BILL ANALYSIS Ó AB 2086 Page 1 Date of Hearing: April 20, 2016 ASSEMBLY COMMITTEE ON APPROPRIATIONS Lorena Gonzalez, Chair AB 2086 (Cooley) - As Amended March 30, 2016 ----------------------------------------------------------------- |Policy |Insurance |Vote:|13 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: Yes State Mandated Local Program: NoReimbursable: No SUMMARY: This bill provides a statutory authorization for neuropsychologists to perform the services of a qualified medical examiner (QME) in the workers' compensation system. FISCAL EFFECT: AB 2086 Page 2 Any costs to the Department of Industrial Relations (DIR) are minor and absorbable as part of an ongoing regulatory effort (Workers Compensation Administration Revolving Fund). COMMENTS: 1)Purpose. This bill is intended to supersede regulations in one narrow aspect related to QMEs, by authorizing neuropsychologists who meet certain criteria to be QMEs. 2)QME process. Qualified medical evaluators (QMEs) are qualified physicians who are certified by the Division of Workers' Compensation - Medical Unit to examine injured workers to evaluate disability and write medical-legal reports. The reports are used to determine an injured worker's eligibility for workers' compensation benefits. QMEs include medical doctors, doctors of osteopathy, doctors of chiropractic, dentists, optometrists, podiatrists, psychologists and acupuncturists. The QME process is not related to treatment. Rather, QMEs are appointed to evaluate medical-legal disputes (disputes over the extent to which an injured employee's injuries or conditions are disabling or are work-related), upon request of a party to a workers' compensation claim. The requesting party specifies the type of expertise needed to resolve the dispute, and the Division of Worker's Compensation (DWC) appoints a panel, from which a single QME is selected. A clinical psychologist or physician who is acting as a QME can refer for a consultation with a neuropsychologist if necessary. Proponents suggest if neuropsychology is the required expertise, but only general clinical psychologists are on the QME lists, the system will incur added expense and AB 2086 Page 3 time for consultations. 3)Clinical neuropsychology is a specialty recognized by the American Psychological Association. Neuropsychologists assess, diagnose, and treat neurological disorders or injuries, and have expertise in the applied science of brain and behavior. A neuropsychologist may evaluate a patient or an injured worker who has a known or suspected brain injury or brain disease, and evaluate how their brain function impacts day-to-day behavior and ability. 4)Division of Workers' Compensation (DWC) Regulations. According to DIR, the DWC intends to rely on appropriate professional regulatory boards such as the Medical Board and the Board of Psychology to recognize the types of specialties that are appropriate to be on QME panels. 5)Board of Psychology recognition of specialties. The Board does not currently recognize specialties the way some other healing arts boards do. Instead, the Board enforces competency of practice on a complaint basis using expert review to establish competency. For example, if the complaint is against someone performing neuropsychology then the Board would refer the matter to an expert in neuropsychology to see if the subject deviated from the standard of care or provided care outside of his/her expertise. 6)Urgency. The author explains an urgency clause is necessary because the DWC recently abolished the recognition of neuropsychologists as QMEs in the workers' compensation system. AB 2086 Page 4 7)Prior legislation. Last year, AB 1542 (Mathis and Cooley) was substantially similar to AB 2086, and was vetoed. The Governor's veto message stated: "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." Proponents have committed to working with the Administration to clarify these issues, and find an acceptable methodology for identifying qualified neuropsychologists. Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081 AB 2086 Page 5