BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2072
                                                                  Page  1

          Date of Hearing:   April 18, 2072

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                      AB 2072 (Eng) - As Amended:  April 9, 2012
           
          SUBJECT  :   Workers' compensation: acupuncturists

           SUMMARY  :   Repeals in part the prohibition on acupuncturists 
          making disability determinations in the workers' compensation 
          system. Specifically,  this bill  :  

          1)Repeals and re-enacts using the same language, but in a 
            different location, the definition of "acupuncturist" for 
            purposes of the workers' compensation law.

          2)Repeals, in part, the prohibition on acupuncturists making 
            disability determinations in the workers' compensation system 
            by allowing an acupuncturist who is also a qualified medical 
            evaluator (QME) to make disability determinations.

           EXISTING LAW  :

          1)Provides for a comprehensive system of workers' compensation 
            benefits for workers who are injured on the job, including 
            medical benefits.

          2)Defines as "physicians" for purposes of the workers 
            compensation law the health care providers who may lawfully 
            treat, and be compensated for treating, injured workers, 
            including physicians and surgeons having either an MD or DO 
            degree, psychologists, acupuncturists, optometrists, dentists, 
            podiatrists, and chiropractors.

          3)Provides for the designation by the Administrative Director 
            (AD) of the Division of Workers' Compensation (DWC) of QMEs to 
            evaluate and report on workers' compensation cases where legal 
            issues or conclusions are required to be drawn from medical 
            conditions or diagnoses, or when certain disputes on these 
            issues arise.

          4)Prohibits acupuncturists from making disability 
            determinations. 

           FISCAL EFFECT  :   Unknown.








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           COMMENTS  :  

           1)Purpose  .  According to the author, the bill is designed to 
            "conform the law to actual practice, which is that 
            acupuncturists who complete the training to become qualified 
            medical evaluators have the ability to determine disability 
            for worker's (sic) compensation."  

           2)Workers' Compensation "Physicians"  .  As a general rule, the 
            term "physician" is limited to  medical doctors who hold 
            either MD or DO degrees and are licensed as physicians and 
            surgeons in California.  The workers' compensation law works a 
            little differently, defining for narrow purposes all of the 
            health care providers who may treat injured workers as 
            "physicians." And then using the word "physician in various 
            places in the workers' compensation law (rather than listing 
            the string of authorized providers each time).

           3)Inappropriate Repeal and Re-enactment  .  For reasons that are 
            unclear, the bill proposes to repeal and re-enact in identical 
            language the definition of "acupuncturist".  In doing so, it 
            elevates the definition of "acupuncturist" to subdivision (a) 
            of the Labor Code section dealing with authorized health care 
            providers.  However, logic dictates that the initial 
            subdivision contain the basic definition of "physician" and 
            the later subdivisions address exceptions and qualifications.  
            Should the bill move forward, the repeal and re-enactment of 
            the definition of "acupuncturist" should be removed from the 
            bill.

           4)Support  .  The author and supporters, The Council of 
            Acupuncture and Oriental Medicine Associations, collectively 
            argue that acupuncturists who attain QME status are primary 
            care providers who are qualified to make disability 
            determinations in the workers' compensation system.  In 
            support of this contention, proponents point to the extensive 
            examination that an acupuncturists needs to pass to attain QME 
            status.

           5)Bill May Not Conform to Practice  .  While the author asserts 
            that the bill conforms to actual practice, it is far from 
            clear that current QME acupuncturists are actually making 
            disability evaluations.  No evidence has been presented to 
            this actual practice, and the DWC's QME materials specifically 








                                                                  AB 2072
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            discuss the current prohibition and that certain elements do 
            not apply to acupuncturists.

           6)Opposition  .  The California Medical Association and the 
            Association of California Insurance Companies oppose the bill. 
             These organizations argue that while acupuncturists are 
            qualified health care practitioners to provide treatment, 
            where appropriate, to injured workers in the workers' 
            compensation system, it is inappropriate for them to make 
            disability determinations.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          The Council of Acupuncture and Oriental Medicine Associations

           Opposition 
           
          Association of California Insurance Companies
          California Coalition on Workers' Compensation
          California Medical Association
           
          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086