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Walters Starts Reform Talk

  • State: California
  • Topic: WEST
  • - Popular with: Legal
  • -  4 shares

Veteran Sacramento reporter Dan Walters suggested unions will be partnering with providers and possibly attorneys to draft California’s next workers’ compensation reform.

Senate Bill 863 was so successful in controlling system costs that organized labor is reportedly complaining that employers fared much better under the 2012 bill, Walters wrote in a column published Monday.

Walters said California’s comp system is reformed every 10 or so years, so the clock is running down before the next round of major system changes.

“With the passage of time and a new governor in office, the next decennial battle may be on the horizon,” Walters wrote. “It won’t happen this year, but with 2020 an election year, that could be the moment. Several bills kicking around the Capitol this year are viewed in the insular community of workers’ compensation lobbyists as stalking horses for the larger conflict and hints to a potential new alliance.”

Medical providers and unions have joined in support of SB 537, Walters writes. The bill, by Sen. Gerald Hill, D-San Mateo, would prohibit networks from contracting with medical providers at rates lower than what Medicare pays.

Meanwhile, organized labor and attorneys are supporting AB 1107, by Assemblyman Kansen Chu, D- Milpitas. It would repeal a law saying an independent medical review determination overturning a utilization review decision is not conclusive evidence that treatment was unreasonably delayed or denied.

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James Witkop Jun 18, 2019 a 1:25 pm PDT

Two really easy ways to "fix" the system. First, do away with a competitive med-legal process which solely depends on who hits "submit" after 5 p.m. Second, let WCJs determine medical treatment disputes again. The idea of some unknown stranger (UR/IMR reviewer) determining someone's medical fate makes the process mechanical, sterile and unfair. I think it is somewhat of a slap in the face to the WCAB to suggest that its judges cannot be trusted to resolve medical disputes.

Steven Chandler Jun 18, 2019 a 4:06 pm PDT

So wait, you are in favor of a judge making a potentially dangerous medical decision as opposed to a trained medical professional? That sounds absurd - and it was, when it was in practice. Judges decide the legality of matters, not the appropriateness of treatment! I agree with your position on the competitive med-legal process as I see staffers waiting for that opportunity to click at 5pm. It's also a game regarding the specialty too. Those are the slaps in the face that I see.

Anne Bazel Jun 18, 2019 a 4:06 pm PDT

Medical treatment control must go back to providers. Workcompcentral posted an article few days ago about the study which showed that there was a much better outcome for patients who had medical coverage outside of work comp. Basically, it demonstrated, when a patient has ability to get care denied by UR, there’s a better outcome...big surprise.

MPNs and faceless UR/IMR should be gone. The doctor performing UR should have as much liability risk as treating physician.

Dr Jun 19, 2019 a 3:06 am PDT

It turns out that AB 1107 has been watered down. See "Reneging on AB 1107," workcompcentral column;

As for SB 863, it has long been known to benefit employers more than injured workers, see "SB 863 Benefits Employers, Harms Injured Workers," column on workcompcentral, 7/26/2916, and

"Utilization Review hypocrisy in velvet gloves" also workcompcentral column, 3/26/14, where it is stated that "the underlying fault is inherent in SB 863 which provides the legal basis that allowed for the wrongful termination of lyrica in the case of the patient with the three-level fusion and klonopin in the case of Kirk King."

-- robert L. weinmann, MD, San Jose

Dr. Robert Weinmann Jun 19, 2019 a 3:06 am PDT

OOOPS! The correct date for the last reference is 2019 -- maybe by 2916 we can get the policy and the law repaired! -- robert weinmann, MD

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