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Wednesday, January 12, 2022

Committee Passes MPN Identification Bill

  • State: California
  • Topic: WEST
  • - Popular with: Legal
  • -  0 shares
The California Assembly Insurance Committee on Tuesday passed a bill that would create a requirement…

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Anne Bazel Jan 12, 2022 a 8:38 am PST

Such watered down bill, basically useless. It’s original language had meaningful measures to make sure the carrier doesn’t get two bites at the apple, if fails to follow UR timely, the treatment is presumed authorized. Now, it was removed. Providing MPN details does not help injured worker to get timely treatment, just more MPN control.

Daniel Rosenberg Jan 12, 2022 a 5:23 pm PST

This is a good first step towards fixing the MPN access issue, though more is needed. Designated treaters must be able to request MPN information directly, and there must be a clearly defined step if employers fail to provide MPN information to the requestor timely.
Our practice places thousands of Workers' Compensation patients each month, and determining the MPN for many, if not most, is impossible. Fixing that is in the interest of the injured worker and their employer. I'm hopeful additional legislation will follow that reduces this friction.

Steve Cattolica Jan 12, 2022 a 6:35 pm PST

Steve CattolicaJan 12, 2022 a 10:34 am PST
Daniel Rosenberg is on the right track. However, not only the injured worker, but Providers need a clear indication they are or are not contracted to/with each MPN. Presently, there is virtually no way for a provider to know which MPNs they are contracted to. Contracts have been leased by aggregators without knowledge or approval of the provider and rates stacked by computers in violation of "silent PPO" statutes. The presence or absence of a contract used to be a proper subject for IBR, but the DWC suddenly decided instead to require filing a lien to recoup improperly taken discounts. That makes the WCAB the only venue to settle contract issues which all but buries the possibility of resolution. By all indications, this decision was made in similar fashion to the Division's improper implementation of underground regulations regarding QME renewal eligibility a few years ago.

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