ARTICLE 2. Medical and Hospital Treatment
Article 2 enacted by Stats. 1937, Ch. 90.
§§ 4600–4615 · 34 sections
- § 4600 (a) Medical, surgical, chiropractic, acupuncture, licensed clinical social worker, and hospital treatment, including nursing, medicines, medical and surgical…
- § 4600.05 (a) An employer, as defined in Section 3300, shall provide immediate support from a nurse case manager for employees injured by an act of domestic terrorism,…
- § 4600.1 (a) Subject to subdivision (b), any person or entity that dispenses medicines and medical supplies, as required by Section 4600, shall dispense the generic…
- § 4600.2 (a) Notwithstanding Section 4600, if a self-insured employer, group of self-insured employers, insurer of an employer, or group of insurers contracts with a…
- § 4600.3 (a) (1) Notwithstanding Section 4600, when a self-insured employer, group of self-insured employers, or the insurer of an employer contracts with a health care…
- § 4600.35 Any entity seeking to reimburse health care providers for health care services rendered to injured workers on a capitated, or per person per month basis, shall…
- § 4600.4 (a) A workers’ compensation insurer, third-party administrator, or other entity that requires, or pursuant to regulation requires, a treating physician to…
- § 4600.5 (a) Any health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act, a disability insurer licensed by the Department of…
- § 4600.6 Any workers’ compensation insurer, third-party administrator, or other entity seeking certification as a health care organization under subdivision (e) of…
- § 4600.7 (a) The Workers’ Compensation Managed Care Fund is hereby created in the State Treasury for the administration of Sections 4600.3 and 4600.5 by the Division of…
- § 4601 (a) If the employee so requests, the employer shall tender the employee one change of physician. The employee at any time may request that the employer tender…
- § 4602 If the employee so requests, the employer shall procure certification by either the administrative director or the appeals board as the case may be of the…
- § 4603 If the employer desires a change of physicians or chiropractor, he may petition the administrative director who, upon a showing of good cause by the employer,…
- § 4603.2 (a) (1) Upon selecting a physician pursuant to Section 4600, the employee or physician shall notify the employer of the name and address, including the name of…
- § 4603.3 (a) Upon payment, adjustment, or denial of a complete or incomplete itemization of medical services, an employer shall provide an explanation of review in the…
- § 4603.4 (a) The administrative director shall adopt rules and regulations to do all of the following: (1) Ensure that all health care providers and facilities submit…
- § 4603.5 The administrative director shall adopt rules pertaining to the format and content of notices required by this article; define reasonable geographic areas for…
- § 4603.6 (a) If the only dispute is the amount of payment and the provider has received a second review that did not resolve the dispute, the provider may request an…
- § 4604 Controversies between employer and employee arising under this chapter shall be determined by the appeals board, upon the request of either party, except as…
- § 4604.5 (a) The recommended guidelines set forth in the medical treatment utilization schedule adopted by the administrative director pursuant to Section 5307.27 shall…
- § 4605 Nothing contained in this chapter shall limit the right of the employee to provide, at his or her own expense, a consulting physician or any attending…
- § 4606 Any county, city and county, city, school district, or other public corporation within the state which was a self-insured employer under the “Workmen’s…
- § 4607 Where a party to a proceeding institutes proceedings to terminate an award made by the appeals board to an applicant for continuing medical treatment and is…
- § 4608 No workers’ compensation insurer, self-insured employer, or agent of an insurer or self-insured employer, shall refuse to pay pharmacy benefits solely because…
- § 4609 (a) In order to prevent the improper selling, leasing, or transferring of a health care provider’s contract, it is the intent of the Legislature that every…
- § 4610 (a) For purposes of this section, “utilization review” means utilization review or utilization management functions that prospectively, retrospectively, or…
- § 4610.1 An employee shall not be entitled to an increase in compensation under Section 5814 for unreasonable delay in the provision of medical treatment for periods of…
- § 4610.3 (a) Regardless of whether an employer has established a medical provider network pursuant to Section 4616 or entered into a contract with a health care…
- § 4610.5 (a) This section applies to the following disputes: (1) Any dispute over a utilization review decision regarding treatment for an injury occurring on or after…
- § 4610.6 (a) Upon receipt of a case pursuant to Section 4610.5, an independent medical review organization shall conduct the review in accordance with this article and…
- § 4611 (a) When a contracting agent sells, leases, or transfers a health provider’s contract to a payor, the rights and obligations of the provider shall be governed…
- § 4614 (a) (1) Notwithstanding Section 5307.1, where the employee’s individual or organizational provider of health care services rendered under this division and…
- § 4614.1 Notwithstanding subdivision (f) of Section 1345 of the Health and Safety Code, a health care service plan licensed pursuant to the Knox-Keene Health Care…
- § 4615 (a) Upon the filing of criminal charges against a physician, practitioner, or provider for any crime described in subparagraph (A) of paragraph (1) of…