SB 542, as amended, Mendoza. Workers’ compensationbegin insert: home health care services: fee schedulesend insert.
begin insertExisting law establishes a workers’ compensation system, administered by the Administrative Director of the Division of Workers’ Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Existing law requires the administrative director to adopt an official medical fee schedule that establishes reasonable maximum fees paid for specified medical services related to workers’ compensation. Existing law also requires the administrative director to adopt a schedule for payment of home health care services that are not covered by a Medicare fee schedule and are not otherwise covered by the official medical fee schedule. Existing law requires this fee schedule to be based on the maximum service hours and fees set forth in provisions of law governing in-home supportive services.
end insertbegin insertThis bill would authorize, rather than require, the fee schedule to be based on either the maximum service hours and fees set forth in provisions of state law governing in-home supportive services or other state or federal home health care services fee schedules, as specified.
end insertExisting law prohibits a person or entity, other than physicians or attorneys, from advertising, printing, displaying, publishing, distributing, or broadcasting in any manner a statement concerning services or benefits to be provided to an injured worker, which is paid for by that person or entity that is false, misleading, or deceptive. Violation of these provisions is a misdemeanor punishable by incarceration in the county jail for not more than one year, or by a fine not exceeding $10,000, or by both that imprisonment and fine.
end deleteThis bill would make technical, nonsubstantive changes to these provisions.
end deleteVote: majority.
Appropriation: no.
Fiscal committee: begin deleteno end deletebegin insertyesend insert.
State-mandated local program: no.
The people of the State of California do enact as follows:
begin insertSection 5307.8 of the end insertbegin insertLabor Codeend insertbegin insert is amended to
2read:end insert
begin insert(a)end insertbegin insert end insertNotwithstanding Section 5307.1,begin delete on or before July the administrative director shall adopt, after public
41, 2013,end delete
5hearings, a schedule for payment of home health care services
6provided in accordance with Section 4600 that are not covered by
7a Medicare fee schedule and are not otherwise covered by the
8official medical fee schedule adopted pursuant to Section 5307.1.
9The schedule shall set forth fees and requirements for service
10providers, andbegin delete shallend deletebegin insert
mayend insert be basedbegin delete on theend deletebegin insert upon, but is not limited
11to, being based upon, either of the following:end insert
12begin insert(1)end insertbegin insert end insertbegin insert Theend insert maximum service hours and fees as set forth in
13regulations adopted pursuant to Article 7 (commencing with
14Section 12300) of Chapter 3 of Part 3 of Division 9 of the Welfare
15and Institutions Code.begin delete No fees shallend delete
16(2) A state or federal home health care services fee schedule
17other than the schedule described in paragraph (1), including a
18fee schedule authorized for purposes of the Medi-Cal program or
19a fee schedule administered by the federal Director of the Office
20of Workers’ Compensation Programs.
21begin insert(b)end insertbegin insert end insertbegin insertFees shall notend insert be provided for any services, including any
22services provided by a member of the employee’s household, to
23the extent the services had been regularly performed in the same
24manner and to the same degree prior to the date of injury. If
25appropriate,begin delete anend delete attorney’sbegin delete feeend deletebegin insert
feesend insert for recovery of home health
26carebegin insert servicesend insert fees under this section may be awarded in accordance
27with Section 4906 and any applicable rules or regulations.
Section 139.43 of the Labor Code is amended to
2read:
(a) A person or entity shall not advertise, print, display,
4publish, distribute, or broadcast, or cause or permit to be advertised,
5printed, displayed, published, distributed, or broadcast in any
6manner, a statement concerning services or benefits to be provided
7to an injured worker,
which is paid for directly or indirectly by
8that person or entity and is false, misleading, or deceptive, or that
9omits material information necessary to make the statement therein
10not false, misleading, or deceptive.
11(b) As soon as reasonably possible, but not later than January
121, 1994, the administrative director shall adopt regulations
13governing advertising by persons or entities other than physicians
14and attorneys with respect to services or benefits for injured
15workers. In promulgating regulations pursuant to this subdivision,
16the administrative director shall review existing regulations,
17including those adopted by the State Bar, to identify those
18regulatory approaches that may serve as a model for regulations
19required by this subdivision.
20(c) A violation of subdivision (a) is a misdemeanor, punishable
21by incarceration in the county
jail for not more than one year, or
22by a fine not exceeding ten thousand dollars ($10,000), or by both
23that imprisonment and fine.
24(d) This section shall not apply to physicians or attorneys. It is
25the intent of the Legislature to exempt physicians and attorneys
26from this section because the conduct regulated by this section,
27with respect to physicians and attorneys, is governed by other
28provisions of law.
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