BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1454
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 1454 (Solorio)
          As Amended  August 24, 2012
          Majority vote
           
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          |ASSEMBLY:  |46-22|(April 23,      |SENATE: |23-13|(August 29,    |
          |           |     |2012)           |        |     |2012)          |
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           Original Committee Reference:    INS.  

           SUMMARY  :  Authorizes certain audiologists to be qualified 
          medical evaluators (QMEs) in the workers' compensation system.

           The Senate amendments  eliminate the requirement that an 
          audiologist QME base his/her report on a diagnosis made by a 
          physician and require audiologists treating or evaluating an 
          injury to collaborate with other medical providers upon request 
          of the employer or insurer.  

           AS PASSED BY THE ASSEMBLY  , this bill:

          1)Provided 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)Added audiologist QMEs to the section of the workers' 
            compensation law that defines which health care professions 
            are considered "physicians" for workers' compensation 
            purposes.

          3)Prohibited an audiologist authorized to be a "physician" under 
            the workers' compensation law from advertising or holding his 
            or herself out as a physician.

          4)Required audiologists, when treating or evaluating an injury, 
            to engage in appropriate medical collaboration at the request 
            of the employer or insurer.

           FISCAL EFFECT  :   The Senate Appropriations Committee estimates 
          $135,000 in 2012-13 and 2013-14 from the Workers' Compensation 








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          Administrative Revolving Fund to create and administer 
          examinations and up to $35,000 annually thereafter for exam 
          administration.  All of these costs are offset by fees.
           
          COMMENTS  :  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.  

          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 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.

          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  








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          FN: 0005806