BILL NUMBER: SB 563	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Pan

                        FEBRUARY 26, 2015

   An act to add Section 4610.2 to the Labor Code, relating to
workers' compensation.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 563, as introduced, Pan. Workers' compensation: utilization
review.
   Existing law requires every employer, for purposes of workers'
compensation, to establish a utilization review process to
prospectively, retrospectively, or concurrently review requests by
physicians for authorization to provide recommended medical treatment
to injured employees. Existing law establishes timeframes for an
employer to make a determination regarding a physician's request.
Existing law requires the utilization review process to be governed
by written policies and procedures, and requires that these policies
and procedures be disclosed to employees, physicians, and the public
upon request.
   This bill would require each employer, insurer, or other entity
that is subject to the utilization review process to disclose the
payment methodology for each person who is involved in the process of
reviewing, approving, modifying, delaying, or denying requests by
physicians for authorization prior to, retrospectively to, or
concurrently with the provision of medical treatment services to
injured workers by providing this information to employees,
physicians, and the public upon request.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4610.2 is added to the Labor Code, to read:
   4610.2.  Each employer, insurer, or other entity that is subject
to Section 4610 shall disclose the payment methodology for each
person who is involved in the process of reviewing, approving,
modifying, delaying, or denying requests by physicians for
authorization prior to, retrospectively to, or concurrently with the
provision of medical treatment services to injured workers by
providing this information to employees, physicians, and the public
upon request.