BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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                                 THIRD READING


          Bill No:  SB 457
          Author:   Calderon (D)
          Amended:  5/4/11
          Vote:     21

           
           SENATE LABOR & INDUST. REL. COMMITTEE  :  4-0, 3/23/11
          AYES:  Lieu, Wyland, Padilla, Yee
          NO VOTE RECORDED:  DeSaulnier, Leno, Runner

           SENATE APPROPRIATIONS COMMITTEE  :  6-3, 5/26/11
          AYES:  Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
          NOES:  Walters, Emmerson, Runner


           SUBJECT  :    Workers compensation:  liens

           SOURCE  :     California Professional Firefighters


           DIGEST  :    This bill requires the Workers Compensation 
          Appeals Board to determine, on the basis of liens filed, 
          reimbursement for benefits paid or services provided by a 
          health care service plan, a group disability policy, a 
          hospital service contract, or a self-insured employee 
          welfare benefit plan, notwithstanding the Official Medical 
          Fee Schedule, when an award is made for reimbursement for 
          self-procured medical costs for the effects of an injury or 
          illness arising out of and in the course of employment.  
          This bill states that its provisions are not to be deemed 
          as modifying in any way the rights of any health care 
          provider to file and prosecute a lien.

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           ANALYSIS  :    Existing law establishes a workers' 
          compensation system, administered by the Administrative 
          Director of the Division of Workers' Compensation, to 
          compensate an employee for injuries sustained in the course 
          of his/her employment.  Existing law authorizes a medical 
          provider to file a lien claim with the Workers' 
          Compensation Appeals Board (WCAB) for certain expenses 
          incurred by the provider.  Under existing law, the WCAB is 
          required to allow a lien to the extent of benefits paid or 
          services provided for reimbursement for self-procured 
          medical costs for the effects of an injury or illness 
          arising out of and in the course of employment.

          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 
          prescribed goods and services, in accordance with specified 
          requirements.

          This bill requires the WCAB to determine, on the basis of 
          liens filed, reimbursement for benefits paid or services 
          provided by a health care service plan, a group disability 
          policy, a hospital service contract, or a self-insured 
          employee welfare benefit plan, notwithstanding the Official 
          Medical Fee Schedule, when an award is made for 
          reimbursement for self-procured medical costs for the 
          effects of an injury or illness arising out of and in the 
          course of employment.  This bill states that its provisions 
          are not to be deemed as modifying in any way the rights of 
          any health care provider to file and prosecute a lien.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions        2011-12    2012-13     2013-14      Fund  

          Exemption from OMFS            Unknown, potentially 
          significant           General/
          of self-procured medical       costs ongoing        Special

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          costs

           SUPPORT  :   (Verified  5/27/11)

          California Professional Firefighters (source)
          California Labor Federation, AFL-CIO
          California Society of Industrial Medicine and Surgery
          California Society of Physical Medicine and Rehabilitation
          State Building and Construction Trades Council

           OPPOSITION  :    (Verified  5/27/11)

          Acclamation Insurance Management Services
          Allied Managed Care
          ALPHA Fund
          Association of California Insurance Companies
          California Association of Joint Powers Authorities
          California Chamber of Commerce
          California Coalition on Workers' Compensation
          California Joint Powers Authority 
          California State Association of Counties
          CSAC Excess Insurance Authority
          League of California Cities
          Los Angeles County

           ARGUMENTS IN SUPPORT  :    The proponents write:

            "This bill closes-off a loophole in existing law that 
            impedes the reimbursement for the actual costs associated 
            with providing for an employee's medical care in 
            instances where such are has been determined to be 
            related to an industrial injury or illness and therefore, 
            compensable under workers' compensation.

            "This becomes a significant financial problem when the 
            non-industrial health plan is an employee funded health 
            benefits trust, whereby employees have to pay for a 
            portion of their care for a job related injury - a direct 
            violation of the constitution which obligates the 
            employer to provide a system of workers' compensation.

            "Clarifying the law in the manner proposed by SB 457 not 
            only ensures that these health care trusts will be made 
            whole, which in turn sustains the ability for the trust 

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            to adequately provide for payment of services for 
            non-industrial care for worker, it will provide a much 
            needed incentive to workers' compensation system to 
            mitigate these disputes over compensability quickly."

           ARGUMENTS IN OPPOSITION  :    The California Coalition on 
          Workers' Compensation (CCWC) argues:

            "CCWC is opposed to your SB 457, which would increase 
            cost n the workers' compensation system by entitling 
            medical providers, health care service plans, and other 
            lien claimants to reimbursement above and beyond the 
            Official Medical Fee Schedule (OMFS) established under LC 
            Section 5307.1.

            "The state purpose of the bill is to allow 
            employee-funded health care trusts to receive 
            reimbursement for their actual costs when medical 
            treatment has been provided to injured workers whose 
            claims where denied and later determined to be 
            compensable.  However, the amended section of the labor 
            code is not specific to employee-funded health care 
            trusts and would impact other lien claimants.

            "SB 457 appears to go beyond its stated purpose and 
            create a loophole that would allow for reimbursement 
            above and beyond the OMFS for self-procured medical 
            treatment.  The amended LC Section 4903.1(a)(B) deals 
            with all liens for self-procured medical costs for a 
            "health care provider, a health care service plan, a 
            group disability policy, a self-insured employee welfare 
            benefit plan, or a hospital service contract".  The scope 
            of this bill is clearly beyond employee-funded health 
            care trusts.

            "Liens for medical treatment have become a huge problem 
            in California's workers' compensation arena.  Liens 
            increase costs for employers and create unnecessary 
            litigation that clog the courts and slow down the process 
            of resolving claims for injured workers.  SB 457 could be 
            interpreted to allow doctors and private health care 
            service plans to file liens demanding reimbursement for 
            self-procured medical treatment above the OMFS.  This 
            modification to the Labor Code would compound the current 

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            lien problems being faced by California.

            "SB 457 would weaken the protections for employers at a 
            time when medical costs are already escalating 
            substantially.  For these reasons, CCWC must oppose your 
            SB 457."  
           

          PQ:mw:do  5/27/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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