Bills amended on the first day of California's 2022 legislative session address presumptive coverage for some first responders, and requirements to provide injured workers with information about medical provider networks.

Lawmakers on Monday read through A.B. 399, which proposes allowing injured workers to request the medical provider network name and network identification number if an employer objects to their selection of a treating physician because the doctor is not part of the network.

The employer would be required to provide the requested information within five business days and the employer’s “failure to provide notice as required by this subdivision is not a basis for the employee to treat outside the network unless it is shown that the failure to provide notice resulted in a denial of medical care,” the amended bill reads.

Included in the proposal is a provision calling for a $1,000 penalty for failing to reimburse providers for independent bill review fees within five business days and mandating that MPN providers treat patients at least eight hours per week at any location that is counted toward the network’s access standard.

Also on the table is A.B. 991, which proposes giving full-time lifeguards in the Boating Safety Unit of the San Diego Fire and Rescue Department access to the same presumptions that apply to other first responders such as police and firefighters.

The bill would cover conditions including hernias, pneumonia, heart trouble, cancer, tuberculosis, blood-borne infectious diseases, methicillin-resistant Staphylococcus aureus skin infections, meningitis and post-traumatic stress disorder.

The bills amended Monday will join other measures that were not passed by both chambers of the Legislature in 2021:

S.B. 216 would expand the license classifications required to have a certificate of comp insurance on file with the Contractors State License Board. Effective Jan. 1, 2025, the measure would require all classifications under the jurisdiction of the CSLB to file a certificate of comp coverage.

A.B. 1465 would request that the Commission on Health and Safety and Workers Compensation complete a study on delays and access to care in medical provider networks. The Assembly unanimously passed the measure in 2021.

A.B. 1148 would require the insurance commissioner to evaluate the Workers Compensation Insurance Rating Bureau’s website every five years, starting in 2023, to assess whether it is achieving its purpose, including assisting the public in determining whether an employer has comp coverage. The Assembly also unanimously passed the bill in 2021.

A.B. 404 would require the Division of Workers Compensation to review the Medical-Legal Fee Schedule every two years and update it, if necessary, to increase the conversion factor by the percentage increase in the most recent federal Medicare Economic Index. The Assembly also unanimously passed that bill in 2021.

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