BILL ANALYSIS                                                                                                                                                                                                    Ó






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          |SENATE RULES COMMITTEE            |                        SB 522|
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                                   THIRD READING 


          Bill No:  SB 522
          Author:   Mendoza (D)
          Amended:  4/6/15  
          Vote:     21  

           SENATE LABOR & IND. REL. COMMITTEE:  5-0, 4/22/15
           AYES:  Mendoza, Stone, Jackson, Leno, Mitchell

           SUBJECT:   Workers compensation:  advertisements


          SOURCE:    Author


          DIGEST:  This bill differentiates between two processes in  
          California's workers' compensation system that are both known as  
          "Independent Medical Review" (IMR).


          ANALYSIS:   


          Existing law:


          1)Establishes a workers' compensation system that provides  
            benefits to an employee who suffers from an injury or illness  
            that arises out of and in the course of employment,  
            irrespective of fault.  This system requires all employers to  
            secure payment of benefits by either securing the consent of  
            the Department of Industrial Relations to self-insure or by  
            securing insurance against liability from an insurance company  
            duly authorized by the state.








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                                                                    Page  2




          2)Provides that medical, surgical, chiropractic, acupuncture,  
            and hospital treatment, including nursing, medicines, medical  
            and surgical supplies, crutches, and apparatuses, including  
            orthotic and prosthetic devices and services, that is  
            reasonably required to cure or relieve the injured worker from  
            the effects of his or her injury shall be provided by the  
            employer.  (Labor Code § 4600)


          3)Allows an insurer, employer, or entity that provides physician  
            network services to establish a medical provider network (MPN)  
            for the provision of medical treatment to injured employees.  
            MPN shall include physicians primarily engaged in the  
            treatment of occupational injuries to treat common injuries  
            experienced by injured employees based on the type of  
            occupation or industry in which the employee is engaged, and  
            the geographic area where the employees are employed.  (Labor  
            Code § 4616)


          4)Provides that, in the event over a dispute over a utilization  
            review decision, all disputes must be submitted for IMR.  The  
            independent reviewer's information must be kept confidential.   
            (Labor Code §§ 4610.5 and 4610.6)


          5)Creates a process through which an injured worker in a MPN may  
            seek an independent medical opinion if the injured worker does  
            not agree with the MPN physician's diagnosis or recommended  
            medical treatment.  This process is also known as IMR.  (Labor  
            Code § 4616.4)


          This bill renames the process through which an injured worker in  
          a MPN may seek an independent medical opinion as "MPN  
          independent medical review."


          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:NoLocal:    No









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                                                                    Page  3


          SUPPORT:   (Verified4/24/15)


          None received


          OPPOSITION:   (Verified4/24/15)


          None received


          ARGUMENTS IN SUPPORT:     The author notes that, under existing  
          law, the workers' compensation system has two processes that are  
          known as IMR. The author believes that this could create  
          confusion and create barriers for injured workers to access  
          their rights.  The author argues that this bill resolves this  
          issue by retitling the independent opinion process within a MPN  
          as "MPN independent medical review," thereby clarifying the  
          different processes and helping to ensure injured workers better  
          understand the rights that are available to them. 




           
          Prepared by:Gideon Baum / L. & I.R. / (916) 651-1556
          4/24/15 15:45:09


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