Tag Archives: SB 863

Public Hearing Set for Medical Provider Network (MPN) Rules

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Adelson, Testan, Brundo, Novell & Jimenez (ATB Law) would like to make its audience aware that the California Division of Workers’ Compensation (DWC) will be holding a public hearing to discuss issues and changes connected with the Medical Provider Networks, or MPNs, following the passage of SB 863 last year. The term MPN was coined in 2005 as a way to describe health care providers and groups maintained by insurers and self-insured employers and approved by the DWC for workers’ compensation cases. SB 863 will bring significant changes to the way that MPNs operate in workers’ compensation claims. The DWC hearing will be the first occasion for members of the public to supply recommendations on these MPN changes as part of the state rulemaking process.

The details for this hearing are as follows:

January 31, 2013

10 AM to 12 noon

Elihu Harris State Office Building Auditorium

1515 Clay Street

Oakland, CA 94612

All Employers Should Have a Voice in the Rule making Process

It is hoped that the pending reforms will reduce costs to employers while developing a more navigable workers’ compensation system for all. The DWC is seeking public input on a variety of issues, including new MPN applicants, MPN audits and investigations, and the Independent Medical Review process. Employers will have the opportunity to participate in the formation of regulations for these new processes on January 31, and will also be able to share input on other facets of the law.

Adelson, Testan, Brundo, Novell & Jimenez believes it is important for employers to have a voice in workers’ compensation legislation, and encourages all employers potentially impacted by the coming changes to send a representative to this hearing and voice any suggestions or concerns they may have.

 

Workers’ Compensation Bill SB 863 – New Legislation

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The recently passed workers’ compensation bill SB 863 (full text available here) will significantly change the current workers’ compensation system in California. This new law is designed to decrease litigation costs to employers.

The attorneys of Adelson, Testan, Brundo & Jimenez are already familiar with the changes in SB 863, which will be implemented on a rolling basis over the next two years.

SB 863 offers modifications that are projected to save millions of dollars in workers’ compensation expenses.  Briefly, some of the changes are:

  • The lien system will see a major overhaul. The lien filing fee has been reinstituted at $150. The statute of limitations is now 18 months from the date of service, and liens will not be permitted for treatment disputes that should be handled through Independent Medical Review (IMR). This reduces the cost to the defense while ensuring that truly injured workers can access care timely and within the existing system.
  • There will no longer be permanent disability add ons for psychological, sexual, or sleep disorders arising from a physical injury, except for catastrophic injury or violent act claims. Though in most cases, treatment for these disorders is still required as part of a legitimate workers’ compensation claim for other injury, costs for the defense will be reduced through the removal of the add on treatment packages.
  • The old system of AME/QME review is changing, so that IMR will be mandatory in almost all treatment disputes, and the decision of the Independent Medical Reviewer will be final, limiting expenses related to endless court appeals.

These reforms, in particular the lien system changes and the IMR process, is projected to reduce the backlog of unnecessary and fatuitous litigation that is currently clogging the workers’ compensation system.

Contact Adelson, Testan, Brundo & Jimenez for seminars on SB 863.