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Thursday, November 21, 2019

Auditor's Proposed QME Fixes Might Not Be Enough, Observers Say

  • By Greg Jones
  • State: California
  • Topic: Top
  • - Popular with: Legal
  • -  3 shares
The California auditor’s recommendations for addressing the problems caused by a shortage of q…

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Anne Bazel Nov 21, 2019 a 1:11 am PST

QME isn’t the end of the story. SB863 pushed many good physicians out of the system. It’s impossible to get many specialists to see patients. No one wants to deal with red tape complexity going through UR/IMR and getting paid for such basic codes as simple follow up.

Steven Dewberry Nov 21, 2019 a 8:11 am PST

I agree. Dueling QME's were fast,cheaper, allowed the parties to strategize as they chose.We spend 50% of our time now litigating the PQME process. Employers are paying tens of thousands of dollars per claim over what should be non-issues.

James Witkop Nov 21, 2019 a 7:16 am PST

Increase the rate from $250/hour and go back to dueling QMEs....there, problem solved.

Steven Dewberry Nov 21, 2019 a 8:11 am PST

I agree. Dueling QME's were fast,cheaper, allowed the parties to strategize as they chose.We spend 50% of our time now litigating the PQME process. Employers are paying tens of thousands of dollars per claim over what should be non-issues.

Gary Martinovsky Nov 21, 2019 a 9:36 am PST

Doctors will not return to the system unless there is a total overhaul of the system, starting with elimination of MPNs, UR and increased oversight and accountability of the insurance industry, as well as increases in payments for medical services commensurate with not just inflation but cost of living in California.

Steven Dewberry Nov 21, 2019 a 8:11 am PST

I agree. Dueling QME's were fast,cheaper, allowed the parties to strategize as they chose.We spend 50% of our time now litigating the PQME process. Employers are paying tens of thousands of dollars per claim over what should be non-issues.

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