Scott Thompson Jul 1, 2024 a 7:45 am PDT

Interesting study performed by CWCI, whose primary interests include employers and payers. California’s Med/Legal Fee Schedule was negotiated by employers, payers, physicians, and other stakeholders during the course of several meetings at the DWC headquarters in 2020. The fee schedule is loosely based on Nevada’s fee schedule, which actually pays more even though the cost of living in Las Vegas is 40% lower compared to Los Angeles according to salary.com. It’s also worth noting that there’s no income tax in NV, compared to over 13% for the maximum in CA. Another important detail lost on CWCI is that there’s no built-in cost of living adjustment for CA’s medical legal fee schedule, unlike the other medical-based fee schedules that apply to workers’ compensation reimbursements. In light of the past three years of high inflation, this can be perceived as a 20% discount compared to a fee schedule with a COLA. Finally, it cannot be overstated that the new CA MLFS removed the expensive friction and gamesmanship by both payers and providers by creating a more simple fee schedule that reduced costs to the system associated with lien hearings, and years long payment delays and litigation. It’s no wonder physicians were fleeing the system prior to 2021. Another benefit to the system has been an influx of Qualified Medical Evaluators, which filled a gap in what was a QME shortage before the fee schedule update. Thank you for the research CWCI, but it’s important to tell the whole story.