Workers’ Compensation Medical Care Alert
Jack Heidler, Director
If a University of Florida employee is hurt at work, his or her treatment for this work-related injury or illness will be handled differently than it has been in the past, starting January 1. This change in workers’ compensation coverage is substantially different from our previous coverage and will require training of you and your employees.
This week, University Personnel Services was informed that effective January 1, 1997, Humana Medical Plan, Inc., will provide managed medical care for all compensable work-related injuries or illnesses affecting state employees. This managed medical care contract was awarded by the state Division of Risk Management (DRM) in response to a legislative mandate.
This contract brings with it dramatic changes to the way in which we will handle workers’ compensation injuries or illnesses. If any University of Florida employee is injured while performing his or her assigned job duties on or after January 1, he or she must receive authorized care from a Humana Medical Plan, Inc., provider. For university employees in Gainesville, this means that workers’ compensation care will no longer be available through the Student Health Care Center (infirmary) for injuries occurring on or after January 1.
Because this contract for managed medical care is a statutory requirement, all state employees must strictly adhere to the established referral procedures, and Humana is requiring that each employee on the University of Florida payroll (including student assistants and OPS employees) attend an orientation program on the use of Humana’s plan. Our Workers’ Compensation Office currently is working with Humana to schedule these orientation sessions, which will be held between January 6 and January 10. Sessions will be held every hour on the hour during the designated time periods and will last between 30 and 45 minutes. Worksites outside of Alachua County will be contacted directly by Humana to schedule orientation sessions.
At these orientation sessions, employees will learn how the Humana system works, sign a statement acknowledging their orientation to the program, and receive their Workers’ Compensation Program Handbook and Treatment Access Card. The handbook includes a provider list. Each employee must have the Treatment Access Card to receive workers’ compensation treatment through Humana. Therefore, it is necessary for employees to attend one of these sessions and understand how to receive compensable workers’ compensation medical care.
If an employee is injured on the job on or after January 1, whether before attending an orientation session or after, he or she must contact our Workers’ Compensation Office, Monday through Friday, between 8 a.m. and 5 p.m. at 392-4940, SC 622-4940, to receive direction on where to go for care. If an injury occurs outside of these hours, employees must contact Humana at 1-800-424-6689 to receive assistance. Unless the injury is an emergency, meaning the employee’s life or health would be placed in serious jeopardy without emergency treatment, all employees must call for direction. Otherwise, treatment rendered outside of the Humana Medical Plan, Inc., will not be covered, and the employee will be responsible for all associated costs. If the injury or illness is a life-threatening emergency, employees should go to the nearest emergency room or health care facility.
FOR MORE INFORMATION
Although we have been given minimal notice of this new managed medical care contract, with your assistance we can insure that all employees receive the necessary orientation to make this approach to workers’ compensation medical care successful. Attached please find information on how to report a workplace injury and a description of our modified duty program. Please post these in an area where all employees may have access to them.
Our Workers’ Compensation Office will contact you very soon regarding dates, times, and locations for the orientation sessions. Additionally, each employee will receive a letter explaining this new contract with his or her December 20 paycheck. This letter will include an assigned location and available times for attending an orientation session.
We appreciate your cooperation in implementing this new approach to workers’ compensation medical care. If you have any questions, please contact Henry Zunker, Workers’ Compensation Manager, at 392-4940, SC 622-4940.