It is enacted by the General Assembly as follows:

SECTION 1. Section 28-29-2 of the General Laws in Chapter 28-29 entitled "Workers' Compensation -- General Provisions" is hereby amended to read as follows:

{ADD 28-29-2. Definitions. -- ADD} In chapters 29-38, inclusive, of this title, unless the context otherwise requires:

(1) "Employer" shall include any person, co-partnership, corporation or voluntary association, and the legal representative of a deceased employer; it shall include the state, and the City of Providence. It shall include also each city, town, and regional school district therein that shall vote or accept the provisions of chapters 29-38, inclusive, of this title in the manner herein provided.

(2) "Employee" means any person who has entered into the employment of or works under contract of service or apprenticeship with any employer, except that in the case of a city or town other than the City of Providence it shall only mean those class or classes of employees as may be designated by a city, town, or regional school district in the manner herein provided to receive compensation under chapters 29-38 inclusive, of this title. It shall not include any partner or sole proprietor, or a person whose employment is of a casual nature and who is employed otherwise than for the purpose of the employer's trade or business, or a person whose services are voluntary or who performs charitable acts, nor shall it include the members of the regularly organized fire and police departments of any town or city; and whenever a contractor has contracted with the state, a city, town, or regional school district any person employed by that contractor in work under contract shall not be deemed an employee of the state, city, town or regional school district as the case may be. In the case of a person whose services are voluntary or who performs charitable acts, any benefit received, in the form of monetary remuneration or otherwise, shall be reportable to the appropriate taxation authority but shall not be deemed to be wages earned under contract or hire for purposes of qualifying for benefits under chapters 29-38, inclusive, of this title. Any reference to an employee who had been injured shall, where the employee is dead, include a reference to his or her dependents as hereinafter defined, or to his or her legal representatives, or, where he or she is a minor or incompetent, to his or her conservator or guardian. A "seasonal occupation" means those occupations in which work is performed on a seasonal basis of not more than sixteen (16) weeks.

(3) "General or special employer":

(A) A general employer shall include but shall not be limited to temporary help companies and employee leasing companies and shall mean a person who for consideration and as the regular course of its business supplies an employee with or without vehicle to another person.

(B) A special employer shall mean a person who contracts for services with a general employer for the use of an employee, a vehicle or both.

(C) Whenever there be a general employer and special employer wherein the general employer supplies to the special employer an employee and the general employer pays or is obligated to pay the wages or salaries of such supplied employee, then and in that event notwithstanding the fact that direction and control shall be in the special employer and not the general employer, the general employer if it be subject to the provisions of the workers' compensation act or has accepted the same, shall be deemed to be the employer as set forth in subdivision (1) of this section and both the general and special employer shall be the employer for purposes of sections 28-29-17 and 28-29-18.

(4)(A) "Injury" means and refers to personal injury to an employee arising out of and in the course of his or her employment connected therewith and referable thereto.

(B) An injury to an employee while voluntarily participating in a private, group or employer sponsored carpool, vanpool, commuter bus service or other rideshare program, having as its sole purpose the mass transportation of employees to and from work shall not be deemed to have arisen out of and in the course of employment. Nothing in the foregoing shall be held to deny benefits under chapters 29-38, inclusive, and 47 of this title, to employees such as drivers, mechanics and others who receive remuneration for their participation in the rideshare program. Provided, however, that the foregoing shall not bar the right of an employee to recover against an employer and/or driver for tortious misconduct.

(5) "Physician" shall mean medical doctor, surgeon, dentist, chiropractor, osteopath, podiatrist and optometrist, as the case may be.

(6)(A) "Earnings capacity" means the weekly straight time earnings which an employee could receive if the employee accepted an actual offer of suitable alternative employment. Earnings capacity can also be established by the court based on evidence of ability to earn, including, but not limited to, a determination of the degree of functional impairment and/or disability, that an employee is capable of employment The court may, in its discretion, take into consideration the performance of the employee's duty to actively seek employment in scheduling the implementation of the reduction. The employer need not identify particular employment before the court can direct an earnings capacity adjustment.

