Workers’ compensation: medical-legal expenses: fee schedule.
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Majority
Fiscal committee
No
Appropriation
No
Current location
Appropriations
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed Assembly
- To Governor
- Became Law
Overview
This bill changes the way fees are set for medical-legal evaluations in California’s workers’ compensation system. It allows the medical administrative director to adjust the fee schedule every two years, considering factors like increases in the conversion factor and record review costs. The adjustments will be made alongside revisions to the medical treatment fee schedule, ensuring that evaluations are compensated fairly based on the complexity and time involved.
Key provisions
- The medical administrative director can adjust the medical-legal fee schedule every two years.
- Adjustments will consider increases in the conversion factor and record review costs.
- The fee schedule will be updated concurrently with revisions to the medical treatment fee schedule.
- The fee schedule uses procedure codes, relative values, and a conversion factor to determine fees.
- Providers can only charge fees within the established schedule unless extraordinary circumstances justify a higher fee.
- Employers and employees can contest fees exceeding the schedule.
- Providers cannot receive additional compensation beyond the authorized fee schedule.
- Violations of the compensation restrictions can result in disciplinary action.
Who is affected
- Injured workers
- Employers
- Insurance carriers
- Medical-legal evaluators
- The Division of Workers’ Compensation
Bill text
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Sponsors
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1 on record
Primary sponsor
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