Young: Rand Posts Med-Legal Study Draft Report

Wednesday, December 12, 2018 | 0

Rand Corp. has posted its draft report on medical-legal reporting in California workers’ compensation.

Julius Young

The report, authored by Rand researcher Barbara Wynn, titled “California Workers’ Compensation Medical-Legal Fee Schedule” notes that:

“The California Department of Industrial Relations (DIR) Division of Workers' Compensation (DWC) requested that Rand review the California workers’ compensation medical-legal (ML) fee schedule, which has not been revised since 2007. Because evaluation and management maximum allowable fees were increased as a result of Resource-Based Relative Value Scale (RBRVS) reforms introduced in Senate Bill (SB) 863, DWC inquired whether comparable ML fee schedule changes might also be appropriate.”

This report has been widely anticipated by many stakeholders. I was one of a number of stakeholders who was interviewed by Rand in its research on this issue.

The issue of payments for medical-legal reports has been a hot one in the system for several years. Quite a few qualified medical evaluators found themselves embroiled in disputes with the DWC Medical Unit over billing issues.

In May 2018, the DWC posted proposed changes to the fee schedule for online comment. A follow-up May 2018 DWC online forum on med-legal billing reform led to widespread commentary by QMEs, with many expressing alarm over possible changes that might cause them to leave a system where the number of QMEs has already been declining.

In October 2018, a public meeting was held by the DWC in Oakland on the issue.

At this point the issue will clearly wind up in the lap of the new Newsom administration.

Stakeholders will want to study the report carefully. I’ll be providing more commentary on this issue in due course.

Julius Young is a claimants' attorney for the Boxer & Gerson law firm in Oakland. This column was reprinted with his permission from his blog, www.workerscompzone.com.