BILL ANALYSIS �
AB 1454
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ASSEMBLY THIRD READING
AB 1454 (Solorio)
As Introduced January 9, 2012
Majority vote
INSURANCE 12-0 APPROPRIATIONS 12-3
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|Ayes:|Solorio, Hagman, |Ayes:|Fuentes, Blumenfield, |
| |Bradford, | |Bradford, Charles |
| |Charles Calderon, Carter, | |Calderon, Campos, Davis, |
| |Feuer, Hayashi, Miller, | |Gatto, Hall, Hill, Lara, |
| |Olsen, Skinner, Torres, | |Mitchell, Solorio |
| |Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Donnelly, Norby, Wagner |
| | | | |
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SUMMARY : Authorizes certain audiologists to be qualified medical
evaluators (QMEs) in the workers' compensation system.
Specifically, this bill :
1)Provides that an audiologist who holds a doctoral degree in
audiology, and who has five years post-doctoral experience in the
practice of audiology, may apply to the Administrative Director
(AD) of the Division of Workers' Compensation (DWC) to be a QME,
if he or she passes the examination required of all QME
applicants.
2)Requires an audiologist QME to use a diagnosis made by a physician
when preparing a QME report.
3)Adds audiologist QMEs to the section of the workers' compensation
law that defines which health care professions are considered
"physicians" for workers' compensation purposes.
4)Prohibits an audiologist authorized to be a "physician" under the
workers' compensation law from advertising or holding his or
herself out as a physician.
EXISTING LAW :
1)Provides that a person who meets specified criteria in the
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Business and Professions Code, including holding a masters degree
in audiology, may be licensed as, and perform the functions of, an
audiologist, as defined.
2)Authorizes the AD to appoint QMEs, who meet specified criteria and
pass an examination, to perform medical-legal evaluations to
resolve medical-legal issues in the workers' compensation system.
3)Provides that physicians and surgeons, psychologists,
acupuncturists, optometrists, dentists, podiatrists, and
chiropractors are "physicians" as that term is used in the
workers' compensation law, and therefore eligible to be appointed
as QMEs.
4)Specifies that these health care providers can only provide
services that are within their defined scope of practice.
5)Provides that a QME be able to conduct an evaluation to determine
compensability of a disputed medical issue, including course of
treatment and causation, and evaluate whether or not the injury
causes a permanent disability.
FISCAL EFFECT : According the Assembly Appropriations Committee,
one-time costs of up to $100,000 (workers compensation fund) if it
is determined that a specific audiology exam is required.
COMMENTS :
Purpose . According to the author, audiologists are qualified to
perform the QME functions in cases that involve hearing loss. They
argue that other allied health care professionals are already
allowed, within their specialized areas, to perform QME functions,
and that there is no reason to preclude audiologists from performing
this function in their area of expertise.
Use of the term "physician" . In general, only medical doctors -
"physicians and surgeons" with M.D. or D.O. degrees who are licensed
by the medical board or the osteopathic medical board - are
authorized to use the term "physician." Many professions may use
the term "doctor," but the "physician" designation has been reserved
to medical doctors to avoid confusion. The workers' compensation
law, for unclear historical reasons, uses the term "physician" to
describe the range of health care providers who provide treatment to
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injured workers. As a result, care is taken in the workers'
compensation law to ensure that this broader policy is not
undermined by non-physician practitioners listed as lawful workers'
compensation providers.
Support . Supporters (audiology professional associations) generally
make a fairness argument, noting that other providers who are no
better trained in their respective specialties are already allowed
to be QMEs. They additionally argue that the bill benefits injured
workers by ensuring their cases can be evaluated by a professional
who is specially trained in hearing and hearing loss cases. In
addition, supporters point to increased hearing-related issues
associated with an aging workforce, and suggest that increasing the
number of hearing specialists able to participate in the evaluation
process will be beneficial.
Prior legislation . SB 577 (Wiggins) of 2007 proposed, in the form
it went to the Governor, the same provisions as in this bill. SB
577 was vetoed by Governor Schwarzenegger. The veto message
provides:
This bill would allow audiologists to issue
qualified medical evaluator (QME) reports relative
to workers' compensation claims.
Although SB 557 would allow audiologists to
issue a QME report, it would still require the
final diagnosis to be made by a physician as
audiologists are not able to render disability
determinations in the workers' comp system. This
could result in unnecessary delays for injured
workers and increased costs to the system by
delaying prompt resolution of claims. In
addition, the proponents of this measure have not
demonstrated an unmet need for evaluating hearing
loss in the workers' comp system.
Analysis Prepared by : Mark Rakich / INS. / (916) 319-2086 FN:
0003331
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