Massachusetts Regulations 452.6.01
From Wcc
§ 452.6.01 Scope And Authority
| 452 CMR 6.00 is promulgated pursuant to M.G.L. c. 152, § § 5, 13, and 30 as most recently amended by St. 1991, c. 398. 452 CMR 6.00 shall apply to all claims irrespective of date of injury for health care services rendered on or after October 1. 1993. 452 CMR 6.00:
(a) requires workers' compensation insurers to undertake utilization review; (b) reference the guidelines and review criteria that the Department of Industrial Accidents (DIA) requires providers to consider when treating certain medical conditions, and set forth the mechanism for the development, endorsement, dissemination, and implementation of future guidelines; (c) set forth the nature of utilization data that must be reported to the Department of Industrial Accidents; (d) set forth the methods for quality assessment that will be used by the Department of Industrial Accidents; (e) set forth the nature of the mechanisms that DIA will use to ensure compliance with 452 CMR 6.00; and (f) concerns adequate and reasonable health care services provided to workers' compensation recipients, including consideration for cost containment. |
