DWC Proposes Rules to Clarify Use of IME Reports to Deny Authorization, Payment

The Colorado Division of Workers' Compensation will hold a public hearing in November to discuss proposed changes to rules that it says will clarify when an independent medical examiner's report can be used to deny prior authorization or refuse payment for billed services. Proposed changes to the division's utilization standard rules would explicitly allow an IME report that predates a request for authorization or payment unless the authorized treating provider presents new reasoning or relevant documentation. The rules would add to 16-7(A) and 16-11(B)(2) language clarifying tha...