SB 542, as amended, Mendoza. Workers’ compensation: home health care services: fee schedules.
Existing 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.
This 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.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 5307.8 of the Labor Code is amended to
2read:
(a) Notwithstanding Section 5307.1, the administrative
4director shall adopt, after public hearings, a schedule for payment
5of home health care services provided in accordance with Section
64600 that are not covered by a Medicare fee schedule and are not
7otherwise covered by the official medical fee schedule adopted
8pursuant to Section 5307.1. The schedule shall set forth fees and
9requirements for service providers, and may be based upon, but is
10not limited to, being based upon, either of the following:
11(1) The maximum service hours and fees as set forth in
12regulations adopted pursuant to Article 7 (commencing with
13Section 12300) of Chapter 3 of Part 3 of Division 9 of the Welfare
14and
Institutions Code.
15(2) A state or federal home health care services fee schedule
16other than the schedule described in paragraph (1), including a fee
17schedule authorized for purposes of the Medi-Cal program or a
18fee schedule administered by the federalbegin delete Director of theend delete Office of
19Workers’ Compensation Programs.
20(b) Fees shall not be provided for any services, including any
21services provided by a member of the employee’s household, to
22the extent the services had been regularly performed in the same
23manner and to the same degree prior to the date of injury. If
24appropriate, attorney’s fees for recovery of home health care
25services fees under this section may be awarded in accordance
26with Section 4906 and any
applicable rules or regulations.
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