensation claimants. The general assembly, therefore, hereby declares that the purpose of the utilization review process authorized in this section is to provide a mechanism to review medical care or health-care services rendered pursuant to this article that may not be reasonably necessary or reasonably appropriate according to accepted professional standards and to provide a mechanism to prevent such health-care providers from providing medical care or health-care services.

(2)

The provisions relating to the procedures for utilization review found in section 8-43-501 (2), (3), (4), (5)(a), (5)(c), and (5)(d) shall apply to utilization review under this section. A unanimous vote by the committee created in section 8-43-501 (3) shall be required for a recommendation to the director that a health-care provider not be allowed to provide medical care or health-care services to claimants.

(3)

Employers, insurers, claimants, or their representatives shall not dictate to any physician the type or duration of treatment or degree of physical impairment. Nothing in this subsection (3) shall be construed to abrogate any managed care or cost containment measures authorized in articles 40 to 47 of this title.

Source: Section 8-43-503 — Utilization review of health-care providers, https://leg.­colorado.­gov/sites/default/files/images/olls/crs2023-title-08.­pdf (accessed Oct. 20, 2023).

8‑43‑101
Record of injuries - occupational disease - reported to division - rules - definition
8‑43‑102
Notice to employer of injury - notice to employees - failure to report
8‑43‑103
Notice of injury - time limit
8‑43‑104
Electronic filings - rules
8‑43‑201
Disputes arising under “Workers’ Compensation Act of Colorado”
8‑43‑202
Director may refer taking of evidence in cases to appropriate officials of other states
8‑43‑203
Notice concerning liability - notice to claimants - notice of rights and claims process - rules
8‑43‑204
Settlements - rules
8‑43‑205
Mediation
8‑43‑206
Settlement conference procedures
8‑43‑206.5
Right to binding arbitration for resolution of disputes under articles 40 to 47
8‑43‑207
Hearings
8‑43‑207.5
Prehearing conferences - rules - definition
8‑43‑208
Investigations
8‑43‑209
Time schedule for hearings - establishment
8‑43‑210
Evidence
8‑43‑211
Notice - request for hearing
8‑43‑212
Compulsion of testimony
8‑43‑213
Transcripts
8‑43‑214
Transcript certified - evidence
8‑43‑215
Orders
8‑43‑217
Claims management - legislative declaration
8‑43‑218
Authority of director
8‑43‑219
Not a limitation on rights or privileges
8‑43‑220
Injured worker exit survey
8‑43‑301
Petitions to review
8‑43‑302
Corrected orders
8‑43‑303
Reopening
8‑43‑304
Violations - penalty - offset for benefits obtained through fraud - rules
8‑43‑304.5
Penalties in rate-making
8‑43‑305
Each day separate offense
8‑43‑306
Collection of fines, penalties, and overpayments
8‑43‑307
Appeals to court of appeals
8‑43‑308
Causes for setting aside award
8‑43‑309
Actions in court tried within thirty days
8‑43‑310
Error disregarded unless prejudicial
8‑43‑311
Court record transmitted to industrial claim appeals office - when
8‑43‑312
Court may remand case or order entry of award
8‑43‑313
Summary review by supreme court
8‑43‑314
Fees - costs - duty of district attorneys and attorney general
8‑43‑315
Witnesses and testimony - mileage - fees - costs
8‑43‑316
Appearance by officer for closely held entity
8‑43‑317
Service of documents
8‑43‑318
Remand of case or order - time limit for further proceedings consistent with ruling on appeal
8‑43‑401
District attorney or attorney of division to act for director or office - penalties for failure of insurer to pay benefits
8‑43‑401.5
Financial incentives to deny or delay claim or medical care - prohibition - penalties
8‑43‑402
False statement - felony
8‑43‑403
Attorney fees
8‑43‑404
Examination - refusal - personal responsibility - physicians to testify and furnish results - injured worker right to select treating physicians - injured worker right to third-party communications - definitions - rules
8‑43‑405
Payment as discharge of liability - conflicting claims
8‑43‑406
Compensation in lump sum
8‑43‑407
Election to waive vocational rehabilitation benefits and become subject to permanent partial disability provisions
8‑43‑408
Default of employer - additional liability
8‑43‑409
Defaulting employers - penalties - enjoined from continuing business - fines - procedure - definition - repeal
8‑43‑410
Right to compensation operates as lien - interest on award
8‑43‑501
Utilization review process - legislative declaration - cash fund
8‑43‑502
Independent medical examinations
8‑43‑503
Utilization review of health-care providers
8‑43‑601
Short title
8‑43‑602
Legislative declaration
8‑43‑603
Definitions
8‑43‑604
Performance programs
8‑43‑605
Due process
8‑43‑606
Enforcement
8‑43‑607
Filing with director
Green check means up to date. Up to date

Current through Fall 2024

§ 8-43-503’s source at colorado​.gov