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Calif. comp independent medical reviews up in 2023: Report

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medical reviews

The California workers compensation system saw a 2.45% increase in independent medical reviews in 2023 from the prior year, and regulators overturned 8.2% more utilization review decisions last year than in 2022, the California Department of Industrial Relations said in a Thursday report.

The independent medical review program is the state’s process for resolving disputes over injured worker medical treatment. 

The report shows that pharmaceutical requests made up 31% of all treatment requests, which constitutes a higher proportion of total service requests than in previous years. Opioid prescriptions comprised a majority of those requests, at 26%, according to the report.

The slight increase in drug requests contrasts with prior years, which had seen a decreasing pharmaceutical trend.

Treatment request denials most often overturned related to services for mental and behavioral health, evaluation and management, the report states.