SECTION 310:657-9-3. Access to services

(a)   Medical and health services shall be provided or arranged in the service area by the Plan.

(b)   Services shall be available to the Plan's employees with reasonable promptness considering:

(1)   Geographic location, hours of operation, and provisions for after-hours services; and

(2)   Staffing patterns and types of providers.

(c)   A Plan whose service area is located in a nonmetropolitan area may provide service outside its area if:

(1)   The service is not primary or emergency care; and

(2)   Providers in the area are not sufficient to offer the service.

(d)   The Plan shall ensure continuity of services using at least the following:

(1)   A provider responsible for coordinating the employee's services; and

(2)   A system to report on eligibility and services rendered to the injured worker.

[Source: Added at 12 Ok Reg 2977, eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok Reg 2404, eff 6-25-06]