BILL ANALYSIS Ó
SENATE COMMITTEE ON LABOR AND INDUSTRIAL RELATIONS
Senator Tony Mendoza, Chair
2015 - 2016 Regular
Bill No: SB 914 Hearing Date: April 6,
2016
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|Author: |Mendoza |
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|Version: |January 26, 2016 |
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|Urgency: |No |Fiscal: |No |
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|Consultant:|Gideon Baum |
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Subject: Workers' compensation: medical provider networks:
independent medical reviews
KEY ISSUE
Should the Legislature strike an out-of-date reference to the
American College of Occupational and Environmental Medicine's
Occupational Medicine's Practice Guidelines in the California
Labor Code?
ANALYSIS
Existing law 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.
Existing law 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
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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)
Existing law provides that the Administrative Director must
adopt, after public hearings, a medical treatment utilization
schedule (MTUS), that shall incorporate the evidence-based,
peer-reviewed, nationally recognized standards of care and must
address, at a minimum, the frequency, duration, intensity, and
appropriateness of all treatment procedures and modalities
commonly performed in workers' compensation cases. (Labor Code
§5307.27)
This bill strikes an out-of-date reference to the American
College of Occupational and Environmental Medicine's
Occupational Medicine Practice Guidelines.
This bill also makes additional minor and technical changes to
existing law.
COMMENTS
1. Need for this bill?
In 2004, the Legislature passed SB 899 (Poochigian), Chapter
34, Statutes of 2004, which was a holistic reform of the
California workers' compensation system. As a part of that
reform, SB 899 required that the Division of Workers'
Compensation (DWC) create an evidence-based set of medical
guidelines to ensure that injured workers were receiving
consistent, appropriate treatment from physicians. In the
intervening period, SB 899 required that physicians use the
American College of Occupational Medicine's Medicine Practice
Guidelines (ACOEM), which are a set of widely-utilized
evidence-based, peer reviewed medical guidelines that continue
to be used in California's workers' compensation system and
many other state workers' compensation systems.
In 2009, the DWC promulgated the California-specific workers'
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compensation system medical treatment guidelines. Known as the
Medical Treatment Utilization Schedule (MTUS), the guidelines
utilized many of the chapters that make up ACOEM, but also
referenced additional guidelines or developed independent
guidance on medical treatment. As such, while ACOEM is still
used as a part of the MTUS, it is no longer referred to as a
stand-alone guideline.
SB 914 would strike references to the use of ACOEM as a
stand-alone medical guideline.
2. Proponent Arguments :
The author notes that the Medical Treatment Utilization
Schedule (MTUS) was created in 2009, and since that time has
been the sole medical guideline for medical treatment in the
California workers' compensation system. Despite this, some
out-of-date Labor Code sections continue to reference the
predecessor American College of Occupational Medicine's
Medicine Practice Guidelines (ACOEM). SB 914 would strike
these out-of-date references, ensuring that existing law
accurately reflects the status of the MTUS as the sole medical
guideline, reducing confusion and increasing the clarity of
existing law.
3. Prior Legislation :
SB 542 (Mendoza), Chapter 542, Statutes of 2015, also struck
out-of-date references to the ACOEM Medical Practice
Guidelines.
SUPPORT
None on file.
OPPOSITION
None on file.
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