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| | California Division of Workers' Compensation Issues Notice of Second 15-Day Public Comment Period for Utilization Review and Related Regulations
By Lonce Lamonte, editor, and the California DWC Newsline - April 17, 2025The Division of Workers’ Compensation (DWC) has issued a second notice of public comment period beginning on April 17, 2025, for modifying the text of proposed amendments to the Utilization Review and Related Regulations. The affected regulations are Title 8, California Code of Regulations, sections 9767.6, 9781, 9785, 9785.6, 9786, 9792.6.1, 9792.7, 9792.9.1, 9792.9.2, 9792.9.3, 9792.9.5, 9792.9.8, 9792.9.10.5, 9792.10.8, and 9792.11.
*Some of the changes proposed in the modified regulations include the following:
*Rescinding the PR-1 for this rulemaking.
*Addition of electronic data interchange (EDI) as an option for providers to submit treatment requests if made available by the claims administrator.
*Amendments to the UR plan application and modification submissions and approval process.
*Deletion of the provision regarding the handling of treatment requests submitted via a non-designated channel.
*Amendment to the prohibition of deferral in response to a treatment request accompanied by a physician’s express and unequivocal statement or opinion that there is a change in material fact pertinent to the resubmission.
*Amendment to the submission of documentation that triggers retrospective UR.
*Amendment to clarify cost of withdrawn independent medical review applications.
*Non-substantive rewording of some regulatory texts for better readability.
*DWC will consider all public comments. The 15-day notice of modification to the text of the proposed regulations, the text of the modified regulations, and the modified forms can be found on DWC’s rulemaking webpage.
Written comments should be addressed to:
Maureen Gray, regulations coordinator
Department of Industrial Relations
Division of Workers' Compensation
1515 Clay Street, 18th floor
Oakland, CA 94612
The Division’s contact person must receive all written comments concerning the proposed modification to the regulations no later than 11:59 p.m. on Friday, May 2, 2025. Written comments addressed to the contract person may be submitted by facsimile transmission (FAX) at (510) 286-0687. Written comments may also be sent electronically (via e-mail), using the following e-mail address: dwcrules@dir.ca.gov.
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The California Department of Industrial Relations, established in 1927, protects and improves the health, safety, and economic well-being of over 18 million wage earners, and helps their employers comply with state labor laws. DIR is housed within the Labor & Workforce Development Agency.
Lonce Lamonte, journalist, editor, adjustercom, lonce@adjustercom.com
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