(A) An employer in the QHP system shall authorize and pay for initial emergency medical treatment for an injury or occupational disease that is an allowed claim or condition provided by a health-care provider who is not part of the employer's QHP in accordance with the provisions and limitations contained in this rule.
(B) The employer shall pay a health-care provider who is not part of the employer's QHP only for initial emergency treatment of an employee for a workers' compensation injury. The health-care provider who is not part of the employer's QHP shall inform the employee upon the initial emergency treatment that the provider is not a participant in the QHP and that the provider will not be paid nor will the employee be reimbursed by the QHP or employer for the cost of further treatment after the initial emergency treatment, unless authorized otherwise by the employer or QHP.
(C) Subsequent emergency medical treatment by a provider who is not part of the employer's QHP for the same injury or occupational disease shall be reviewed by the QHP unless payment is otherwise authorized by the QHP. The employee may continue to obtain treatment from the health-care provider who is not part of the employer's QHP, but the payment for the treatment shall be the employee's sole responsibility, except as provided above.
(D) A provider that provides initial emergency medical treatment or subsequent emergency medical treatment for the same injury or occupational disease authorized by the QHP shall be paid in accordance with the rates established in Ohio workers' compensation fee schedule or the provider's billed charges, whichever is less unless an alternate payment arrangement is negotiated between an employer or QHP and a provider.