Privacy, Apportionment, Dynamex Bills Clear Houses of Origin

Bills had until the end of May to clear their house of origin to remain alive and nearly a dozen measures impacting workers’ comp in particular and the insurance industry at large remain viable. Nearly all of the bills are expected to undergo additional amendments and refinements as they make their way through the legislative … Read More »

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Court Says WCAB Usurped UR/IMR Process

The Workers’ Compensation Appeals Board overstepped its authority when it ordered parties to submit a dispute over additional housekeeping services back to the nurse that made the initial determination, says the Second District Court of Appeal. Because the housekeeping services were necessary to “cure or relieve” the effects of the industrial injury, utilization review, and … Read More »

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UR Bill Clears Assembly, Apportionment Bill Still Alive

Two bills backed by the California Applicants’ Attorneys Association (CAAA) are advancing in the Legislature. One addressing utilization review is moving “as a vehicle for on-going discussions” about potential reforms, while the second would restrict apportionment for permanent disabilities. As recently amended, AB 1107 by Assemblyman Kansen Chu (D-Milpitas) would allow claimants to seek penalties … Read More »

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IMR Applications Are Down So Far In 2019

California’s independent medical review system hit new highs in 2018 as IMR decisions topped 184,000, but the trends are reversing so far in 2019. The total eligible applications are down over 10% through the first three months of the year.  A reduction in disputes involving prescription drugs appears to be driving much of the decline. … Read More »

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MPN Bill Includes Small Perk for Payers

The Division of Workers’ Compensation could get a new weapon to combat the persistently high rate of independent medical review applications and decisions under legislation moving through the Capitol. Of course, it won’t come free. The same bill that would make clear that the DWC can reveal the identity of the providers driving the bulk … Read More »

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Seldom Used System Recovered Nearly $14M For Providers

California’s independent system for settling billing disputes between providers and payors is used infrequently, but when it is providers typically come out on top. A creation of the Baker SB 863 workers’ comp reforms, the independent bill review (IBR) process has recovered roughly $14 million for providers who had been shorted by workers’ comp carriers … Read More »

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California Workers’ Comp Costs Continue To Drop

The Workers’ Compensation Insurance Rating Bureau governing board has a tough decision to make early next month when it meets to discuss a potential mid-year workers’ comp rate filing. A first look at the year-end 2018 industry data shows a five-point decrease in the projected loss ratio from the one used for its Jan. 1, … Read More »

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DWC Eyes New Rules And Improvements For Old Ones

Alphabet soup was the dish of the day at the Division of Workers’ Compensation annual educational conference in Los Angeles. Administrative Director George Parisotto opened the event by outlining plans for updating the state’s Qualified Medical Examiner (QME) fee schedule and reducing the persistently high number of Independent Medical Reviews (IMR). Central to this goal … Read More »

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