HCO has 90 days of medical control
Cal Lab Code § 4600.3 (c) (1) When an employee is not receiving or is not eligible to receive health care coverage for nonoccupational
injuries or illnesses provided by the employer, if 90 days from the date the injury is reported the employee who has been receiving
treatment from a health care organization or his or her physician, chiropractor, acupuncturist, or other agent notifies his or her employer in
writing that he or she desires to stop treatment by the health care organization, he or she shall have the right to be treated by a physician,
chiropractor, or acupuncturist or at a facility of his or her own choosing within a reasonable geographic area.
Cal Lab Code § 4600.3 . Employees covered by employer's contracts with health care organizations
(a)
(1) Notwithstanding Section 4600, when a self-insured employer, group of self-insured employers, or the insurer of an employer contracts
with a health care organization certified pursuant to Section 4600.5 for health care services required by this article to be provided to injured
employees, those employees who are subject to the contract shall receive medical services in the manner prescribed in the contract,
providing that the employee may choose to be treated by a personal physician, personal chiropractor, or personal acupuncturist that he or
she has designated prior to the injury, in which case the employee shall not be treated by the health care organization. Every employee
shall be given an affirmative choice at the time of employment and at least annually thereafter to designate or change the designation of a
health care organization or a personal physician, personal chiropractor, or personal acupuncturist. The choice shall be memorialized in
writing and maintained in the employee's personnel records. The employee who has designated a personal physician, personal
chiropractor, or personal acupuncturist may change their designated caregiver at any time prior to the injury. Any employee who fails to
designate a personal physician, personal chiropractor, or personal acupuncturist shall be treated by the health care organization selected by
the employer. If the health care organization offered by the employer is the workers' compensation insurer that covers the employee or is
an entity that controls or is controlled by that insurer, as defined by Section 1215 of the Insurance Code, this information shall be included
in the notice of contract with a health care organization.
(2) Each contract described in paragraph (1) shall comply with the certification standards provided in Section 4600.5, and shall provide all
medical, surgical, chiropractic, acupuncture, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches,
and apparatus, including artificial members, that is reasonably required to cure or relieve the effects of the injury, as required by this
division, without any payment by the employee of deductibles, copayments, or any share of the premium. However, an employee may
receive immediate emergency medical treatment that is compensable from a medical service or health care provider who is not a member of
the health care organization.
(3) Insured employers, a group of self-insured employers, or self-insured employers who contract with a health care organization for
medical services shall give notice to employees of eligible medical service providers and any other information regarding the contract and
manner of receiving medical services as the administrative director may prescribe. Employees shall be duly notified that if they choose to
receive care from the health care organization they must receive treatment for all occupational injuries and illnesses as prescribed by this
section.
(b) Notwithstanding subdivision (a), no employer which is required to bargain with an exclusive or certified bargaining agent which
represents employees of the employer in accordance with state or federal employer-employee relations law shall contract with a health
care organization for purposes of Section 4600.5 with regard to employees whom the bargaining agent is recognized or certified to
represent for collective bargaining purposes pursuant to state or federal employer-employee relations law unless authorized to do so by
mutual agreement between the bargaining agent and the employer. If the collective bargaining agreement is subject to the National Labor
Relations Act, the employer may contract with a health care organization for purposes of Section 4600.5 at any time when the employer
and bargaining agent have bargained to impasse to the extent required by federal law.
(c)
(1) When an employee is not receiving or is not eligible to receive health care coverage for nonoccupational injuries or illnesses provided by
the employer, if 90 days from the date the injury is reported the employee who has been receiving treatment from a health care
organization or his or her physician, chiropractor, acupuncturist, or other agent notifies his or her employer in writing that he or she desires
to stop treatment by the health care organization, he or she shall have the right to be treated by a physician, chiropractor, or acupuncturist
or at a facility of his or her own choosing within a reasonable geographic area.
