24.29.1401    INITIAL LIABILITY

(1) Initial liability for payment of medical claims is the responsibility of the injured worker.

(2) After determination that the claim is covered under the Workers' Compensation or Occupational Disease acts, the liability for payment of the claim is the responsibility of the appropriate workers' compensation insurer.

(3) Pursuant to 39-71-743 , MCA, when a claim is covered under the Workers' Compensation or Occupational Disease acts, providers may not bill the injured worker for the difference between the initial amount billed and the amount reimbursed to the provider by the insurer as set by applicable statutes and rules, except for the co-pay provided by 39-71-704 , MCA.

(a) For injured workers who are receiving benefits from the Uninsured Employers' Fund pursuant to 39-71-503 , MCA, the provisions of this rule are subject to 39-71-510 , MCA.

(4) The injured worker is responsible for charges incurred for treatment of conditions which were not the result of the injury or for treatment when medical benefits have terminated according to 39-71-704 , MCA.

History: 39-71-203, MCA; IMP, 39-71-510, 39-71-704, 39-71-743, MCA; Eff. 12/31/72; AMD, 1991 MAR p. 2622, Eff. 12/27/91; AMD, 2007 MAR p. 260, Eff. 2/23/07.