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40% of IMR Docs Licensed in Golden State
06/11/2014
medical review.
The fact that only 40 of doctors performing IMR for the workers compensation system are licensed in California is not sitting well with some doctors and applicants attorneys who in the past have unsuccessfully pursued legislation that would require any provider making a determination
Category: News
Two File Protest of DIR Intent to Award IMR Contract to Maximus
06/05/2014
By Greg Jones
Western Bureau Chief
Two companies that submitted proposals to provide independent medical review services including one that offered the lowest fees are protesting the California Department of Industrial Relations' notice of intent to award the contract to Maximus Federal
Category: News
WCAB Grants Reconsideration of Dubon Decision on Defective UR
05/23/2014
invalid because Dr. deGrange did not receive or did not review all of the relevant medical records related to his condition. A workers' compensation judge ruled that such procedural defects had to be resolved through IMR.
The WCAB however reversed the decision finding that IMR physicians are not
Category: News
Bill Review Fee Dropped to $250
05/16/2014
By Greg Jones
Western Bureau Chief
Medical providers on Thursday applauded a decision by Maximus Federal Services Inc. to reduce its charge for performing independent bill review to 250 from 335 effective April 1.
Lou Shields project director of IBR and independent medical review for Maximus
Category: News
Med-Legal Costs Highest of 16 States, Reform Savings Uncertain
05/13/2014
modify a treatment or procedure requested by his treating physician an independent physician will compare relevant medical records with evidence-based treatment guidelines and issue a determination either affirming the UR decision or overturning it.
IMR decisions remain in force for 12 months unless
Category: News
Attorneys in North Say QME Disputes Dominate Board Dockets
05/06/2014
piece of crap."
"You can't depose an IMR doctor and you don't even know the name of the IMR doctor" he complained. Plus with the low rate of pay that IMR reviewers get Dittrich said he doubted the doctors are spending the time necessary to go through all the medical reports and records that
Category: News
Attorneys Say SB 863's Changes Are Causing Clogged Dockets
05/05/2014
.
Pursuant to the Labor Code the IMR reviewer must "promptly review all pertinent medical records of the employee provider reports and any other information submitted to the organization or requested from any of the parties to the dispute." The reviewer then has 30 days to render a decision on whether the
Category: News
WCAB Panel Says Unsigned UR Decisions Are Invalid
04/18/2014
UR decisions issued by doctors who had not signed their decisions and who had not seen the reports of the agreed medical evaluator were invalid.
Based on the WCAB's en banc decision last month in Dubon v. World Restoration this means that the board will decide the medical necessity of the
Category: News
System Users Hope Competitive Bidding Improves IMR
04/07/2014
to data provided on April 1. Decisions are pending in 31560 cases or 34 of the cases that are eligible for review and for which Maximus has the medical records and other documents it needs to make a decision.
Maximus needs additional information in almost 40 of disputes eligible for IMR or
Category: News
State Fund Seeks Reconsideration of WCAB's Dubon Decision
03/26/2014
from "material procedural defects" that undermine the integrity of the decision Wong insists this shouldn't keep the dispute from IMR. The IMR doctor just can't consider the UR decision he says.
Wong goes on to argue that the responsibility for providing adequate medical records to the UR
Category: News
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