Special programs

The organization may enter into special agreements for services provided by, or under the direction of, licensed medical service providers authorized to bill the organization. Special agreements may be made for services not covered under the fee schedule and may include multidisciplinary or interdisciplinary programs such as pain management, work hardening, and physical conditioning. Special programs include new programs and pilot projects to streamline, waive, or modify selected managed care rules to provide medical care for injured employees with greater efficiency. The organization shall establish payment rates for special agreements and may establish outcome criteria, measures of effectiveness, minimum staffing levels, certification requirements, special reporting requirements, and other criteria to ensure injured employees receive good quality and effective services at a reasonable cost. The organization may terminate special agreements and programs upon thirty days' notice to the medical service provider.