Illinois Workers Compensation Reform Bill HB 1698/Preferred Provider Program (PPP)
Frequently Asked Questions
What is HB 1698?
HB 1698 is a workers’ compensation reform bill by Govenor Quinn in June 2011. This legislation gives employers more control of medical care delivered to the injured worker through a Preferred Provider Program (PPP).
What is a Preferred Provider Program (PPP)?
A PPP is a network of medical care providers designated for treatment of work-related injuries. Each PPP is required to have adequate choice of medical providers within a reasonable distance from the injured worker. An employer can only use a certified PPP if the employer selects to participate in the PPP.
What is the benefit of a PPP?
The key benefit is the ability to direct medical care (within the PPP) provided the notification to the injured worker has occurred and the injured worker or employer has not declined participation in the program. Direction of care provides the opportunity to reduce the overall cost of workers’ compensation cases through negotiated provider contracts and provides consistency in the management of cases.
Can the employer choose the initial treatment provider?
Yes. If the employer offers a PPP for the injured worker and the injured worker has not declined participation the employer can direct the injured worker to a medical provider within the PPP.
What PPP notifications are required of the employer to give to employees to implement the PPP?
The only required notificaiton is at time of injury. It is recommended to notify all employees when the PPP is implemented, and to notify all new hire thereafter. It is not required to do so.
What does an employer have to provide to the injured worker?
An employer is required to notify the injured worker of the use of the PPP for the workers’ compensation program and give the employee the choice to decline participation. The Employee can only choose twice to change PPP status.
Can an employer revise the IL PPP notices?
GB does not recommend the notices be revised. An employer can co-brand the notices with their company logo.
Are there formal requirements for the employee to opt out of the PPP?
The PPP regulations are silent on formal opt out procedures beyond notifying the employer.
If the employee does not sign the PPP notices, does that mean the employee has automatically opted out of the PPP?
There are no regulations about the employee not signing the notices, or a proof of process the employee was notified. GB recommends that employers place the employees’ name and addresses on the notices, retain an electronic copy of the notices, Excel files distributions lists, and document employees’ refusals to accept the PPP notices.
For the PPP employee notices, are there language requirements?
There are no formal requirements for English, Spanish, or any other language.
Is there a timeframe to notify the employees about the PPP?
There are no formal timeline requirements.
Can Open Legacy Claims be moved into the PPP?
Only new claims after the PPP has been implemented are under the PPP for medical direction. Open claims cannot be moved into the PPP.
Can employers obtain premium discounts from their insurance carrier when a PPP is implemented?
The PPP regulations are silent on this matter.
Can an employer utilize an existing on-site physical therapist/clinic if the therapist/clinic is not in the PPP?
Yes, as only as the injured worker is not penalized regarding his choice of physicians within the PPP for his/her work-related injury.
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