{ADD In the event that an employee returns to light duty employment while partially disabled, an earnings capacity shall not be set based upon actual wages earned until the employee has successfully worked at light duty for a period of at least thirteen (13) weeks. ADD}

(B) As used under the provisions of this title, the term "functional impairment" means an anatomical or functional abnormality existing after the date of maximum medical improvement as determined by a medically or scientifically demonstrable finding and based upon the most recent edition of the American Medical Association's Guide to the Evaluation of Permanent Impairment or comparable publications of the American Medical Association.

(7) "Suitable alternative employment" means employment, or an actual offer of employment which the employee is physically able to perform and will not exacerbate the employee's health condition and which bears a reasonable relationship to the employee's qualifications, background, education and training. The employee's age alone shall not be considered in determining the suitableness of the alternative employment.

(8) "Director" means the director of labor or his or her designee unless specifically stated otherwise.

(9) "Department" means the department of labor.

(10) "Maximum medical improvement" means a point in time when any medically determinable physical or mental impairment as a result of injury has become stable and when no further treatment is reasonably expected to materially improve the condition. Neither the need for future medical maintenance nor the possibility of improvement or deterioration resulting from the passage of time and not from the ordinary course of the disabling condition, nor the continuation of a pre-existing condition shall preclude a finding of maximum medical improvement. A finding of maximum medical improvement by the workers' compensation court may be reviewed only where it is established that an employee's condition has substantially deteriorated or improved.

SECTION 2. Section 28-33-8, 28-33-10, 28-33-25, and 28-33-47 of the General Laws in Chapter 28-33 entitled "Workers' Compensation -- Benefits" are hereby amended to read as follows:

{ADD 28-33-8. Employee's choice of physician, dentist or hospital -- Payment of charges -- Physician reporting schedule. -- ADD} (a) An injured employee shall have freedom of choice to obtain health care, diagnosis and treatment from any qualified health care provider initially. The initial health care provider of record may, without prior approval, refer the injured employee to any qualified specialist for independent consultation or assessment, or specified treatment. If the insurer or self-insured employer has filed with the director of business regulation a preferred provider network approved by the medical advisory board, any change by the employee from the initial health care provider of record shall only be to a health care provider listed in the approved preferred provider network. If the employee seeks to change to a health care provider not in the approved preferred provider network, the employee must obtain the approval of the insurer or self-insured employer. Nothing herein contained shall prevent the treatment, care or rehabilitation of an employee by more than one (1) physician, dentist or hospital. {DEL Examination or treatment at a facility providing emergency care or by a physician under contract with the employer or insurer shall not constitute the employee's initial choice to obtain health care, diagnosis or treatment. DEL} {ADD The employee's first visit to any facility providing emergency care or to a physician or medical facility under contract with or agreement with the employer or insurer to provide priority care shall not constitute the employee's initial choice to obtain health care, diagnosis or treatment. ADD}

(b) Within three (3) days of an initial visit following an injury, the health care provider shall provide to the insurer or self-insured employer a notification of compensable injury form to be approved by the administrator of the medical advisory board. Within three (3) days of the injured employee's release or discharge, return to work, and/or recovery from an injury covered by chapters 29 -- 38, inclusive, of this title, the health care provider shall provide a notice of release to the insurer or self-insured employer on a form approved by the division. A twenty dollar ($20.00) fee may be charged by the health care provider to the insurer or self-insured employer for such notification of compensable injury forms or notice of release forms or for affidavits filed pursuant to subsection (c) hereof, but only if filed timely.

No claim for care or treatment by a physician, dentist or hospital chosen by an employee shall be valid and enforceable as against his or her employer, the employer's insurer or the employee, unless the physician, dentist or hospital gives written notice of the employee's choice to the employer/insurance carrier within fifteen (15) days after the beginning of the services or treatment. The health care provider shall in writing present to the employer/insurance carrier a final itemized bill for all unpaid services or treatment within three (3) months after the conclusion thereof. The employee shall not be personally liable to pay any physician, dentist or hospital bills in cases where the physician, dentist or hospital has forfeited the right to be paid by the employer/insurance carrier because of non-compliance with this section.

