Workers Comp Zone


RAND has posted its draft report on Medical -Legal reporting in California workers’ compensation.

The report, authored by RAND researcher Barbara Wynn, titled “California Workers’ Compensation Medical-Legal Fee Schedule” notes that:

“The California Department of Industrial Relations (DIR) Division of Workers Compensation (DWC) requested that RAND review the California workers’ compensation Medical-Legal (ML) fee schedule, which has not been revised since 2007. Because evaluation and management maximum allowable fees were increased as a result of Resource-based Relative Value Scale (RBRVS) reforms introduced in Senate Bill (SB) 863, DWC inquired whether comparable ML fee schedule changes might also be appropriate.”

This report (see link below) has been widely anticipated by many stakeholders.

Your trusty blogger was one of a number of stakeholders who was interviewed by RAND in their research on this issue.

The issue of payments for Medical-Legal reports has been a hot one in the system for several years. Quite a few QMEs found themselves embroiled in disputes with the DWC Medical Unit over billing issues.

In May 2018 the DWC posted proposed changes to the fee schedule for online comment. A  followup May 2018 DWC online forum on Med-Legal billing reform led to widespread commentary by  QMEs, with  many expressing alarm over possible changes that might cause them to leave a system where the number of QMEs has already been declining:

In October 2018 a public meeting was held  by the DWC in Oakland on the issue.

At this point the issue will clearly wind up in the lap of the new Newsom administration.

Stakeholders will want to study the report carefully. I’ll be providing more commentary on this issue in due course.

Here is the link to the RAND study:

Julius Young