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The Division of Workers’ Compensation (DWC) has issued a notice of public hearing to revise various provisions of the Official Medical Fee Schedule (OMFS). The public hearing has been scheduled for 10 a.m., November 14, 2014, in the Auditorium of the Elihu Harris Building, 1515 Clay Street, Oakland, CA 94612. Members of the public may also submit written comment on the regulations until 5 p.m. that day.

The proposed amendments are as follows:

• Amend the fee schedules provisions in Article 5.3 and section 9790 in Article 5.5, to reiterate the applicable dates of fee schedule provisions. The Division has become aware of the misapplication of the effective dates of various fee schedule provisions.
• Amend the inpatient hospital fee schedule provisions that address the operating disproportionate share hospital (DSH) adjustments. The proposed amendments are necessary as a result of changes made by Medicare to their operating DSH adjustment methodology.
• Amend the inpatient hospital fee schedule provisions that address the outlier payments for eligible transfer cases. The Division has become aware of the need to clarify that hospitals transferring an inpatient to another hospital or post-acute care provider are eligible to receive an outlier payment for qualifying cases. The proposed amendments provide the methodology for determining whether a case is eligible for an outlier payment, and if so, how the payment amount would be calculated. The proposed methodology conforms to Medicare’s payment methodology.
• Minor amendments that are required to conform to the proposed changes, to update, or to clarify various sections of the Official Medical Fee Schedule.

The notice, initial statement of reasons, and text of the regulations can be found on the proposed regulations webpage.

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  California Department of Industrial Relations,  P.O. Box 420603 · San Francisco, CA · 94142-0603 · www.dir.ca.gov