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No. 76 Page 41 of 74 2023

VT LEG #371318 v.1 establishes that a preponderance of all evidence now supports the claim. If the Commissioner’s decision, after a hearing, is that the employee was not entitled to any or all benefits paid between the discontinuance and the final decision, upon request of the employer, the Commissioner may order that the employee repay all benefits to which the employee was not entitled. The employer may enforce a repayment order in any court of law having jurisdiction. Sec. 29. 21 V.S.A. § 640b is amended to read: § 640b. REQUEST FOR PREAUTHORIZATION TO DETERMINE IF PROPOSED TREATMENT IS BENEFITS ARE NECESSARY (a) As used in this section, “benefits” means medical treatment and surgical, medical, and nursing services and supplies, including prescription drugs and durable medical equipment. (b) Within 14 days of after receiving a written request for preauthorization for a proposed medical treatment benefits and medical evidence supporting the requested treatment benefits, a workers’ compensation insurer shall do one of the following, in writing: (1) authorize Authorize the treatment benefits and notify the health care provider, the injured worker, and the Department; or. (2)(A) deny Deny the treatment benefits because the entire claim is disputed and the Commissioner has not issued an interim order to pay benefits; or. The insurer shall notify the health care provider, the injured worker, and the Department of the decision to deny benefits.

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Page 41

Official source

No. 76 Page 41 of 74 2023

VT LEG #371318 v.1 establishes that a preponderance of all evidence now supports the claim. If the Commissioner’s decision, after a hearing, is that the employee was not entitled to any or all benefits paid between the discontinuance and the final decision, upon request of the employer, the Commissioner may order that the employee repay all benefits to which the employee was not entitled. The employer may enforce a repayment order in any court of law having jurisdiction. Sec. 29. 21 V.S.A. § 640b is amended to read: § 640b. REQUEST FOR PREAUTHORIZATION TO DETERMINE IF PROPOSED TREATMENT IS BENEFITS ARE NECESSARY (a) As used in this section, “benefits” means medical treatment and surgical, medical, and nursing services and supplies, including prescription drugs and durable medical equipment. (b) Within 14 days of after receiving a written request for preauthorization for a proposed medical treatment benefits and medical evidence supporting the requested treatment benefits, a workers’ compensation insurer shall do one of the following, in writing: (1) authorize Authorize the treatment benefits and notify the health care provider, the injured worker, and the Department; or. (2)(A) deny Deny the treatment benefits because the entire claim is disputed and the Commissioner has not issued an interim order to pay benefits; or. The insurer shall notify the health care provider, the injured worker, and the Department of the decision to deny benefits.