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Columnist: State's Once-a-Decade Comp Fight Expected to Heat Up

  • State: California
  • Topic: WEST
  • - Popular with: Legal
  • -  4 shares

California’s workers’ comp players are due for their once-a-decade fight to change the system in their respective favor, columnist Dan Walters said in his latest CalMatters column, published Monday.

Dan Walters

Dan Walters

“Over the last half-century, a predictable cycle has emerged,” Walters wrote. “Once a decade — or once a governorship — the five contending factions go to war, three of the five cut a deal to grab bigger slices of the financial pie, and push it through the Legislature. It takes a few years for the changes to impact the system and a few more for a new tripartite alliance to form for another battle.”

Walters said the “war” last happened during Gov. Jerry Brown’s most recent term when labor advocates and employers made a deal “with the implicit blessing of work comp insurers.” 

The deal was to tamp down medical costs in hopes of increasing benefits for injured workers while lowering premiums, Walters wrote.

Two groups — lawyers and medical providers — were left out of the deal, but they may be able to tip the scales this time around thanks to at least two comp bills that have been introduced, Walters wrote.

Assembly Bill 1465, by Assemblywoman Lorena Gonzalez, D-San Diego and Majority Leader Eloise Reyes, D-San Bernardino, would require the Division of Workers’ Compensation’s administrative director to create a statewide organization called the California Medical Provider Network. 

Another bill, Assembly Bill 404, by Assemblymember Rudy Salas, D-Bakersfield, would require the DWC to update the Medical-Legal Fee Schedule at least yearly to increase cost-of-living adjustments in line with changes in the most recent federal Medicare Economic Index. 

“Medical care providers, who were on the short end of the last big work comp deal, want legislation to provide automatic inflation increases in their fees,” he wrote. “Another bill would create a state-operated network of medical care providers for work comp treatment that would bypass employers’ provider networks.”

If labor groups, medical providers and legal reps are able to form an alliance, another major system overhaul is likely, Walters wrote.

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Jacob Rosenberg Apr 6, 2021 a 7:03 am PDT

Ab 404 simply fixes a flaw in the current DWC authority to adjust fee schedules. Director George Parisotto has been clear that he does not have the statutory authority to adjust the medical-legal fee schedule for inflation. The DWC director does have the authority to increase other schedules including fee schedules for treating physicians, surgery centers, hospitals, interpreters, pharmacies, and durable medical goods. AB404 simply corrects a flaw in current statute. Because of this flaw medical-legal fees were the same in 2020 as they were in 2006. Further the state independent auditor recommended such a bill after reviewing DWC policy on medical-legal evaluations. Frankly it shouldn't be controversial in any way
Jacob Rosenberg md, president of CSIMS

Ron Perelman Apr 6, 2021 a 8:00 am PDT

The ML fee schedule has been fixed but a COLA is needed. Treatment needs reimagining but we need to be careful not to bring back the old problems and abuses. This can be tricky. A statewide MPN is good if run by CMA or an equivalent and a chiropractic organization. The fee schedule definitely needs increasing

Ron Perelman Apr 6, 2021 a 8:00 am PDT

The ML fee schedule has been fixed but a COLA is needed. Treatment needs reimagining but we need to be careful not to bring back the old problems and abuses. This can be tricky. A statewide MPN is good if run by CMA or an equivalent and a chiropractic organization. The fee schedule definitely needs increasing

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