(c) Every six (6) weeks, any qualified physician or other health care professional providing medical care or treatment to any person for an injury covered by chapters 29 - 38, inclusive, of this title, shall file an itemized bill and an affidavit with the insurer and the medical advisory board. A ten percent (10%) discount may be taken on the itemized bill affidavits not filed timely and received by the insurer one (1) week or more late. The affidavit shall be on a form designed and provided by the administrator of the medical advisory board and shall state:

(1) The nature of the injury being treated;

(2) The type of medical treatment provided to date, including type and frequency of treatment(s);

(3) Anticipated further treatment including type, frequency and duration of treatment(s), whether or not maximum medical improvement has been reached or when it is expected to be reached, and the anticipated date of discharge;

(4) Whether the employee can return to the former position of employment or is capable of other work, specifying work restrictions and work capabilities and the degree of functional impairment and/or disability of the employee;

(5) Any ownership interest in any ancillary facility to which the patient has been referred for treatment of a compensable injury.

The affidavit shall be admissible as an exhibit of the workers' compensation court with or without the appearance of the affiant. (d) An "itemized bill", as referred to herein, shall mean a statement of charges, on a form HCFA 1500 or other form suitable to the insurer, which includes but is not limited to an enumeration of specific types of care provided, facilities or equipment used, services rendered, and appliances or medicines prescribed, for purposes of identifying the treatment given the employee with respect to his or her injury.

(e)(1) The treating physician shall furnish to the employee, or to his or her legal representative, a copy of his or her medical report within ten (10) days of the examination date.

(2) The treating physician shall notify the employer immediately when an employee is able to return to full or modified work.

(f)(1) Compensation for medical expenses and other services under sections 28-33-5, 28-33-7 or 28-33-8 is due and payable within twenty-one (21) days from the date a request is made for payment of these expenses by the provider of the said medical services. In the event payment is not made within the twenty-one (21) days from the date a request is made for payment, the provider of medical services may add, and the insurer or self-insurer shall pay, interest at the per annum rate as provided in section 9-21-10 on the amount due. The employee or the medical provider may file a petition with the administrator of the workers' compensation court which petition shall follow the procedure as authorized in chapter 35 of this title.

(2) The twenty-one (21) day period in subsection (f)(1) above shall begin on the date the insurer receives a request with appropriate documentation required to determine whether the claim is compensable and the payment requested is due.

{ADD 28-33-10. Dental -- Hospital and Medical services defined. -- ADD} (a) The term "dental services" as used in sections 28-33-5 --28-33-9, inclusive, shall be construed to include services rendered in making, repairing and replacing artificial teeth and dentures.

(b) The term "hospital services" as used in sections 28-33-5 -- 28-33-9, inclusive, shall be construed to include any and all services normally furnished by the hospital for the care of patients.

(c) The term "medical services" as used in sections 28-33-5 --28-33-9, inclusive, shall be construed to include {ADD palliative care ADD} services by a physician licensed by the state of Rhode Island {DEL or, for a period of sixty (60) days from the date of the first visit on the claim or DEL} for twelve (12) visits, {DEL whichever first occurs, palliative care. DEL} {ADD after reaching maximum medical improvement. ADD} Additional palliative care must be authorized by the {ADD insurer or self-insured ADD} employer. A request for additional palliative care must be submitted {ADD to the insurer or self-insured employer ADD} at least ten (10) working days prior to delivery of the services and shall include {DEL documentation of the need for services requested. When palliative care is expected to extend beyond ninety (90) days from the date of initial treatment, the request for such services shall include DEL} a treatment plan, including a time schedule of measurable objectives, a projected termination date of treatment, and an estimated total cost of services. The director shall promulgate rules governing {DEL the response to DEL} a request for additional palliative care and review of any decision thereon. Any disputes as to the definition of "palliative care" shall be resolved by the medical advisory board. These limitations on palliative care shall not apply to any conditions for which a contrary treatment protocol has been established by the medical advisory board. {DEL Protocols for palliative care shall be promulgated no later than six (6) months following the date of enactment of this legislation. DEL}

{ADD 28-33-25. Settlement for lump sum or structured-type payment. -- ADD} (a)(1) In case payments have continued for not less than six (6) months the parties may petition the workers' compensation court for an order approving a settlement of the future liability for a lump sum or structured-type periodic payment over a period of time.

(2)(A) In considering the petition, a judge shall give due weight to the fact that it is the policy of this chapter that compensation be paid weekly.

