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Bill would further regulate medical-legal fee reimbursement

Posted On: Jul. 15, 2019 12:50 PM CST


Lawmakers in California on Thursday got a first look at a bill that would regulate conversion factors for reimbursed medical-legal fees for injured workers and require the state to periodically raise reimbursements for medical care.

A.B. 1832, introduced by Assembly member Rudy Salas, D-Bakersfield, would amend state law that requires the administrative director of the state Division of Workers’ Compensation to adopt and revise a fee schedule for medical-legal expenses; a fee schedule that consists of a series of procedure codes, relative values and a conversion factor to produce the fees that provide remuneration to physicians performing the medical-legal evaluations, as provided.

The bill proposes that effective upon passage the conversion factor would be at least $18.75 and would require the administrative director to increase the conversion factor quarterly, as necessary, “to reflect any increase in the Bureau of Labor Statistics Consumer Price Index for medical care, as specified,” according to a legislative analysis.

The bill would also require the administrative director, on or before Jan. 15, 2020, to assign a “reasonable relative value, greater than zero,” for a missed or failed appointment for a comprehensive or follow-up medical-legal evaluation and for a review of medical records associated with a missed or failed appointment, according to the proposed bill.

The bill is slated for committee hearing on Aug. 11.