May 2004

California WC reforms concern CCA

California lawmakers have passed legislation that will codify and overhaul the state’s workers’ compensation, but the California Chiropractic Association (CCA) takes issue with the legislation.

“The new reforms dramatically limit an injured worker’s treatment options by making employers and insurers the gatekeepers for care. The new provider networks outlined in the proposal must include access to all qualified providers, including doctors of chiropractic,” said Douglas S. Wilson, DC, president of the CCA.

Specifically, CCA has concerns about:

• Employer control. Under the reforms, an injured worker must see three employer-selected physicians in the network before being allowed to ask for the opportunity to seek treatment from a doctor outside the network. CCA believes people with life-threatening conditions or who are in extreme pain should not be forced to wait what may stretch into several months to receive appropriate care.

• Provider network. Under the new bill, an insurer or employer is allowed to establish medical provider networks for the provision of medical treatment to injured workers. CCA contends that regulations should be promulgated that ensure all qualified providers are allowed to participate in a provider network.

• Independent medical review. The agreement creates an independent medical review system to adjudicate disputed diagnosis or treatment after the third physician has examined the injured worker. The legislation would limit the type of physicians that can perform the IMR to medical doctors. CCA believes this should be amended to allow for like-provider review.

Source: California Chiropractic Association, www.calchiro.org

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