(B) The petition shall be considered by a judge of the court and may be granted where it is shown to the satisfaction of the court that the payment of a lump sum or structured-type payment in lieu of future weekly payments will be in the best interest of all parties including the employee, employer {ADD , ADD} {DEL and DEL} insurance carrier {DEL . DEL} {ADD , and where applicable, the workers' compensation administrative fund. ADD} Any proposed settlement that exceeds one hundred four (104) weeks of compensation for partial incapacity may be rejected by the chief judge in his or her discretion. {ADD The employee shall be entitled to a finding amortizing the net settlement over his or her life expectancy. ADD}

(C) In determining whether the settlement is in the best interest of all parties, the judge may refer the employee for a rehabilitation evaluation pursuant to the provisions of section 28-33-41.

(3) Upon payment, the employer and insurer shall be entitled to a duly executed release, which fully and finally absolves and discharges the employer and insurer from any and all liability arising out of the injury.

(b) The provisions of this section shall be strictly construed and all hearings for settlement shall be conducted in open session.

(c) No case may be settled to a lump sum or structured-type periodic payment while the Rhode Island temporary disability insurance fund and/or the department of social and rehabilitative services has a claim for payments made under chapter 41 of this title unless agreement is made to pay any such claim from the lump sum or structured-type periodic payments.

(d) Attorneys' fees shall be fixed by the court, but in no event shall any attorney's fee for representing an employee in connection with a petition brought pursuant to this section exceed a sum equal to fifteen percent (15%) of the lump sum or fifteen percent (15%) of the structured-type periodic payment reduced to present day value.

(e) No case shall be settled for a lump sum or structured-type periodic payment unless it be placed upon the record, in open session, that the employer, if insured, has been advised by the insurer or its agent of the potential effect of the settlement on its workers' compensation premium, and has the opportunity to appear and state its disapproval of the settlement.

(f) Settlements must be paid within fourteen (14) days of entry of an order to pay or the date(s) upon which payment(s) is/are due pursuant to a court order, and a penalty of one hundred dollars ($100) shall be assessed for every day the payment is delinquent.

{ADD 28-33-47. Reinstatement of injured worker. -- ADD} (a) A worker who has sustained a compensable injury shall be reinstated by the worker's employer to the worker's former position of employment upon demand for such reinstatement, if the position exists and is available and the worker is not disabled from performing the duties of such position, with reasonable accommodation made by the employer in the manner in which the work is to be performed. A workers' former position is "available" even if that position has been filled by a replacement while the injured worker was absent as a result of the worker's compensable injury. If the former position is not available, the worker shall be reinstated in any other existing position which is vacant and suitable. A certificate by the {DEL attending DEL} {ADD treating ADD} physician that the physician approves the worker's return to the worker's regular employment or other suitable employment shall be prima facie evidence that the worker is able to perform such duties.

(b) Such right of reinstatement shall be subject to the provisions for seniority rights and other employment restrictions contained in a valid collective bargaining agreement between the employer and a representative of the employer's employees, and nothing shall exempt any employer from or excuse full compliance with any applicable provisions of the Americans with Disabilities Act and chapter 42-87 (Discrimination Against the Handicapped) of the general laws.

(c) Notwithstanding subsection (a) of this section:

(1) The right to reinstatement to the worker's former position under this section terminates upon any of the following:

(A) a medical determination by the treating physician, impartial medical examiner or comprehensive independent health care review team that the worker cannot, at maximum medical improvement, return to the former position of employment or any other existing position with the same employer that is vacant and suitable;

(B) the approval by the director of labor of a vocational rehabilitation program for the worker to train the worker for alternative employment with another employer;

(C) the worker's acceptance of suitable employment with another employer after reaching maximum medical improvement;

(D) the worker's refusal of a bona fide offer from the employer of light duty {DEL or modified DEL} employment {DEL which is DEL} {ADD or ADD} suitable {ADD alternative employment, ADD} prior to reaching maximum medical improvement;

(E) the expiration of ten (10) days from the date that the worker is notified by the insurer or self-insured employer by mail at the address to which the weekly compensation benefits are mailed that the worker's treating physician has released the worker for employment unless the worker requests reinstatement within that time period;

(F) the expiration of (i) thirty (30) days after the employee reaches maximum medical improvement or concludes or ceases to participate in an approved program of rehabilitation, or (ii) one (1) year from the date of injury, whichever is sooner. Notwithstanding the foregoing, where the employee is participating in an approved program of rehabilitation specifically designed to provide the employee with the ability to perform a job for which he or she would be eligible under subsection (a) the right of reinstatement shall terminate when the employee concludes or ceases to participate in such program or eighteen (18) months from the date of injury, whichever is sooner;

(G) except where otherwise provided under a collective bargaining agreement, the approval by the court of a settlement pursuant to this act.

