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Bill could make public treatment denials for injured workers


California’s Department of Industrial Relations would have to publish data on its website of physicians whose treatment review decisions resulted in denials, according to one workers compensation-related bill now being considered by state lawmakers.

S.B. 537, amended in the state Assembly on Sept. 6 and now with the state Senate, would specifically require the administrative director to annually publish data on physicians “who treated 10 or more injured workers during the 12 months before July 1 of the previous year, including the number of injured workers treated by the physician and the number of utilization review decisions that resulted in a modification or denial of a request for authorization of medical treatment based upon a determination of medical necessity.”

The bill also calls for the director to issue a report to the Legislature, on or before Jan. 1, 2023, comparing potential payment alternatives for providers to the official medical fee schedule.

Lawmakers are also considering other comp-related bills:

  • A.B. 1400, which passed the state Senate on Wednesday and is now with the Assembly,  would require the state Commission on Health and Safety and Workers’ Compensation, in partnership with the County of Los Angeles and relevant labor organizations, on or before Jan. 1, 2021, to submit a study to Legislature, the Occupational Safety and Health Standards Board, and the Los Angeles County Board of Supervisors on the risk of exposure to carcinogenic materials and incidence of occupational cancer in mechanics who repair and clean firefighting vehicles.
  • S.B. 542, which passed the Senate on Wednesday and the Assembly on Tuesday, addresses mental injuries suffered by first responders, stating that the “only until January 1, 2025, that in the case of certain state and local firefighting personnel and peace officers, the term ‘injury’ also includes post-traumatic stress that develops or manifests itself during a period in which the injured person is in the service of the department or unit.” The bill would apply to injuries occurring on or after Jan. 1, 2020,  and “would prohibit compensation from being paid for a claim of injury unless the member has performed services for the department or unit for at least 6 months, unless the injury is caused by a sudden and extraordinary employment condition,” according to a draft.






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