§ 28-30-22. Medical advisory board.
(a) The chief judge of the workers' compensation court, in consultation with the appropriate
medical or professional association, shall appoint a medical advisory board that shall
serve at the chief judge's pleasure and consist of eleven (11) members in the following
specialties: one orthopedic surgeon; one neurologist; one physiatrist; one chiropractor;
one physical therapist; one internist; one psychiatrist or psychologist; and four
(4) ad hoc physician members appointed at the discretion of the chief judge. Members
of the board shall be reimbursed five hundred dollars ($500) per day served in the
discharge of the board's duties, not to exceed six thousand dollars ($6,000) per member
in any year. The chief judge shall designate the chairperson of the board.
(b) The chief judge is authorized, with the advice of the medical advisory board, to do
the following:
(1)(i) Adopt and review protocols and standards of treatment for compensable injury, which
shall address types, frequency, modality, duration, and termination of treatment,
and types and frequency of diagnostic procedures;
(ii) Within thirty (30) days of its establishment, the medical advisory board shall prepare
a recommended standard for the consideration and weighing by the court of medical
evidence, including, but not limited to, medical test results, objective clinical
findings, subjective complaints supported by tests for inconsistency, and purely subjective
complaints, with the purposes of assuring treatment and compensation for legitimate,
compensable injuries; reducing litigation, inefficiency, and delay in court proceedings;
and deterring false or exaggerated claims of injury. The standards shall be applicable
to proceedings before the workers' compensation court, including specifically those
to determine the nature and extent of injury and the achievement of maximum medical
improvement, and shall be effective in all proceedings when adopted by the court;
(2) Approve and promulgate rules, regulations, and procedures concerning the appointment
and qualifications of comprehensive, independent healthcare review teams that would
be composed of any combination of one or more healthcare provider(s), rehabilitation
expert(s), physical therapist(s), occupational therapist(s), psychologist(s), and
vocational rehabilitation counselor(s);
(3) Approve and administer procedures to disqualify or disapprove medical service providers
and maintain the approved provider list;
(4) Appoint an administrator of the medical advisory board;
(5) Approve and promulgate rules, regulations, and procedures concerning the appointment
and qualifications of impartial medical examiners; and
(6) Annually review the performance of each comprehensive, independent healthcare review
team and impartial medical examiner.
(c) The administrator of the medical advisory board is authorized and directed to establish
terms and conditions for comprehensive, independent healthcare review teams and impartial
medical examiners to apply for approval by the medical advisory board and to perform
any other duties as directed by the board.
(d) Any reference to an impartial medical examiner in chapters 29 — 38 of this title shall
be deemed to include the impartial medical examiners and comprehensive, independent
healthcare review teams referred to in subsection (b) of this section.
(e)(1) Disqualification of medical-care providers. Every healthcare provider licensed in the state of Rhode Island shall be presumed
to be qualified to provide healthcare services for injuries compensable under this
title and may recover costs of treatment consistent with established fee and cost
schedules. The administrator of the medical advisory board is thereafter authorized
to disqualify and/or suspend any qualified provider based upon one or more of the
following:
(i) The violation of the protocols and standards of care established by the medical advisory
board;
(ii) The filing of affidavits that are untimely, inadequate, incomplete, or untruthful;
(iii) The provision of unnecessary and/or inappropriate treatment;
(iv) A pattern of violation and/or evasion of an approved fee schedule;
(v) The censure or discipline of the provider by the licensing body of the provider's
profession; or
(vi) The billing of, or pursuing collection efforts against, the employee for treatment
or diagnostic tests causally related to an injury not deemed noncompensable by the
workers' compensation court.
(2) Upon disqualification or during suspension, the provider shall not be permitted to
recover any costs or fees for treatment provided under this title. The appropriate
body with professional disciplinary authority over the provider shall be notified
of any such action. Appeal of disqualification or suspension shall be to the medical
advisory board, with final review by the workers' compensation court.
(3) If unnecessary or inappropriate treatment is provided by an entity affiliated with
the treating physician, the administrator of the medical advisory board may increase
the penalty for a violation.
(4) This section shall not prevent the recovery of reasonable costs for immediate emergency
care rendered by a provider.
(f) As a guide to the interpretation and application of this section, the policy and intent
of this legislature is declared to be that every person who suffers a compensable
injury with resulting disability should be provided with high-quality medical care
and the opportunity to return to gainful employment as soon as possible with minimal
dependence on compensation awards.