BILL NUMBER: SB 896	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator De León

                        FEBRUARY 18, 2011

   An act to amend Section 5318 of the Labor Code, relating to
workers' compensation.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 896, as introduced, De León. Workers' compensation: spine
surgeries.
   Existing law establishes a workers' compensation system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for injuries
sustained in the course of his or her employment. Existing law,
operative only until the administrative director adopts a regulation
specifying separate reimbursement, if any, for implantable medical
hardware or instrumentation for complex spinal surgeries, requires
that implantable medical devices, hardware, and instrumentation for
specified Diagnostic Related Groups (DRGs) be separately reimbursed
in accordance with a prescribed formula.
   This bill would instead require that specified spine surgeries be
reimbursed to the performing hospital at the rate of 1.8 times the
applicable DRG rate, with no separate reimbursement for any
implantable devices, hardware, or instrumentation.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 5318 of the Labor Code is amended to read:
   5318.   (a)    
Implantable   Spine surgeries with implantable 
medical devices, hardware, and instrumentation for Diagnostic Related
Groups (DRGs)  004, 496, 497, 498, 519, and 520 
 030, 453, 454, 455, 457, 459, 460, 471, 473, and 491  shall
be  separately reimbursed at the provider's documented paid
cost, plus an additional 10 percent of the provider's documented paid
cost, not to exceed a maximum of two hundred fifty dollars ($250),
plus any sales tax and shipping and handling charges actually paid
  reimbursed to the performing hospital at the rate of
1.8 times the applicable DRG rate, with no separate reimbursement for
any implantable devices, hardware, or instrumentation  .

   (b) This section shall be operative only until the administrative
director adopts a regulation specifying separate reimbursement, if
any, for implantable medical hardware or instrumentation for complex
spinal surgeries.