Two freshly minted laws aim to build on California workers’ compensation reforms by improving service to injured workers and weeding out fraudulent claims from the system.
California governor Jerry Brown Jr. recently signed SB 1160 (Mendoza) and AB 1244 (Gray and Daly) into law. The two laws build on the 2012 workers’ compensation reforms aimed at increasing benefits and improving medical care for injured workers, while at the same time managing costs for employers.
“Expedited and appropriate treatment in the critical first month of injury encourages the best outcome for injured workers and employers,” Christine Baker, director of the Department of Industrial Relations (DIR), explained. “In reforming the utilization review process used to contest care to injured workers and tightening controls on fraud, these new laws further the treatment and savings goals initiated by the Governor and the Legislature in 2012.”
SB 1160 reduces utilization review in the first 30 days following a work-related injury and requires electronic reporting of the review data by claims administrators. The new process is expected to expedite the monitoring of the claim process and allow regulators to address problems that may arise.
Meanwhile, AB 1244 mandates the Division of Workers’ Compensation Administrative Director to suspend medical providers and practitioners from participating in the workers’ compensation system upon conviction of fraud.
“These new laws will protect injured workers and employers from continued abuse by suspending providers convicted of fraud from participating in the workers’ compensation system and by staying liens filed by indicted parties,” the division’s acting administrative director George Parisotto noted.