(2) When an employee is receiving or is eligible to receive health care coverage for nonoccupational injuries or illnesses provided by the
employer, and has agreed to receive care for occupational injuries and illnesses from a health care organization provided by the employer,
the employee may be treated for occupational injuries and diseases by a physician, chiropractor, or acupuncturist of his or her own choice
or at a facility of his or her own choice within a reasonable geographic area if the employee or his or her physician, chiropractor,
acupuncturist, or other agent notifies his or her employer in writing only after 180 days from the date the injury was reported, or upon the
date of contract renewal or open enrollment of the health care organization, whichever occurs first, but in no case until 90 days from the
date the injury was reported.
(3) For purposes of this subdivision, an employer shall be deemed to provide health care coverage for nonoccupational injuries and
illnesses if the employer pays more than one-half the costs of the coverage, or if the plan is established pursuant to collective bargaining.
(d) An employee and employer may agree to other forms of therapy pursuant to Section 3209.7.
(e) An employee enrolled in a health care organization shall have the right to no less than one change of physician on request, and shall be
given a choice of physicians affiliated with the health care organization. The health care organization shall provide the employee a choice of
participating physicians within five days of receiving a request. In addition, the employee shall have the right to a second opinion from a
participating physician on a matter pertaining to diagnosis or treatment from a participating physician.
(f) Nothing in this section or Section 4600.5 shall be construed to prohibit a self-insured employer, a group of self-insured employers, or
insurer from engaging in any activities permitted by Section 4600.
(g) Notwithstanding subdivision (c), in the event that the employer, group of employers, or the employer's workers' compensation insurer
no longer contracts with the health care organization that has been treating an injured employee, the employee may continue treatment
provided or arranged by the health care organization. If the employee does not choose to continue treatment by the health care
organization, the employer may control the employee's treatment for 30 days from the date the injury was reported. After that period, the
employee may be treated by a physician of his or her own choice or at a facility of his or her own choice within a reasonable geographic
area.
Cal Lab Code § 4600.3 (c) (1) When an employee is not receiving or is not eligible to receive health care coverage for nonoccupational
injuries or illnesses provided by the employer, if 90 days from the date the injury is reported the employee who has been receiving
treatment from a health care organization or his or her physician, chiropractor, acupuncturist, or other agent notifies his or her employer in
writing that he or she desires to stop treatment by the health care organization, he or she shall have the right to be treated by a physician,
chiropractor, or acupuncturist or at a facility of his or her own choosing within a reasonable geographic area.
Cal Lab Code § 4600.3 . Employees covered by employer's contracts with health care organizations
(a)
(1) Notwithstanding Section 4600, when a self-insured employer, group of self-insured employers, or the insurer of an employer contracts
with a health care organization certified pursuant to Section 4600.5 for health care services required by this article to be provided to injured
employees, those employees who are subject to the contract shall receive medical services in the manner prescribed in the contract,
providing that the employee may choose to be treated by a personal physician, personal chiropractor, or personal acupuncturist that he or
she has designated prior to the injury, in which case the employee shall not be treated by the health care organization. Every employee
shall be given an affirmative choice at the time of employment and at least annually thereafter to designate or change the designation of a
health care organization or a personal physician, personal chiropractor, or personal acupuncturist. The choice shall be memorialized in
writing and maintained in the employee's personnel records. The employee who has designated a personal physician, personal
chiropractor, or personal acupuncturist may change their designated caregiver at any time prior to the injury. Any employee who fails to
designate a personal physician, personal chiropractor, or personal acupuncturist shall be treated by the health care organization selected by
the employer. If the health care organization offered by the employer is the workers' compensation insurer that covers the employee or is
an entity that controls or is controlled by that insurer, as defined by Section 1215 of the Insurance Code, this information shall be included
in the notice of contract with a health care organization.
