Workers’ Compensation Rules Under Consideration
The Division of Workers' Compensation last week proposed rules that would allow the agency to issue fines of as much as $25,000 if anyone other than a physician hinders medical treatment through the utilization review process, the Silicon Valley/San Jose Business Journal reports. Current laws permit fines of $50 to $100 for minor violations.
Utilization review is intended as a form of cost control to allow workers' compensation insurers and employers to contract with independent physicians to evaluate claimants' treatment plans.
Some state officials said that inappropriate use of the process could result in as many as 30,000 workers' compensation insurance claimants experiencing unfair delays or care denials.
DWC will solicit public comment on the rules. The agency might not release a final version of the rules before February 2007.
The American Insurance Association opposes the rules (Silicon Valley/San Jose Business Journal, 11/24).