UR Reforms, Drug Formulary Boost Treatment Approvals

Recent reforms that established a prescription drug formulary for California’s workers’ comp system, and which created a utilization review exemption for many treatments rendered during the first 30 days of … Read More »

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Spotlight on Providers’ Adherence To Treatment Guidelines

A new law will soon shine a spotlight on the workers’ comp doctors who are frequently recommending treatments that do not adhere to California’s evidence-based medical treatment utilization schedule (MTUS). … Read More »

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Formulary Committee Adds Cost Rationale To Drug Reviews

California’s evidence-based prescription drug formulary may soon add cost consideration to the process for selecting which drugs will qualify as exempt and which must go through utilization review.  Members of … 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 … Read More »

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DWC Working On Providing Free Access To ACOEM Guides

Officials at the Division of Workers’ Compensation say they are now offering providers in California’s workers’ comp system free access to the evidence-based treatment guidelines that are the underpinnings of … Read More »

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DWC Adopts New Pricing Regs, Treatment Guidelines

The Division of Workers’ Compensation adopted regulations to expand the state’s medical treatment utilization schedule and to implement a geographic-based reimbursement methodology for providers. The additions to the MTUS are … Read More »

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Controversial Medical Schedule Faces Pushback

A Division of Workers’ Compensation proposal to update four sets of medical treatment utilization schedule (MTUS) guidelines with newer material from the American College of Occupational and Environmental Medicine (ACOEM) … Read More »

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Early Returns From Rx Formulary Promising

California’s workers’ comp prescription drug formulary is just seven months old, but the early returns are promising according to preliminary industry data. A review of utilization review data through the … Read More »

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