Managed Care Organization
Managed Care Organizations (MCO) are organizations certified
by the Bureau of Workers' Compensation to manage medical care.
Providers submit bills to the MCO, which will make the initial
determination on whether or not to pay the bill.The MCO process is explained more fully in our Guide to Ohio Workers' Compensation Medical Benefits.
Other Information:
- Court: On July 18, 2001, the Ohio
Supreme Court held in Northwest Ohio Bldg. and Construction Trades
Council v. Conrad, that the method used to fund the MCO system was
constitutional. (August, 2001)
- Court: A Court of Appeals' Magistrate
found that medical treatment that produces a temporary benefit can be
reasonably necessary to treat an injury and ruled that the Commission
improperly denied medical treatment because it would not provide
"lasting benefits." (May, 2001)
- Court: Court of Appeals finds MCO program improperly funded. (March 2000)
- Court: Supreme Court rules MCO program
consitutional. (February 2000)
- Administrative: BWC regulation changes
affecting MCO appeals and vocational rehabilitation. (January, 1999)
- Court: Common Pleas judge upholds MCO program. (October, 1998)
- Administrative: The BWC has new
medical "treatment plan approval guidelines", which will be effective
on June 1, 1998. (May, 1998)
- Court: A case has been filed in the
Ohio Supreme Court challenging the practice of permitting Managed Care
Organizations (MCOs) to terminate medical treatment in workers'
compensation claims. (May, 1998)
- Court: Lawsuit challenging MCO
procedure transferred to Franklin County. (September, 1997)
- Court: On June 30, 1997, a case challenging the BWC MCO procedure was filed in the Lucas County Court of Common Pleas. The case is called Northwest Ohio Bldg. and Construction Trades Council v. Conrad. The case asks for declaratory judgment, as well as a temporary restraining order and a preliminary injunction to stop enforcement, implementation or application of statutes dealing with managed care for workers' compensation. The suit claims that the MCO procedure violates Art. II, Sec. 35 of the Ohio Constitution. (June, 1997)