(2) The right to reinstatement under this section does not apply to:

(A) a worker hired on a temporary basis;

(B) a worker employed in a seasonal occupation;

(C) a worker who works out of a hiring hall operating pursuant to a collective bargaining agreement;

(D) a worker whose employer employs nine (9) or fewer workers at the time of the worker's injury;

(E) a worker who is on a probationary period of less than ninety-one (91) days.

(d) Any violation of this section is hereby deemed an unlawful employment practice. If the employee applies for reinstatement under this section and the employer in violation of this section refuses to reinstate the employee, the department of labor is authorized to order reinstatement and award back pay and the cost of fringe benefits lost during the period as appropriate, and may require the employer to reimburse the carrier for indemnity benefits, which the carrier shall continue to pay during the period of violation.

{ADD (1) Determinations of reinstatement disputes shall be rendered by the director or the director's designee, department of labor, after a hearing held pursuant to rules and regulations promulgated by the director. The director shall prescribe forms, make suitable orders, and adopt rules of procedure to secure a speedy, efficient, informal and inexpensive disposition of proceedings brought under this chapter. The director shall have the authority and such jurisdiction as may be necessary to carry out his or her duties under the provisions of this chapter, including the power to subpoena, to grant attorney's fees, and to make an official record suitable for transmission to the workers' compensation court.

(2) Review of director's determinations:

(i) Any party aggrieved of a determination made by the director of the department of labor pursuant to this section may institute proceedings to review said determination by filing a petition with the workers' compensation court. The petition shall set forth the date of the order and a concise statement of the grounds upon which the appellant seeks relief. No responsive pleading need be filed unless required by statute or by order of the workers' compensation court.

(ii) The appellant shall file the petition to review the director's order, together with a copy of the decision and order to be reviewed, within thirty (30) days of the date on which the order was entered.

(iii) Upon receipt of the petition to review the order of the director, the workers' compensation court administrator's office shall assign the matter to a judge who shall fix a date upon which briefs shall be filed with the workers' compensation court. In the event that either party seeks to rely upon evidence introduced before the director in support of their arguments, the party shall submit the necessary portions of the transcript of the hearing with their memoranda.

(iv) The review proceedings shall be governed by the workers' compensation court rules of procedure and shall be confined to the record. In cases of alleged irregularities in procedure before the director, not shown in the record, proof thereon may be taken in the workers' compensation court.

(v) The workers' compensation court shall not substitute its judgment for that of the director as to the weight of the evidence on questions of fact. The workers' compensation court may affirm the decision of the director or remand the case for further proceedings, or it may reverse or modify the decision if substantial rights of the appellant have been prejudiced because the administrative findings, conclusions, or decisions are: (1) in violation of constitutional or statutory provisions; (2) in excess of the statutory authority of the director; (3) made upon lawful procedure; (4) affected by other error of law; (5) clearly erroneous in view of the reliable, probative, and substantial evidence on the whole record; or (6) arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion. ADD}

(e) When an employee is entitled to reinstatement under section 28-33-47, but the position to which reinstatement is sought does not exist or is not available, the employee may file for unemployment benefits as if then laid off from that employment, and unemployment benefits shall be calculated pursuant to section 28-42-3(10) of the Employment Security Act. Provided, however, that an employee cannot collect both workers' compensation indemnity benefits and unemployment benefits under this section.

(f) The education division of the department of labor shall provide information to employees who receive benefits under this title of the provisions of this section.

