Bruce Wick has attended several stakeholders meetings in the last month, aimed at finding a consensus set of regulatory changes to the WC system, which would benefit all parties. Those changes were amended into SB 1160-Mendoza, on August 18, 2016.
On the plus side for employers, the new changes make it easier for WC insurers and claims handlers to discipline medical providers who proscribe medical care outside the Medical Treatment Utilization Schedule (MTUS), as well as staying a WC lien filed by a provider who has been charged with fraud, and dismissing liens filed by parties who have been convicted of fraud. The legislation would also limit the ability of liens to be assigned or transferred to collectors, who clog up the system. The medical provider fraud is estimated to cost well into the hundreds of millions of dollars annually in California.
On the plus side for workers, there will be limits that take effect in 2018, during the first 30 days of an injury, for insurers and claims handlers using Utilization Review procedures. This will reduce unnecessary delays in treatment, with significant safeguards to prevent unnecessary treatment being provided.
CALPASC supports the efforts to make the system work more efficiently for workers, while reducing fraudulent and unnecessary costs to the WC system. CLICK HERE to see the changes to SB 1160.