BILL ANALYSIS Ó
AB 1542
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GOVERNOR'S VETO
AB
1542 (Mathis and Cooley)
As Enrolled September 3, 2015
2/3 vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+--------------------+--------------------|
|Insurance |12-0 |Daly, Beth Gaines, | |
| | |Calderon, Cooley, | |
| | |Cooper, Dababneh, | |
| | |Frazier, Gatto, | |
| | |Gonzalez, Grove, | |
| | |Mayes, Rodriguez | |
| | | | |
|----------------+------+--------------------+--------------------|
| Appropriations |14-0 |Gomez, Bigelow, | |
| | |Bloom, Bonta, | |
| | |Calderon, Chang, | |
| | |Eggman, Gallagher, | |
| | | | |
| | | | |
| | |Eduardo Garcia, | |
| | |Jones, Quirk, | |
| | |Rendon, Weber, Wood | |
| | | | |
| | | | |
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AB 1542
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|ASSEMBLY: |79-0 |(July 16, 2015) |SENATE: |40-0 |(September 1, |
| | | | | |2015) |
| | | | | | |
| | | | | | |
| | | | | | |
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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.
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
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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.
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.
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FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS:
1)Purpose. According to the author, this bill 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
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
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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. This bill
also seeks to authorize the AD to accept as QMEs those
physicians who obtained their specialty training from a
predecessor accrediting organization.
GOVERNOR'S VETO MESSAGE:
This bill requires the Division of Worker's Compensation to
appoint qualified clinical neuropsychologists as Qualified
Medical Examiners.
This bill undermines the Division of Workers' Compensation's
authority to apply consistent standards when it determines
eligible medical specialties for the Qualified Medical Evaluator
panel. The Division is not in the position to determine the
validity of a physician's qualifications. That power resides
with the physician's licensing board. If the Board of
Psychology believes there is value in recognizing
neuropsychology as a subspecialty, it should do so.
Analysis Prepared by:
Tracy Elwell / INS. / (916) 319-2086 FN:
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