Regulations
| 9792.10....Utilization Review Standards-Dispute Resolution - For Utilization Review Decisions Communicated Prior to July 1, 2013 for Injuries Occurring Prior to January 1, 2013 | |
| The 20-day time limit may be extended for good cause or by mutual agreement of the parties. Â (2) Medical care provided during a concurrent review shall be medical ...more | |
| 9792.10.1....Utilization Review Standards -Dispute Resolution - On or After January 1, 2013 | |
| Neither the employee nor the claims administrator shall have any liability for medical treatment furnished without the authorization of the claims administrator if the ...more | |
| 9792.6....Utilization Review Standards-Definitions - For Utilization Review Decisions Issued Prior to July 1, 2013 for Injuries Occurring Prior to January 1, 2013 | |
| Â (a) âACOEM Practice Guidelinesâ means the American College of Occupational and Environmental Medicine's Occupational Medicine Practice Guidelines, Second ...more | |
| 9792.6.1....Utilization Review Standards-Definitions - On or After January 1, 2013 | |
| âClaims Administratorâ includes any utilization review organization under contract to provide or conduct the claims administrator's utilization review ...more | |
| 9792.7....Utilization Review Standards - Applicability | |
| The treatment protocols or standards governing the utilization review process shall be consistent with the Medical Treatment Utilization Schedule adopted by the ...more | |
| 9792.8....Utilization Review Standards -Medically-Based Criteria | |
| (a)(1) The criteria shall be consistent with the schedule for medical treatment utilization adopted pursuant to Labor Code section 5307. 27. Prior to adoption of the ...more | |
| 9792.9....Utilization Review Standards-Timeframe, Procedures and Notice Content - For Injuries Occurring Prior to January 1, 2013, Where the Request for Authorization is Received Prior to July 1, 2013 | |
| Â (a) The request for authorization for a course of treatment as defined in section 9792. 6(e) must be in written form. The requesting physician must indicate the need ...more | |
| 9792.9.1....Utilization Review Standards-Timeframe, Procedures and Notice - On or After January 1, 2013 | |
| The requesting physician must indicate if there is the need for an expedited review on the DWC Form RFA. The written decision shall contain the following information ...more | |
| 9828....Use of Terms âMedicalâ, âLegalâ, or Comparable Term | |
| It may also use the term âmedical referralâ if it refers for goods or services by medical providers outside the fields of practice listed in subsection 9820(i), ...more | |
| 9885....U.S. Life Tables [Repealed] | |
| NOTE: Authority cited: Sections 127, 133, 138. 2, 138. 3, 139. 5, 139. 6, 4603. 2, 4603. 5, 5307. 1, 5307. 3, 5450-5455, Labor Code. New section filed 11-9-70; designated ...more | |