(2) Each contract described in paragraph (1) shall comply with the certification standards provided in Section 4600.5, and shall provide all
medical, surgical, chiropractic, acupuncture, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches,
and apparatus, including artificial members, that is reasonably required to cure or relieve the effects of the injury, as required by this
division, without any payment by the employee of deductibles, copayments, or any share of the premium. However, an employee may
receive immediate emergency medical treatment that is compensable from a medical service or health care provider who is not a member of
the health care organization.
(3) Insured employers, a group of self-insured employers, or self-insured employers who contract with a health care organization for
medical services shall give notice to employees of eligible medical service providers and any other information regarding the contract and
manner of receiving medical services as the administrative director may prescribe. Employees shall be duly notified that if they choose to
receive care from the health care organization they must receive treatment for all occupational injuries and illnesses as prescribed by this
section.
(b) Notwithstanding subdivision (a), no employer which is required to bargain with an exclusive or certified bargaining agent which
represents employees of the employer in accordance with state or federal employer-employee relations law shall contract with a health
care organization for purposes of Section 4600.5 with regard to employees whom the bargaining agent is recognized or certified to
represent for collective bargaining purposes pursuant to state or federal employer-employee relations law unless authorized to do so by
mutual agreement between the bargaining agent and the employer. If the collective bargaining agreement is subject to the National Labor
Relations Act, the employer may contract with a health care organization for purposes of Section 4600.5 at any time when the employer
and bargaining agent have bargained to impasse to the extent required by federal law.
(c)
(1) When an employee is not receiving or is not eligible to receive health care coverage for nonoccupational injuries or illnesses provided by
the employer, if 90 days from the date the injury is reported the employee who has been receiving treatment from a health care
organization or his or her physician, chiropractor, acupuncturist, or other agent notifies his or her employer in writing that he or she desires
to stop treatment by the health care organization, he or she shall have the right to be treated by a physician, chiropractor, or acupuncturist
or at a facility of his or her own choosing within a reasonable geographic area.
(2) When an employee is receiving or is eligible to receive health care coverage for nonoccupational injuries or illnesses provided by the
employer, and has agreed to receive care for occupational injuries and illnesses from a health care organization provided by the employer,
the employee may be treated for occupational injuries and diseases by a physician, chiropractor, or acupuncturist of his or her own choice
or at a facility of his or her own choice within a reasonable geographic area if the employee or his or her physician, chiropractor,
acupuncturist, or other agent notifies his or her employer in writing only after 180 days from the date the injury was reported, or upon the
date of contract renewal or open enrollment of the health care organization, whichever occurs first, but in no case until 90 days from the
date the injury was reported.
(3) For purposes of this subdivision, an employer shall be deemed to provide health care coverage for nonoccupational injuries and
illnesses if the employer pays more than one-half the costs of the coverage, or if the plan is established pursuant to collective bargaining.
(d) An employee and employer may agree to other forms of therapy pursuant to Section 3209.7.
(e) An employee enrolled in a health care organization shall have the right to no less than one change of physician on request, and shall be
given a choice of physicians affiliated with the health care organization. The health care organization shall provide the employee a choice of
participating physicians within five days of receiving a request. In addition, the employee shall have the right to a second opinion from a
participating physician on a matter pertaining to diagnosis or treatment from a participating physician.
(f) Nothing in this section or Section 4600.5 shall be construed to prohibit a self-insured employer, a group of self-insured employers, or
insurer from engaging in any activities permitted by Section 4600.
(g) Notwithstanding subdivision (c), in the event that the employer, group of employers, or the employer's workers' compensation insurer
no longer contracts with the health care organization that has been treating an injured employee, the employee may continue treatment
provided or arranged by the health care organization. If the employee does not choose to continue treatment by the health care
organization, the employer may control the employee's treatment for 30 days from the date the injury was reported. After that period, the
employee may be treated by a physician of his or her own choice or at a facility of his or her own choice within a reasonable geographic
area.
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