| (a) As often as it considers necessary, the division
may review the operations of a system participant to determine compliance
with the Act or division rules.
(b) When reviewing the operations of a system participant
to determine compliance with the Act or division rules, the division
may conduct on-site visits to the system participant's premises. On-site
visits may be announced or unannounced.
(c) The on-site visit will occur during the system
participant's normal business hours.
(d) An on-site visit must not disturb a health care
provider's actual provision of health care to a patient.
(e) The division shall provide written notice of each
announced and unannounced on-site visit. This notice shall:
(1) be sent at least 10 days before the on-site visit
unless the on-site visit is unannounced in which case the notice will
be provided at the time of the on-site visit;
(2) specify the alleged violation(s) that is the subject
of the on-site visit;
(3) specify the types of records that must be made
available during the on-site visit;
(4) list the name and telephone number of the division
staff representative; and
(5) specify the date, time, location, and conditions
of the on-site visit.
(f) The person who is the subject of the on-site visit
shall designate a general contact person at the premises. During the
on-site visit the contact person shall:
(1) provide access to requested personnel and information;
(2) respond to the needs of division staff and to inquiries
by division staff; and
(3) be familiar with the system participant's procedures
and recordkeeping systems that are related to the records and information
requested during the on-site visit.
(g) The person subject to an on-site visit shall make
available to the division in the format and manner specified by the
division all records specified in the written notice provided under
subsection (e) of this section. A written notice may specify for inspection
any records related to the person's participation in the workers'
compensation system, including:
(1) claim files;
(2) medical records and reports;
(3) payment records;
(4) billing records;
(5) electronic records;
(6) communications;
(7) adjustor notes;
(8) accident reports;
(9) notifications of lost time;
(10) notifications of injuries;
(11) payroll data and wage statements;
(12) investigative reports;
(13) filed division forms; and
(14) contracts.
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