Oklahoma § 85-373 - Repealed by Laws 2013, c. 208, § 171, eff. Feb. 1, 2014

§ 85-373. Repealed by Laws 2013, c. 208, § 171, eff. Feb. 1, 2014

NOTE: Subsequent to repeal, this section was amended by Laws 2013,

c. 254, § 42 to read as follows:

A. There is hereby created a Physician Advisory Committee comprised of

nine (9) members to be appointed as follows:

1. The Governor shall appoint three members, one of whom shall be

licensed in this state as a doctor of medicine and surgery, one of whom shall

Oklahoma Statutes - Title 85. Workers' Compensation

be engaged in the practice of family medicine in a rural community of the

state, and one of whom shall be an osteopathic physician;

2. The President Pro Tempore of the Senate shall appoint three members,

one of whom shall be licensed in this state as a doctor of medicine and

orthopedic surgery, one of whom shall be licensed in this state either as a

doctor of medicine or a doctor of osteopathy and a neurosurgeon, and one of

whom shall be licensed in this state as a podiatric physician; and

3. The Speaker of the House of Representatives shall appoint three

members, one of whom shall be licensed in this state as an osteopathic

physician, one of whom shall be licensed in this state either as a doctor of

medicine or a doctor of osteopathy and shall be engaged in the practice of

occupational medicine, and one of whom shall be licensed in this state as a

chiropractic physician.

The terms of members serving on the effective date of this act shall end

on the effective date of this act. Thereafter, each position will be filled

by the appointing official for a term of three (3) years. Members shall be

subject to reappointment, with any new appointee to serve out the remainder

of the unexpired term of the Committee member so replaced.

B. The Committee shall:

1. Assist and advise the Administrator of the Workers' Compensation

Court regarding utilization review as it relates to the medical practice and

treatment of work-related injuries. Such utilization review shall include a

review of reasonable and necessary medical treatment; abusive practices;

needless treatments, testing, or procedures; or a pattern of billing in

excess of or in violation of the Schedule of Medical Fees. The Physician

Advisory Committee shall review and make findings and recommendations to the

Administrator with respect to charges of inappropriate or unnecessary

treatment or procedures, abusive practices, or excessive billing disclosed

through utilization review;

2. Assist the Administrator in reviewing medical practices of health

care providers, including evaluations of permanent impairment provided by

health care providers. The Committee shall review and make findings and

recommendations to the Administrator with respect to charges of abusive

practices by health care providers providing medical services or evaluations

of permanent impairment through the workers' compensation system;

3. After public hearing, review and make recommendations for acceptable

deviations from the American Medical Association's "Guides to the Evaluation

of Permanent Impairment";

4. After public hearing, review and make recommendations to the

Administrator for an alternative method or system to evaluate permanent

impairment that shall be used in place of or in combination with the American

Medical Association's "Guides to the Evaluation of Permanent Impairment".

Appropriate and scientific data shall be considered;

5. After public hearing, adopt Oklahoma Treatment Guidelines and

protocols for medical treatment not addressed by the current edition of the

Official Disability Guidelines or addressed but not recommended in the ODG

section in regard to injuries to the cervical, thoracic, and lumbar spine.

The Oklahoma Treatment Guidelines shall be adopted on or before March 1,

2012, and shall remain in full force and effect until superseded.

a.

The OTG shall be based upon evidence based medicine and

scientifically based and nationally peer reviewed literature

and shall include treatment for the top fifteen (15)

medically-recognized conditions (ICD-9 or successor codes).

b.

When completed, the OTG shall be submitted to the Oklahoma

Workers' Compensation Advisory Council for review. After due

notice and public hearing, the Council shall issue a report to

the Administrator concerning the OTG submitted. After due

Oklahoma Statutes - Title 85. Workers' Compensation

notice and public hearing, the Administrator shall adopt or

reject the proposal submitted. The OTG shall be submitted by

the Administrator to the Governor, the Speaker of the House of

Representatives and the President Pro Tempore of the Senate

within ten (10) legislative days following adoption. The OTG

submitted shall be subject to disapproval by joint or

concurrent resolution of the Legislature during the

legislative session in which submitted. If disapproved, the

existing treatment guidelines shall continue in effect. If

the Legislature takes no action on the OTG submitted by the

Administrator, the OTG shall become operative thirty (30) days

following the adjournment of the Legislature;

6. After public hearing, adopt Oklahoma Treatment Guidelines for the

prescription and dispensing of any controlled substance included in Schedule

II of the Uniform Controlled Dangerous Substances Act if not addressed by the

current edition of the Official Disability Guidelines;

7. Review utilization on cases or of providers when requested by any

employer, injured employee or insurer. The Committee may issue a public or

private censure to any provider for utilization which is excessive or

inadequate, or recommend the Court order treatment within the treatment

guidelines;

8. Provide general recommendations to the judges of the Court on the

issues of injury causation and apportionment;

9. Conduct educational seminars for the judges of the Court, employers,

employees, and other interested parties;

10. Assist the judges of the Court in accessing medical information from

scientific literature; and

11. Report its progress annually to the Governor, the President Pro

Tempore of the Senate, and the Speaker of the House of Representatives.

C. The Court shall be bound by treatment guidelines of the latest

edition of the Official Disability Guidelines or the Oklahoma Treatment

Guidelines.

D. Members of the Physician Advisory Committee shall receive no

compensation for serving on the Committee but shall be reimbursed by the

Court for their necessary travel expenses incurred in the performance of

their duties in accordance with the State Travel Reimbursement Act.

E. Meetings of the Physician Advisory Committee shall be called by the

Administrator but held at least quarterly. The presence of a simple majority

of the members constitutes a quorum. No action shall be taken by the

Physician Advisory Committee without the affirmative vote of at least a

simple majority of the members.

F. The Administrator shall provide office supplies and personnel of the

Court to assist the Committee in the performance of its duties.

G. Upon written request, the Insurance Commissioner and every approved

self-insured employer in Oklahoma shall provide the Committee with data

necessary to the performance of its duties.

H. Any health care provider acting in good faith and within the scope of

the provider's duties as a member of the Physician Advisory Committee shall

be immune from civil liability for making any report or other information

available to the judges of the Court or to the Administrator or for assisting

in the origination, investigation, or preparation of the report or other

information so provided.