BILL NUMBER: AB 2749 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 20, 2010
AMENDED IN ASSEMBLY APRIL 8, 2010
INTRODUCED BY Assembly Members Logue and Norby
FEBRUARY 19, 2010
An act to amend Section 4903.5 of the Labor Code, relating to
workers' compensation.
LEGISLATIVE COUNSEL'S DIGEST
AB 2749, as amended, Logue. Workers' compensation: lien claims.
Existing workers' compensation law generally requires employers to
secure the payment of workers' compensation, including medical
treatment, for injuries incurred by their employees that arise out
of, and in the course of, employment. Existing law authorizes a
medical provider to file a lien claim with the Workers' Compensation
Appeals Board for certain expenses incurred by the provider.
Existing law prohibits lien claims for expenses incurred by or on
behalf of the injured employee, as provided, and, to the extent that
the employee is entitled to reimbursement, as specified, for
medical-legal expenses, from being filed after 6 months from the date
on which the appeals board or workers' compensation administrative
law judge issues a final decision, findings, order, or award on the
merits of the claim, after 5 years from the date of the injury for
which the services were provided, or after one year from the date the
services were provided, whichever is later.
This bill would, instead, prohibit lien claims for the
above-described expenses from being filed one year from the date the
services were provided. The bill would prohibit lien claims for
expenses incurred for providing inpatient medical services from being
filed after 6 months from the date the provider of those services
knew or should have known the inpatient services were for treating an
industrial injury.
This bill would require employers or employers' insurance carriers
to include a benefit notice with any objection to a bill for medical
services or an explanation of benefits that advises the provider of
those services or benefits of the above-described deadline for filing
lien claims and the consequences of failing to meet that deadline.
This bill would require the above-described lien claims to be
accompanied by certain documentation, including the original bill or
bills for the services. The bill would provide that if the lien claim
does not include the documentation, it shall be rejected, shall not
receive further consideration, and that notice shall be provided to
all parties of record that the lien claimant did not meet the
documentation requirements and that the lien claim has been rejected.
Vote: majority. Appropriation: no. Fiscal committee: yes
no . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4903.5 of the Labor Code is amended to read:
4903.5. (a) (1)
Except as provided in paragraph (2), no No lien
claim for expenses as provided in subdivision (b) of Section 4903 may
be filed after six months from the date on which the appeals
board or a workers' compensation administrative law judge issues a
final decision, findings, order, including an order approving
compromise and release, or award, on the merits of the claim, after
five years from the date of the injury for which the
services were provided, or after one year from the date the
services were provided , whichever is later .
(2) No lien claim for expenses incurred for providing inpatient
medical services may be filed after six months from the date the
provider of those services knew or should have known the inpatient
services were for treating an industrial injury.
(b) Notwithstanding subdivision (a), any health care provider,
health care service plan, group disability insurer, employee benefit
plan, or other entity providing medical benefits on a nonindustrial
basis, may file a lien claim for expenses as provided in subdivision
(b) of Section 4903 within six months after the person or entity
first has knowledge that an industrial injury is being claimed.
(c) The injured worker shall not be liable for any underlying
obligation if a lien claim has not been filed and served within the
allowable period. Except when the lien claimant is the applicant as
provided in Section 5501, a lien claimant shall not file a
declaration of readiness to proceed in any case until the
case-in-chief has been resolved.
(d) This section shall not apply to civil actions brought under
the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part
2 of Division 7 of the Business and Professions Code), the Unfair
Practices Act (Chapter 4 (commencing with Section 17000) of Part 2 of
Division 7 of the Business and Professions Code), or the federal
Racketeer Influenced and Corrupt Organization Act (Chapter 96
(commencing with Section 1961) of Title 18 of the United States Code)
based on concerted action with other insurers that are not parties
to the case in which the lien or claim is filed.
(e) Employers or employers' insurance carriers shall include a
benefit notice with any objection to a bill for medical services or
an explanation of benefits that advises the provider of those
services or benefits of the deadline for filing lien claims described
in subdivision (a) and the consequences of failing to meet that
deadline.
(f) (1) A lien claimant filing a claim for expenses as provided in
subdivision (b) of Section 4903 shall include the following
documentation with the lien claim:
(A) The original bill or bills for the services for which the lien
claim is being filed. Ledger or billing payment histories shall not
be sufficient for purposes of complying with this subparagraph.
(B) A statement stating that the expenses for which the lien claim
is being made were incurred for services authorized by the employer
or, if the expenses were not authorized by the employer, that the
expenses were for services justified for another specified reason.
(C) Certification that the lien claim complies with applicable
statutes and rules.
(2) If a lien claim for expenses as provided in subdivision (b) of
Section 4903 does not include the documentation required by
paragraph (1), all of the following shall occur:
(A) The lien claim shall be rejected.
(B) The lien claim shall receive no further consideration.
(C) Notice shall be provided to all parties of record that the
lien claimant did not meet the requirements under this subdivision
and that the lien claim has been rejected.