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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 3.6. Independent Medical Review

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§9768.2 Conflicts of Interest



(a) The IMR shall not have any material, professional, familial, or financial affiliation with any of the following:

(1) The injured employee's employer or employer's workers' compensation insurer;

(2) Any officer, director, management employee, or attorney of the injured employee's medical provider network, employer or employer's workers' compensation insurer;

(3) Any treating health care provider proposing the service or treatment;

(4) The institution at which the service or treatment would be provided, if known;

(5) The development or manufacture of the principal drug, device, procedure, or other therapy proposed for the injured employee whose treatment is under review; or

(6) The injured employee, the injured employee's immediate family, or the injured employee's attorney.

(b) The IMR shall not have a contractual agreement to provide physician services for the injured employee's MPN if the IMR is within a 35 mile radius of the treating physician.

(c) The IMR shall not have previously treated or examined the injured employee.

NOTE

Authority cited: Sections 133 and 4616, Labor Code. Reference: Section 4616.4, Labor Code.

HISTORY

1. New section filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 12-31-2004 order transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).

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