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California Department of Industrial Relations Director Christine Baker yesterday, August 22nd, released the following statement on SB 1160 (Mendoza), legislation which makes substantial reforms to the utilization review process used to contest care to injured workers.

“The 2012 workers’ compensation reforms were designed to increase benefits and improve medical care for injured workers, and to control costs for employers. We have been closely monitoring treatment issues, and under the leadership of the administration and the department, we have been meeting with stakeholders on options to improve the utilization review process used by claims administrators and employers to challenge the medical treatment of injured workers.

“We all agree that the sooner an injured worker is treated in the critical first month of injury and the sooner the worker returns to work is the best outcome for the worker and the employer. In reducing and eliminating most utilization review in the first 30 days following an injury, medical care consistent with medical treatment guidelines can be delivered to an injured worker without delay. This legislation clears the way for workers to receive the expedited and appropriate treatment they need so that they can recover from injury and return to work more quickly.

“This bill also improves anti-fraud efforts. Knowing that $600 million in liens have been filed by indicted or convicted providers, SB 1160 will stay liens filed by physicians or providers who are criminally charged with workers’ compensation, insurance or medical fraud, and clarify the prohibition on the assignment of liens as accounts receivables.

“These changes can achieve an estimated overall savings of up to $818 million in the workers’ compensation system, furthering the goals sought by the Governor and the Legislature with the 2012 workers’ compensation reforms.”

journalist Lonce LaMon, lonce@adjustercom.com; with the Department of Industrial Relations News Release dated August 22nd 2016