CWCI: IMR Decisions Up 6.3% in 2016

The total number of independent medical review determination letters issued in 2016 increased 6.3% to 176,002 from 165,525 in 2015, and a greater percentage of those decisions upheld the underlying utilization review decision, the California Workers’ Compensation Institute said in a report released Friday. IMR physicians upheld utilization review decisions to modify or deny treatments 91.2% of the time last year, compared to an uphold rate of 88.4% for decisions in 2015. Since 2014, the first full year in which all dates of service were eligible for IMR, the dispute resolution process c...