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Missouri lawmakers introduced legislation Thursday that would require workers compensation disputes to be solved via binding independent medical review.
H.B. 2267, sponsored by Republican Rep. John Eggleston, creates new provisions for solving disputes regarding the modification, delay or denial of health care services.
Under the legislation, up to three independent medical review organizations that meet state requirements may be procured for the purposes of medical review, and all medical records and information relating to a dispute must be submitted for review within 20 calendar days of the request.
The state’s workers compensation department may review an independent review organization’s decision only in cases where there was a plainly erroneous finding of fact, if the decision was made without the ability to consider any document, test or image available at the time but not provided for review, or due to fraud, according to the language of the bill, and an employer may request review of the decision within 10 calendar days of its certification by the workers comp department.
The bill has not yet been assigned to a committee.
The number of independent medical reviews used to resolve California workers compensation medical disputes rose 4.4% in the first half of 2018, compared with the first half of 2017, and more than 90% of the disputed cases are upheld in the process, according to a report released Monday by the California Workers’ Compensation Institute.