BILL NUMBER: SB 403	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 27, 2009

INTRODUCED BY   Senator Benoit

                        FEBRUARY 26, 2009

   An act to amend Section 4903.5 of the Labor Code, relating to
workers' compensation.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 403, as amended, Benoit. Workers' compensation: lien claims.
   Existing law  provides for   establishes a
 workers' compensation  for   system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for  injuries
incurred in the course of employment.  Existing 

   Existing law requires the administrative director, after public
hearings, to adopt and revise periodically an official medical fee
schedule that establishes reasonable maximum fees paid for medical
services other than physician services, drugs and pharmacy services,
health care facility fees, home health care, and all other treatment,
care, services, and specified goods. Existing law authorizes a
health care provider or licensed health facility and a contracting
agent, employer, or carrier to contract for reimbursement rates
different from those in the fee schedule. 
    Existing  law authorizes the Workers' Compensation
Appeals Board to determine and allow certain expenses, including
certain reasonable expenses incurred by or on behalf of the injured
employee  and medical-legal expenses   for
medical and hospital treatment  , as liens against any award of
compensation.
   This bill, commencing March 1, 2010, would prohibit a lien claim
for expenses incurred by or on behalf of the injured employee
 and medical-legal expenses   for medical and
hospital treatment  from being filed more than one year from the
date the health care provider, or the health care provider's agent,
was sent an explanation of benefits or explanation of review paying
 or objecting to a bill in whole or in part   a
bill pursuant to the official medical fee schedule or a preferred
provider organization (PPO) agreement  . The bill would provide
that this prohibition shall apply without regard to whether the
injury occurs before, on, or after March 1, 2010.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
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) 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.
   (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) Notwithstanding any other law, no lien claim for expenses 
incurred by or on behalf of the injured employee for medical and
hospital treatment  as provided in subdivision (b) of Section
4903 may be filed more than one year from the date the health care
provider, or the health care provider's agent, was sent an
explanation of benefits or explanation of review paying  or
objecting to a bill in whole or in part   a bill
pursuant to the official medical fee sc   hedule promulgated
pursuant to Section 5307.1 or a preferred provider organization
(PPO) agreement  .
   (1) This subdivision shall apply to all injuries, without regard
to whether the injury occurs before, on, or after the operative date
of this subdivision.
   (2) This subdivision shall become operative on March 1, 2010.
   (e) 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.