Lucas Receives favorable Decision in utilization review

    Received a favorable decision in a utilization review where the employer filed a review addressing the employee's opioid prescriptions and the provider under review failed to offer medical records to the utilization review organization.  The review organization found that the treatment was not reasonable and necessary.  The employee filed a petition to review the utilization review determination alleging that the organization did not make adequate efforts to obtain the medical records in question.  Based on testimony of a representative of the review organization, the Workers' Compensation Judge found the opioid prescriptions were not reasonable and necessary because the provider failed to present medical records.  The employer was not required to pay for any additional treatment.

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