BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1687
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 1687 (Fong)
          As Amended  June 18, 2012
          Majority vote
           
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          |ASSEMBLY:  |47-24|(May 17, 2012)  |SENATE: |22-12|(August 29,    |
          |           |     |                |        |     |2012)          |
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           Original Committee Reference:    INS.

          SUMMARY  :   Requires an employer or insurer to provide an 
          explanation of options for objecting to decisions to delay, deny 
          or modify medical treatment recommended by a treating physician, 
          and provides for compensation for attorneys in connection with 
          enforcing future medical treatment orders.  

           The Senate amendments  :

          1)Place the explanation requirement relating to the delay, 
            denial or modification of medical treatment into a different 
            code section.

          2)Add a requirement that, in order to obtain attorney's fees 
            with respect to disputed medical treatment, the injured worker 
            must prevail in the dispute.

          3)Limit the cases where the right to attorney's fees applies to 
            cases where there is a final award of permanent disability 
            benefits.

           AS PASSED BY THE ASSEMBLY  , this bill:

          1)Requires, in connection with a utilization review (UR) 
            decision to delay, deny or modify medical treatment 
            recommended by a treating physician, that an employer or 
            insurer include a clear and concise explanation of the 
            available options for objecting to the delay, denial or 
            modification.

          2)Requires the explanation to be in no less than 12-point bold 
            type on the first page of the communication to the injured 
            employee.









                                                                  AB 1687
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          3)Authorizes the payment of reasonable attorney's fees where a 
            dispute arises concerning medical treatment where there has 
            been an award of future medical treatment and the applicant 
            has employed an attorney to enforce his or her rights.

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee, unknown, likely significant increase annually in 
          state workers' compensation costs; generally 55% from the 
          General Fund and 45% from special funds. 

           COMMENTS  :  According to the author, this bill is designed to 
          provide injured workers more information about how to navigate 
          the workers' compensation system in the event treatment 
          recommended by their treating physician is delayed, denied, or 
          modified, and to establish an appropriate incentive for 
          attorneys to take on "future medical" cases when the injured 
          worker requires the assistance of counsel.

          It is common in a workers' compensation case to enter into 
          settlement agreements that resolve disability and retraining and 
          other issues, but leave future medical benefits open.  This 
          occurs when the parties are unable or unwilling to make 
          reasonable guesses about future medical needs.  That 
          uncertainty, however, is not and should not be a barrier to 
          settlement of all other issues.  This is particularly true when 
          there is a recognition that future medical needs may last for 
          years or for a lifetime.

          It is unfortunately true that disputes can arise long after all 
          other matters have been resolved, often years after an attorney 
          has handled the case.  In these circumstances, it is frequently 
          difficult or impossible for an injured worker to find an 
          attorney to assist in enforcing the award.  If the employer or 
          insurer behavior is egregious enough, there is the potential 
          that attorney's fees can be taken from penalties imposed, but in 
          the usual case, there is no provision for attorney's fees.  The 
          bill is designed to address this issue.

          Employers and insurers are opposed to the bill, arguing that the 
          additional notification requirements are unduly complicating and 
          costly additions to a UR system that is performing a valuable 
          function of preventing inappropriate treatment that is not 
          evidence-based, and which forces treating physicians to practice 
          evidence-based medicine because the failure to provide proper 
          documentation for treatment requests will result in delays due 








                                                                  AB 1687
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          simply to inadequate medical information.  They point out that 
          there are already enforcement provisions for unreasonable 
          delays, denials or modifications, but that good faith use of the 
          UR system should not be made more costly and burdensome.  They 
          argue that this bill creates more frictional costs of the very 
          sort we are trying to eliminate.

          With respect to the attorney's fees provision, they argue that 
          it will add costs to the system, and that the Division of 
          Workers' Compensation already has an Information and Assistance 
          Unit located in 24 places throughout California to help injured 
          workers in these sorts of cases.


           Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086 


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