Title X, SEC. 10001. PROVISION OF WORKERS COMPENSATION SERVICES. (a) Provision of Benefits. Subject to subsection (b) (1) Requirement for certain health plans. (A) In general. Each health plan that provides services to enrollees through participating providers shall enter into such contracts and arrangements as are necessary (in accordance with subparagraph (B)) to provide or arrange for the provision of workers compensation services to such enrollees, in return for payment from the workers compensation carrier under section 10002. (B) Provision of services. For purposes of this paragraph, a health plan provides (or arranges for the provision of) workers compensation services with respect to an enrollee if the services are provided by (i) a participating provider in the plan, (ii) any other provider with whom the plan has entered into an agreement for the provision of such services, or (iii) a specialized workers compensation provider (designated by the State under 10011), whether or not the provider is a provider described in clause (i) or (ii). (2) Individual requirement. An individual entitled to workers compensation medical benefits and enrolled in a health plan (whether or not the plan is described in paragraph (1)(A)) shall receive workers compensation services through the provision (or arrangement for the provision) of such services by the health plan. (3) Exceptions. (A) Emergency services. Paragraphs (1) and (2) shall not apply in the case of emergency services. (B) Electing veterans, military personnel, indians, and prisoners. Paragraphs (1) and (2) shall not apply in the case of an individual described in section 1004(b) and making an election described in such section. (4) Use of specialized workers compensation providers. If a participating State has designated under section 10011 specialized workers compensation providers with respect to one or more types of injuries or illnesses for a geographic area, either a health plan or an injured worker who has an injury or illness of such type may elect to provide or receive the benefits under this subsection through such a provider. (b) Alternative Permitted. Subsection (a) shall not be construed as preventing an injured worker and a workers compensation carrier from agreeing that workers compensation services shall be provided other than by or through the health plan in which the worker is enrolled. (c) Coordination. (1) Designation of case manager. Each health plan shall employ or contract with one or more individuals, such as occupational nurses, with experience in the treatment of occupational illness and injury to provide case management services with respect to workers compensation services provided through the plan under this section. (2) Functions of case manager. The health plan (through the case manager described in paragraph (1)) is responsible for ensuring that (A) there is plan of treatment (when appropriate) for each enrollee who is an injured worker designed to assure appropriate treatment and facilitate return to work; (B) the plan of treatment is coordinated with the workers compensation carrier, the employer, or both; (C) the health plan (and its providers) comply with legal duties and requirements under State workers compensation law; and (D) if the health plan is unable to provide a workers compensation service needed to treat a work-related injury or illness, that the injured worker is referred (in consultation with the workers compensation carrier) to an appropriate provider.