What if my employee has not pre-designated a treating physician and refuses to obtain medical treatment within the MPN?
The law is clear about an employee’s responsibilities and rights concerning Medical Provider Networks. Employees have the right to change treating physicians within the MPN, but unauthorized medical treatment obtained from a doctor outside the MPN is not covered or paid by AARLA. While certain circumstances may arise where treatment outside the MPN can be authorized by AARLA on a case-by-case basis (if for example the MPN does not contain a physician who can provide treatment as approved by AARLA), the rule is, if an employee refuses to treat within the MPN, then this medical treatment is unauthorized, self-procured, and ultimately the financial responsibility of the employee. Likewise, lost time disability indemnity payments can only be authorized by a treating physician within the MPN. AARLA will not pay indemnity disability benefits that arise from the opinion of a treating physician who is outside the MPN.
Related Questions
- What if a treating physician within the MPN is terminated from the network? Can medical treatment be continued with the provider after termination of the contract?
- What if an employee has a bona fide dispute about the diagnosis or treatment recommended by the MPN physician? What legal remedies are available?
- What if my employee has not pre-designated a treating physician and refuses to obtain medical treatment within the MPN?
