BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 542|
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THIRD READING
Bill No: SB 542
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
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
SUBJECT: Workers compensation: home health care services:
fee schedules
SOURCE: Author
DIGEST: This bill allows the Division of Workers' Compensation
(DWC) to follow the recommendations of the RAND Corporation in
the creation of a home healthcare fee schedule.
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
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Page 2
the Department of Industrial Relations to self-insure or by
securing insurance against liability from an insurance company
duly authorized by the state.
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)Requires the DWC to adopt, after public hearings, a fee
schedule for payment of home health care services. The fee
schedule must set forth fees and requirements for home
healthcare service providers. (Labor Code § 5307.8)
4)Requires that home healthcare fee schedule must be based on
maximum service hours and fees for In-Home Supportive Services
(IHSS) program. (Labor Code § 5307.8)
This bill allows the DWC to base the home healthcare fee
schedule on state or federal home healthcare, including fee
schedules authorized by Medi-Cal or the federal Office of
Workers' Compensation Programs.
Background
Need for this bill?Under existing law, the DWC has the
responsibility to create and update a variety of fee schedules
in California's workers' compensation system for medical
services. These fee schedules are designed to increase
stability in California's workers' compensation system by
setting the market for medical services - payors know what they
will pay for medical services, and medical service providers
know what they will be paid for providing their services.
Similar fee schedules are common in other states, as well as in
federal programs, most notably Medicare.
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In 2012, SB 863 (DeLeon, Chapter 363) required the DWC to create
a home healthcare fee schedule by July 1, 2013. This fee
schedule has not yet been created. In January of 2015, the DWC
released a study from the RAND Corporation which recommended
expanding the source material which can be utilized to create a
home healthcare fee schedule beyond the IHSS fee schedule. SB
542 follows the RAND Corporation recommendation to expand the
source material that can be used to create a home healthcare fee
schedule to include state and federal fee schedules, such as
Medi-Cal and the Office of Workers' Compensation Programs.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
SUPPORT: (Verified4/22/15)
California Chamber of Commerce
OPPOSITION: (Verified4/22/15)
None received
ARGUMENTS IN SUPPORT: The author notes that the use of fee
schedules in California's workers' compensation system is a
common occurrence, and argues that they have shown a high degree
of success in helping to control costs by setting a transparent
and predictable market price for goods and services in the
workers' compensation system. The author believes that home
healthcare services are a vital service for California's injured
workers, and argues that it is of paramount importance that a
successful home healthcare fee schedule is created in order to
ensure that home healthcare services are provided readily and
with a minimum of friction. The author believes that SB 542
accomplishes this by following the recommendations of the RAND
Corporation study in drawing from multiple existing fee
schedules to create the home healthcare fee schedule.
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Prepared by:Gideon Baum / L. & I.R. / (916) 651-1556
5/6/15 17:02:26
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