4123-6-042 MCO scope of services - management of medical treatment of provider selected by employee.

(A) An employee may select a bureau-certified provider that is an MCO panel provider for an MCO selected by or assigned to the employee's employer. In such case, the MCO shall manage the medical treatment of all workers' compensation related injuries or diseases incurred by the employee for that employer.

(B) An employee may select a bureau-certified provider that is not an MCO panel provider for an MCO selected by or assigned to the employee's employer. In such case, the MCO for the employee's employer shall manage the medical treatment as if the provider were part of the MCO panel.

(C) An employee may select a provider who is not an MCO panel provider for the MCO selected by or assigned to the employee's employer and is not a bureau-certified provider. In such case, the MCO for the employee's employer shall manage only the initial or emergency care to the employee; further treatment shall not be authorized except as provided by rule 4123-6-12 of the Administrative Code.

Effective date: Feb. 16, 1996