BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
933 (Fong)
Hearing Date: 8/2/2010 Amended: 8/2/2010
As
proposed to be amended
Consultant: Bob Franzoia Policy Vote: L&IR 4-1
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BILL SUMMARY: AB 933 would do the following:
- Require psychologists, for purposes of workers' compensation,
to be licensed by California law.
- Require physicians who authorize medical treatment, for
purposes of workers' compensation, to be licensed by California
law.
- Require reapproval of a medical provider network plan every
three years and specify procedures for submittal of the plan.
- Permit an employer or insurer to submit a written statement to
the effect that there have been no changes to a plan since it
was last approved by the administrative director of the Division
of Workers' Compensation.
- Require, by April 1, 2011, the administrative director require
that procedures be established to ensure that a list of the
medical providers made available for selection to provide
treatment to an injured employee is accurate and updated
semiannually.
- Expressly provide that specified items (see below) are
elements of a workers' compensation claim file that affect the
employer's premium.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Requirement for reapproval $162
to $324 annually Special*
of medical provider network
plans
Establish procedures to Likely minor costs initially
to establish Special*
ensure accuracy of medical procedures; unknown, probably
minor,
provider network plan costs for enforcement
ongoing
information
* Workers' Compensation Administration Revolving Fund
(7350-0223)
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
The Workers' Compensation Administration Revolving Fund is
projected to have a 2010-11 adjusted beginning balance of
approximately $84 million. The mid salary range of a workers'
compensation consultant is $5,118, plus 32 percent for benefits,
results in a cost of $81,061 per consultant.
Based on estimated workload of the bill, as proposed to be
amended, of approximately 650 plans, growing to 800 plans
beginning 2014, and a 20 percent discrepancy rate, which
requires additional review, the division would need two to four
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AB 933 (Fong)
consultants for an annual total of $162,122 to $324,244. At
this time, the division has 2.5 staff and one vacancy providing
plan oversight.
This bill would require by April 1, 2011, the administrative
director to require that procedures be established to ensure
that a list of the medical providers made available for
selection to provide treatment to an injured employee is
accurate and undated semiannually. The lists would be made
available by the medical provider network plans in a manner set
forth by the administrative director.
This analysis estimates there are 1,400 to 1,600 medical
provider network plans, and increasing annually. To provide for
a more even workload and to reduce staffing fluctuations or
contract costs, the author is proposing that the plans be
submitted by initial approval date over three years. The
proposed amendment is as follows:
4616.
(b) (1) The employer or insurer shall submit a plan for the
medical provider network to the administrative director for
approval.
(2) The term of approval for a medical provider network
plan submitted under this subdivision shall be three years.
(3) At least 60 days prior to the anniversary of the three
year approval term, an employer or insurer seeking renewal of
its plan shall resubmit the plan for its medical provider
network. The employer or insurer may verify submit a statement,
signed under penalty of perjury, that there have been no changes
to the plan since it was last approved, and the administrative
director shall approve the resubmitted plan for a new three year
term. The verification shall state: AI, the undersigned officer
or employee of the MPN applicant, have read and know the
contents of the most recent, successfully certified MPN
application, and verify that, to the best of my knowledge and
belief, the information within that application remains true and
correct as when originally submitted.@ In all other cases, the
employer or insurer shall include all the information required
by the administrative director at the time of resubmission, to
determine that the plan meets the requirements of this section.
(4) All plans approved before the effective date of the
amendments to this section that adopted this paragraph shall
submit a plan to the administrative director for re-approval as
follows:
(A) Plans with initial approval dates prior to
4/1/2005 shall be submitted no later than September 30, 2011 and
shall thereafter submit a plan to the administrative director
for re-approval at least sixty days prior to the third
anniversary of the approval and each subsequent re-approval of
the plan.
(B) Plans with initial approval dates of 4/1/2005
through 5/31/2006 shall be submitted during 2012, at least 60
days prior to the anniversary date of their initial approval and
shall thereafter submit a plan to the administrative director
for re-approval at least sixty days prior to the third
anniversary of the approval and each subsequent re-approval of
the plan
(C) Plans with initial approval dates of 6/1/2006
though 12/31/2010 shall be submitted during 2013, at least 60
days prior to the anniversary date of their initial approval and
shall thereafter submit a plan to the
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AB 933 (Fong)
administrative director for re-approval at least sixty days
prior to the third anniversary of the approval and each
subsequent re-approval of the plan
(4) All plans approved before the effective date of the
amendments to this section that adopted this paragraph shall be
resubmitted to the administrative director for approval. Plans
that have been approved for more than two years shall be
resubmitted within 15 months of the effective date. Plans that
have been approved for less than two years shall be resubmitted
pursuant to this section.
(5) The administrative director shall approve the plan
submitted by an employer or insurer if he or she determines that
the plan meets the requirements of this section. If the
administrative director does not act on the plan within 60 days
of submitting the plan, it shall be deemed approved.
(6) The administrative director shall promulgate
regulations consistent with sub-division (g) of Labor Code
Section 4616, for termination of plans not approved or
re-approved according to this section.
Staff notes this is a general form of the amendment and was not
drafted to the August 2, 2010 version of the bill. This
amendment would not result in costs above the language in the
August 2, 2010 version and should result in some administrative
efficiencies and potentially cost savings.