An employee is considered a covered employee in the Medical Provider Network when the employer?

An employee is considered a covered employee in the Medical Provider Network when the employer?

• A. Provides a notice explaining access to the MPN on a website
• B. Provides a MPN with 5 physicians within 15 miles
• C. Provides a MPN with 3 physicians within 25 miles
• D. Provides the employee with an implementation notice containing information about the MPN and how to access care

Answer: (D)

In California workers’ compensation, an employee becomes covered under the Medical Provider Network when the employer provides an implementation notice that explains the MPN and how to access care. That implementation notice is the formal document the employer must give to each employee, informing them that the MPN exists, which providers are in it, and how to obtain in-network treatment. Without this notice, simply posting information on a website or having a network with a certain number of physicians doesn’t establish coverage for the employee. Therefore, delivering the implementation notice correctly makes the employee a covered participant in the MPN.

In California workers’ compensation, an employee becomes covered under the Medical Provider Network when the employer provides an implementation notice that explains the MPN and how to access care. That implementation notice is the formal document the employer must give to each employee, informing them that the MPN exists, which providers are in it, and how to obtain in-network treatment. Without this notice, simply posting information on a website or having a network with a certain number of physicians doesn’t establish coverage for the employee. Therefore, delivering the implementation notice correctly makes the employee a covered participant in the MPN.