BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1542


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          Date of Hearing:  June 8, 2015


                           ASSEMBLY COMMITTEE ON INSURANCE


                                   Tom Daly, Chair


          AB 1542  
          (Mathis) - As Introduced April 23, 2015


          SUBJECT:  Workers'compensation: neuropsychologists.


          SUMMARY:  Provides a statutory authorization for  
          neuropsychologists to continue to perform the services of a  
          qualified medical examiner (QME) in the workers' compensation  
          system.  Specifically, this bill:  


          1)Provides that neuropsychologists are among the specialty  
            workers' compensation physicians, as defined in the Labor  
            Code, who may be appointed as QMEs for purposes of evaluating  
            medical-legal issues in the workers compensation system.



          2)Specifies that, in order to qualify, the neuropsychologist  
            must be board certified by the American Board of Clinical  
            Neuropsychology, the American Board of Professional  
            Neuropsychology, or another certifying board recognized by the  
            Administrative Director (AD) of the Division of Workers'  
            Compensation (DWC), or who was appointed as a QME prior to  
            January 1, 2015.











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          3)Provides, in addition to the qualifications listed above, that  
            a neuropsychologist who meets specified training and practice  
            experience requirements may also be appointed as a QME.

          4)Provides that a physician and surgeon who completed a  
            residency training program accredited by a predecessor  
            certifying organization to the Accreditation Council for  
            Graduate Medical Education (ACGME) is also eligible to be  
            appointed as a QME.



          5)Provides that the bill is an urgency measure, to take effect  
            immediately.



          EXISTING LAW:  


          1)Establishes a comprehensive system to provide workers'  
            compensation benefits to employees who suffer injuries or  
            conditions that arise out of or in the course of employment.   
            Benefits include medical care to cure and relieve the effects  
            of the injury or condition, temporary disability benefits for  
            injured employees who are unable to work during the period of  
            recovery, permanent disability benefits for injured employees  
            who suffer permanent disabilities as a consequence of the  
            injury or condition, among other benefits.

          2)Provides for a formal system of administrative dispute  
            resolution for cases where the employer and employee are not  
            in agreement over any issue associated with the delivery of  
            workers' compensation benefits.



          3)Provides for the appointment of a QME to evaluate the injured  
            employee whenever disputed medical-legal issues arise.








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          4)Specifies the qualifications necessary for workers'  
            compensation physicians to be appointed as QMEs, including  
            with respect to physicians and surgeons, that they  
            successfully completed a residency program accredited by ACGME  
            - the body recognized as the accrediting organization for  
            medical specialty training programs.    



          FISCAL EFFECT:  Undetermined.


          COMMENTS:  


          1)Purpose.  According to the author, AB 1542 is necessary  
            because neuropsychologists provide valuable input in serious  
            brain injury cases in the workers' compensation system.  
            Neuropsychologists appointed as QMEs have been providing this  
            input in workers' compensation cases for the last 22 years.   
            However, the DWC has recently proposed regulations that would  
            repeal the authorization for neuropsychologists to perform QME  
            functions, apparently on the belief that this authorization  
            (currently established by regulation) is not authorized by  
            statute.  The bill is intended provide a clear statutory  
            authorization for neuropsychologists to perform QME functions.

          2)QME process.  When a medical-legal dispute arises, a QME is  
            appointed to evaluate the injured employee.  "Medical-legal"  
            does not refer to whether or not a treatment at issue is  
            legally required.  There is a separate medical treatment  
            dispute resolution process.  "Medical- legal" relates to the  
            legal consequences of medical conditions, frequently the  
            extent to which an injured employee's injuries or conditions  
            are disabling, or whether the injuries or conditions have  
            become permanent and stationary.  When there is a dispute on  








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            an issue of this nature, a party can request appointment of a  
            QME.  The requesting party specifies what sort of expertise is  
            needed to resolve the dispute, and the DWC appoints a panel,  
            from which a single QME is selected.  If a neuropsychologist  
            is the expertise required, but only general psychologists are  
            on the QME lists, there is no guarantee that a person with the  
            proper expertise will be the QME.  In that case, the  
            under-qualified QME will be forced, with additional expense  
            and delay, to "consult" with a neuropsychologist.  No  
            stakeholder group involved in the workers' compensation system  
            has suggested that this would be a desirable result.



          3)ACGME.  Currently, ACGME is the accepted entity that accredits  
            medical specialty training programs, and as a consequence the  
            Labor Code refers to completion of ACGME-accredited programs  
            as a basis to qualify to perform QME functions. However, there  
            are practicing physicians and surgeons who completed their  
            residency prior to the establishment of ACGME in the early  
            1980's, and who could otherwise qualify as QMEs.  The bill  
            also seeks to authorize the AD to accept as QMEs those  
            physicians who obtained their specialty training from a  
            predecessor accrediting organization.



          REGISTERED SUPPORT / OPPOSITION:




          Support


          California Society of Industrial Medicine and Surgery  
          (co-sponsor)










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          California Psychological Association (co-sponsor)


          California Applicants' Attorneys Association


          California Neurological Society


          California Society of Physical Medicine and Rehabilitation


          California Psychiatric Association




          Opposition


          None received




          Analysis Prepared by:Mark Rakich / INS. / (916) 319-2086





















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