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Average medical-legal service costs increased 66% between 2007 and 2014 for California workers compensation claims following a change in the state's med-legal fee schedule structure, according to the California Workers' Compensation Institute.
The Oakland, California-based institute said in a report Monday that medical-legal service costs averaged $1,628 per California comp claim in 2014, up from $979 in 2007.
California enacted a revised fee schedule in 2007 for medical-legal services related to workers comp claims, the CWCI said. While the older fee schedule included a flat fee payment system for medical-legal services, the newer fee schedule began providing payments based on the length of time it took to perform services such as follow-up exams for injured workers and supplemental reports for workers comp claims.
The study found that there was a significant jump in costs related to services billed in 15-minute increments. For instance, there was a 136.4% increase in the average cost of workers comp follow-up evaluations provided within nine months of an injured worker's prior evaluation.
The average payment for supplemental evaluations increased 86.1% from 2007 to 2014, while the average payment for comprehensive evaluations involving extraordinary circumstances increased 66.2% during that time, the CWCI said.
The San Diego District Attorney's office says 13 people have been indicted in what it calls “one of the largest workers' compensation health care insurance bribery schemes ever uncovered in San Diego County.”