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Draft EAMS Regulations

The Division of Workers’ Compensation is seeking feedback from the workers’ compensation community on draft changes to the rules governing its Electronic Adjudication Management System. EAMS, as it’s known, is the case management system that tracks the approximately 250,000 workers’ compensation cases that are heard in California’s workers’ compensation courts each year. The Division has … Read More »

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DWC’s Utilization Review Regulations Rejected

The Division of Workers’ Compensation spent over a year drafting and redrafting regulations to update California’s utilization review system, but the Office of Administrative Law disapproved the regulatory package for failing to follow proper procedures. OAL has given the Division 120 days to correct the deficiencies and resubmit. DWC says it will revise and resubmit. … Read More »

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New Utilization Review Draft Regulations

Faced with significant pushback from the workers’ compensation community, the Division of Workers’ Compensation made extensive changes to last year’s proposed utilization review regulations. It is now circulating the changes as part of a second 15-day public comment period. The regulations implement parts of SB 1160 and AB 1124 that exempt some care from utilization … Read More »

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Supplemental Job Benefits Regulatory Changes

The Division of Workers’ Compensation is considering revising the Supplemental Job Displacement Benefit and Return-to-Work regulations. The idea is to target rampant fraud and abuse in a system intended to help injured workers who can’t return to their jobs acquire new skills to compete in the job market. DIR received both support and pushback from … Read More »

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Comment Period Open for Pharmacy Fee Regulations

The Division of Workers’ Compensation is taking public comments before an April hearing on proposed changes to the workers’ comp pharmacy drug reimbursement and dispensing fee regulations. The plan includes a proposed two-tier dispensing fee that generated controversy before but otherwise aligns the program with the Medi-Cal pharmacy fee regulations. It includes modifications to the … Read More »

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Single Payer Health, Presumptions & Expanded Benefits Bills Introduced

California legislators are setting the stage for the second half of the legislative session by introducing bills to create a single-payer health care system, expand 4850 leave for public safety officers, create a presumption for farmworkers and expand workers’ comp medical benefits for injured workers who have to travel for treatment. Legislators also introduced bills … Read More »

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April Hearing For September 1st Workers’ Comp Regulations

Insurance Commissioner Ricardo Lara will hold a virtual public hearing on April 24th to take public comment on the Workers’ Compensation Insurance Rating Bureau’s proposed regulatory changes for workers’ comp policies incepting on or after September 1st, 2023. The rule changes include a major restructuring of the classifications for the restaurant and tavern industry, updated … Read More »

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Contractors, Brokers Face New Workers’ Comp Laws

The 2022 legislative session was a small year for workers’ compensation, but the industry still faces several new laws. As of January 1st, four classes of contractors are now required to carry workers’ comp insurance even if they have no employees, while brokers face new fraud training requirements to get or maintain their licenses. For … Read More »

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