BILL ANALYSIS Ó
AB 2086
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Date of Hearing: April 20, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2086 (Cooley) - As Amended March 30, 2016
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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:
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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
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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.
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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
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