CompFox AI Summary
This case concerns whether medical treatment provided within a Medical Provider Network (MPN) is subject to Utilization Review (UR) and Independent Medical Review (IMR). The Appeals Board reversed the WCJ, holding that MPN treatment is indeed subject to UR/IMR. Delays in IMR determinations do not invalidate them. The March 21, 2014 IMR determination was deemed binding as no grounds for appeal were established.
Full Decision Text1 Pages
This case concerns whether medical treatment provided within a Medical Provider Network (MPN) is subject to Utilization Review (UR) and Independent Medical Review (IMR). The Appeals Board reversed the WCJ, holding that MPN treatment is indeed subject to UR/IMR. Delays in IMR determinations do not invalidate them. The March 21, 2014 IMR determination was deemed binding as no grounds for appeal were established.
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