Trial Starting In MRI Provider’s Kickback Case

Federal prosecutors were scheduled to start making their case yesterday that Sam Sarkis Solakyan engaged in a major kickback scheme to direct referrals of workers’ comp claimants to his chain of magnetic resonance imaging (MRI) centers in exchange for cash payments. The scheme is alleged to have racked up $284 million in charges related to … Read More »

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Intended Consequences

Earlier this year, April 1st to be exact, the Division of Workers’ Compensation (DWC) adopted changes to the Medical-Legal Fee Schedule (MLFS). This is the schedule governing the payment of … Read More »

Division Gets Pushback, Support For Draft QME Regulations

Draft regulations to boost the training and educational requirements for qualified medical evaluators (QMEs), including anti-bias training that the Division of Workers’ Compensation agreed to require of QMEs two years ago, generated significant feedback from employers and providers alike. The Division is reviewing 20-some pages of comments in preparation for starting the formal rulemaking process. … Read More »

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Alternative MPN Bill Downgraded

Proposed legislation that threatened to undermine the curated medical provider networks that employers and insurance carriers use to keep medical costs down and fight fraud in the workers’ comp system is being downgraded. Assemblymen Eloise Gomez Reyes (D-San Bernardino) and Lorena Gonzalez (D-San Diego) are dropping plans – for now – to create a statewide … Read More »

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Workers’ Comp Rates Likely to Increase

The Workers’ Compensation Insurance Rating Bureau’s staff of actuaries will be presenting their recommendations for a September 1st, 2021, California pure premium rate filing to the Bureau’s governing committee members later this morning. The actual rate recommendation was unknown as of deadline because the staff was still adjusting for the economic impact of the COVID-19 … Read More »

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Democrat Proposal A Major Cost Driver For Employers

California employers can expect to pay more, a lot more, if a proposed bill to create a state-run wraparound medical provider network (MPN) becomes law. Experts note that employers will pay millions to develop and maintain this state-run all-encompassing network. The proposed change will drive up the cost of care by losing network discounts on … Read More »

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Fact Checking

As noted in the last edition of this publication, the latest existential threat to California’s workers’ compensation system is Assembly Bill 1465 co-authored by Assembly Majority Leader Eloise Reyes (D-San … Read More »