CompFox AI Summary
The applicant challenged the admissibility of a Utilization Review (UR) denial for a hospital bed, arguing that UR is not applicable to requests from an MPN physician. The WCJ admitted the UR denial, finding the applicant's objection lacked merit and that the UR process is mandatory for all treatment requests, even those from MPN physicians. The Appeals Board dismissed the applicant's reconsideration petition as premature. However, treating it as a removal petition, the Board affirmed the WCJ's decision, clarifying that MPN participation does not preclude UR review for treatment authorization.
Full Decision Text1 Pages
The applicant challenged the admissibility of a Utilization Review (UR) denial for a hospital bed, arguing that UR is not applicable to requests from an MPN physician. The WCJ admitted the UR denial, finding the applicant's objection lacked merit and that the UR process is mandatory for all treatment requests, even those from MPN physicians. The Appeals Board dismissed the applicant's reconsideration petition as premature. However, treating it as a removal petition, the Board affirmed the WCJ's decision, clarifying that MPN participation does not preclude UR review for treatment authorization.
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