Section 260-RICR-50-05-4.4 - Additional Palliative CareA. Additional palliative care beyond the first twelve (12) visits after the employee reaches maximum medical improvement, is conditioned on the authorization of the claim administrator (insurer, self-insured employer, third party administrator) upon the request of the employee's treating physician (Medical Provider).B. A request for additional palliative care shall be submitted to the claim administrator by the employee's treating physician at least ten (10) working days prior to the delivery of the medical services and shall include:1. Treatment plan, including nature and frequency of the proposed examinations2. Measures to evaluate treatment plan's objectives3. Timetable for achieving objectives, including projected end date of treatment4. Estimated total cost for the additional Palliative CareC. The request for additional palliative care shall be submitted by the treating physician on a form prescribed by the Rhode Island Department of Labor and Training with a copy forwarded to the employee.D. Upon receipt of a request for additional palliative care, the claim administrator shall respond to the request in writing and forward a copy thereof to the RI Department of Labor and Training, Division of Workers' Compensation, and the employee and his or her attorney within ten (10) working days of the receipt of the request. The response shall either approve, modify or deny said request and state the reasons in support of a modification or denial.E. In the event that a dispute exists regarding additional palliative care, either party may file a petition at the Workers' Compensation Court pursuant to R.I. Gen. Laws § 28-35-11.260 R.I. Code R. 260-RICR-50-05-4.4
Adopted effective 1/7/2019