SECTION 3. Section 28-36-13 of the General Laws in Chapter 28-36 entitled "Workers' Compensation -- Insurance" is hereby amended to read as follows:

{ADD 28-36-13. Information furnished by insurers or self-insurers on request of director. -- ADD} (a) Any employer insurance company or self-insurers insuring employers against liability for personal injuries to employees shall fill out all blanks and answer all questions submitted to it by the director, relating to classifications, premium rates, amount of compensation paid and such other information which the director may deem important either for the proper administration of chapters 29 -- 38, inclusive, of this title or for statistical purposes. {ADD The director shall have the authority and such jurisdiction as may be necessary to carry out duties pursuant to the provisions of this chapter, including with cause the power to subpoena. ADD} Any employer insurance company or self-insurer who refuses to notify the director as required in this section shall be subject to prosecution for a misdemeanor and upon conviction thereof may be punished by a fine of not more than two hundred fifty dollars ($250.00) for each offense. All criminal actions for any violation of this section shall be prosecuted by the attorney general. The attorney general shall prosecute such actions to enforce the payment of penalties and fines at the request of the director.

(b) Any {DEL employer DEL} insurance company that willfully refuses to {DEL lower rates based on the employer's good faith report of information required by this section DEL} {ADD apply the proper classification based on a ruling of the classification appeals board or to timely adjust incurred losses ADD} shall be subject to prosecution for a misdemeanor and upon conviction thereof may be punished by a fine of not more than two hundred fifty dollars ($250) for each offense. All criminal actions for any violation of this section shall be prosecuted by the attorney general at the request of the director. In addition to the foregoing, the director shall have discretion to assess an administrative penalty and/or to bring a civil action in any court of competent jurisdiction for collection of such penalties and sanctions.

SECTION 4. Sections 28-37-8 and 28-37-14 of the General Laws in Chapter 28-37 entitled "Workers' Compensation -- Administrative Fund" are hereby amended to read as follows:

{ADD 28-37-8. Continuance of payments to totally incapacitated persons. -- ADD} In addition to any other payments authorized to be made from the fund established under section 28-37-1, payments from the fund shall be made for the continuance of compensation and medical expenses at his or her prevailing rate to any employee who subsequent to January 1, 1940 has suffered an injury resulting in his receiving compensation payments for total incapacity and that incapacity has continued or will continue beyond the maximum period of payment for total incapacity provided under chapters 29 -- 38, inclusive, of this title. The payments for continuing total incapacity shall be made from the fund until the employee's total incapacity has ended {ADD or the employee's claim has been settled pursuant to section 28-35-20 ADD} or until his death; provided, however, that no payment shall be made under this section to an employee whose future payments of compensation have been commuted to a lump sum; and provided, further, that the death of the employee from any cause terminates the right to any further compensation under this section.

{ADD 28-37-14. Computation of gross premiums. -- ADD} {ADD (a) ADD} Gross premiums shall include all premiums and premium deposits and assessments on all policies, certificates, and renewals written during the preceding calendar year, covering workers' compensation risks within the state or subject to the jurisdiction of this state, policies subsequently cancelled and reinsurance assumed, whether those premiums and premium deposits and assessments are in the form of money, notes, credits or other substitute for money, after deducting from such gross premiums the amount of return premiums on those contracts covering workers' compensation risks within this state or subject to the jurisdiction of this state and the amount of premiums for reinsurance assumed of those risks; provided, that mutual companies and companies which transact business on the mutual plan shall also be allowed to deduct from such premiums and premium deposits and assessments, the so-called dividends or unused or unabsorbed portion of the premiums and premium deposits and assessments applied in part payment of such premiums and premium deposits and assessments or returned to policyholders in cash or credited to policyholders during the preceding calendar year.

{ADD (b) Except as specifically set forth in section 4 of chapter 33 of this title, in the case of a policy which contains deductible claim payment provisions either on the basis of per claim and/or claims in the aggregate, the gross premium shall be based on the premium the employer would have had to pay to obtain the policy without such deductible provisions and without the application of any deductible premium credit.

(c) Gross premium shall be reported annually to the department of business regulation and to the director of labor pursuant to the provisions of this chapter.

(d) Regulation and enforcement of sections (b) and (c) of this section shall be vested in the director of labor. The director of labor is hereby empowered to bring an action in any court of competent jurisdiction to give effect to the provisions of sections (a) through (c) of this section. ADD}

SECTION 5. This act shall take effect upon passage.