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Despite Some Gains, Comments Show QME Community Not Satisfied With Latest MLFS Proposal

  • State: California
  • Topic: Top
  • - Average time spent on item: 179 minutes
  • - Popular with: Legal
In its latest Medical-Legal Fee Schedule offering, the Division of Workers’ Compensation has u…

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Dr Jul 2, 2020 a 12:07 pm PDT

My comments on page-rate reimbursement are published in
The Weinmann Report, www.politicsofhealthcare.com -- reporters and others are free to use same and also my e-mail comments re pain mgt sent to Mark Powell -- robert L. Weinmann, MD, QME, San Jose

James Witkop Jul 3, 2020 a 7:32 am PDT

There is a reason every regional panel has the same 6-8 names every time, and some disciplines don't even have three names statewide. If we are going to stay with the one panel system, and it appears that we are, then med-legal providers need to be reasonably compensated, end of discussion. If well-reasoned reports are the goal, the system must be willing to pay for them.

Robert McLaughlin Jul 4, 2020 a 9:47 am PDT

From my perspective representing injured workers the fee schedule should strive to do 2 things:
1) Encourage the production of reports which are substantial medical evidence so benefits to injured workers can be quickly and efficiently determined.
2) Encourage other physicians, especially in the medical specialities which have a notoriously low number of QMEs, to become QMEs and enter into the system.
The best way to do both in our capitalistic system is to pay sufficient money to attract good physicians.
As for the comment the DWC is looking out for the payors, this is not a surprise. Look at how many top ranked medical and non-medical individuals in the DWC left or retired and went on to work for the very industry they were to help regulate when working at the DWC. I can think of 3 just off the top of my head. This is a sure sign as well as certain actions by the DWC including several past regulations that the DWC has been captured by the very industry it was to regulate, and now the DWC does the industrys bidding. (Economists have called this Regulatory Capture. Look up Regulator Capture on the internet or look up Nobel prize winning economist George Stigler who discusses this theory in detail.) The only way to fix this now systemic problem in the DWC is to do a major overhaul of the DWC from the top down starting with AD. I hope the CA Secretary of Labor and the Governor will take notice and take appropriate action.

Ron Perelman Jul 2, 2020 a 5:07 pm PDT

The DWC needs to be neutral, not partisan. The parties worked out a plan and suddenly there were changes, not beneficial to the providers. Perhaps the nstakeholders can hire a neutral " mediator" and then give the final draft to the DWC to put into the regs. We have been at this for 2 years

Dr Jul 3, 2020 a 12:07 pm PDT

The Weinmannv Report (www.politicsofhealthcare.com) has today, 3 July 2020, published commentary on the inequity of the DWC approach to the QME Stakeholder Process which we'd thought had actually already been accepted -- guess we were wrong!
-- Robert L. Weinmann, MD, QME, Edtor, Weinmann Report (www,politicsofhealthcare.com)

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