BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 522| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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. SB 522 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 SB 522 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 **** END ****