Current through Register Vol. XLI, No. 45, November 8, 2024
Section 85-15-9 - Registration of Rehabilitation Providers9.1. Qualified rehabilitation professionals and other vocational rehabilitation vendors must register with the Commission, using forms prescribed by the Commission. Any rehabilitation provider who does not meet the requirements set forth in Rule 27 of Title 85 of the Code of State Rules cannot be accepted for registration. a. Upon termination of the Commission, no registration is required of qualified rehabilitation professionals. Qualified rehabilitation professionals are required to verify and provide proof of their certification or qualifications to the Insurance Commissioner, self-insured employer or private carrier, whomever services are provided under this rule, or to their third party administrator or managed care provider. In turn the Insurance Commissioner, self-insured employer or private carrier, or their third party administrator or managed care provider is required to maintain this proof of certification or qualifications of the qualified rehabilitation professional.9.2. The Commission, Insurance Commissioner, self-insured employer or private carrier, whichever is applicable, must use only qualified rehabilitation service professionals in making rehabilitation referrals. a. Rehabilitation services may also be provided by qualified rehabilitation professional employees of the West Virginia Division of Rehabilitation Services or qualified rehabilitation professional employees of the Commission, Insurance Commissioner, self-insured employer or private carrier, whichever is applicable.9.3. All rehabilitation services must be provided in accordance with rehabilitation plans implemented pursuant to these rules and must be monitored by the qualified rehabilitation professional employed by or under contract with the Commission or Insurance Commissioner or employed by the West Virginia Division of Rehabilitation Services, or under contract with a self-insured employer or private carrier, whichever is applicable. The Commission, Insurance Commissioner, self-insured employer or private carrier, whichever is applicable, must remove or suspend from its list of vendors any provider of rehabilitation services who knowingly fails to comply with the provisions of these rules or a rehabilitation plan, or engages in other practices in violation of W. Va. Code § 23-4-3c. Adherence to all applicable Codes of Ethics, including, but not limited to the Codes of Ethics associated with the certifications listed in 85 C.S.R. 27-3.3 is required and a breach of any applicable ethical provision shall be grounds for suspension and/or termination of the provider's right to receive payments from the Commission, Insurance Commissioner, self-insured employer or private carrier whichever is applicable.