BILL ANALYSIS Ó
SB 1175
Page 1
Date of Hearing: June 29, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SB 1175
(Mendoza) - As Amended June 14, 2016
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|Policy |Insurance |Vote:|13 - 0 |
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill requires providers of medical and medical-legal
services in the workers' compensation system to submit bills
within 12 months of providing the services. It also:
1)Requires the administrative director of the Division of
Workers' Compensation (DWC) to adopt rules and regulations to
implement the 12-month limitation period, including
circumstances that constitute good cause for an exception to
SB 1175
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the 12-month period.
2)Provides that, absent good cause, a request for payment after
the 12-month limitation period is barred.
FISCAL EFFECT:
Costs to the Department of Industrial Relations (DIR), in which
DWC is housed, are expected to be minor and absorbable.
COMMENTS:
1)Purpose. This bill is intended to improve administration of
workers' compensation benefits by guarding against charges
that are provided after excessive delays. The author explains
such charges may be impossible to verify due to
record-keeping, which adds to the "frictional" cost of
providing workers' compensation benefits. The author
indicates the practice of instituting time limits for billing
is common in other medical systems and states, and it would
provide greater certainty for employers and quicker, more
accurate resolution of charges billed.
2)Background. The state workers' compensation system provides
benefits, including medical treatment, to employees who are
injured or suffer conditions that arise out of or in the
course of employment. Current law stipulates billing
requirements for medical providers in the workers'
compensation system.
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According to the author, multiple stakeholders report
persistent fraudulent or unnecessarily belligerent billing
activity by some medical providers, including submission of
medical bills more than a year after services were provided.
The time limit imposed by the bill, with good-cause
exceptions, intends to address the issue of excessive delay.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081