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Medical Payments Climb 5.5% to $1.9B for 2021

  • State: California
  • Topic: Top
  • - Popular with: Legal
After falling to $1.8 billion in calendar year 2020, aggregate medical payments rebounded in 2021 an…

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Jacob Rosenberg Sep 26, 2022 a 8:51 am PDT

The DWC audit in 2019 stated that the med legal fee schedule needed to be revised both to reduce friction and to increase reimbursement by 33%. The 2021 schedule simplified billing essenrially eliminating billing disputes. Since the cost for all med legal services rose only 21% per service it appears the new schedule is still not in line with the auditor's recommendation. The fact that comprehensive evaluation costs are up 39% suggests that supplemental reports and re-evaluations are substantially underpaid. The target was to increase med legal payments by 33% not 21%.
Further this increase was long overdue
The med legal fee schedule was unchanged from 2006 to 2020 without a single COLA (as opposed to every other fee schedule)
AB404 would've addressed the DWC's inability to revise the MLFS.

Ron Perelman Sep 26, 2022 a 9:19 am PDT

Jacob is correct. No increases since 2006 in ML charges
The WCIRB report implies we are overcharging. COLAs slone if given every year or two might have done the same .Treatment payments based on Medicare in this inflation are almost not worth it .


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