BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  June 22, 
                                                            2011
                                                                  Page  1

          Date of Hearing:   June 22, 2011

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                     SB 457 (Calderon) - As Amended:  May 4, 2011

           SENATE VOTE  :   25-14
           
          SUBJECT  :   Workers' compensation liens

           SUMMARY  :   Provides that a health plan may recover from an 
          employer or workers' compensation insurer more than the amount 
          for medical expenses provided by the Official Medical Fee 
          Schedule (OMFS), under certain circumstances.  

          Specifically,  this bill  provides that, for purposes of awarding 
          a lien claimant compensation for medical expenses, if the lien 
          claimant is a health care service plan, an insurance company 
          that is claiming pursuant to benefits paid under a group health 
          insurance policy, a claimant pursuant to a hospital service 
          contract, or a self-insured employee welfare benefit plan, where 
          the lien claimant has paid benefits or provided services under 
          its plan, the OMFS does not limit the amount of the lien.

           EXISTING LAW  :

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

          2)Establishes, based on a statutory delegation to the 
            Administrative Director (AD) of the Division of Workers' 
            Compensation (DWC) to develop and adopt, an OMFS that sets the 
            maximum reasonable reimbursement for medical services provided 
            to injured workers.

          3)Authorizes service providers to file a lien with the Workers' 
            Compensation Appeals Board (WCAB) if a dispute arises about 
            the right to payment or the amount paid by the employer or 
            insurer.

          4)Requires the WCAB to determine whether to allow the lien, and 
            how much should be paid on the lien, generally using the OMFS 
            when the lien is for medical services.








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                                                            2011
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           FISCAL EFFECT  :   According to the Senate Appropriations 
          Committee, unknown, potentially significant costs in the event 
          health plans seek liens above the OMFS for benefits paid or 
          services provided to state employees who are determined to have 
          work-related injuries.

           COMMENTS  :   

           1)Purpose  .  According to the sponsor, the California 
            Professional Firefighters, if an employer or its insurer 
            denies a workers' compensation claim, case law requires a 
            non-industrial health program that is otherwise available to 
            the employee to provide coverage.  The law allows that health 
            plan to file a lien to recover its costs "to the extent of 
            benefits paid" in the event the injury is later determined to 
            be work-related.  However, the amount the health plan may have 
            paid in treatment may be greater than the OMFS, and thus the 
            health plan faces a loss of the difference between what it 
            paid, and what the OMFS covers.  The bill is intended to close 
            this "loophole."

           2)When does the bill apply?   Proponents point to the scenario 
            where there has been a denial of the workers' comp claim, and 
            the denial is overturned after being litigated, which may be 
            resolved in fairly short order, or may takes years to resolve, 
            (as in a case that resulted in over $1 million in treatment 
            costs for a firefighter who died of cancer.)  At least some 
            employers have expressed concerns that scenarios other than 
            those involving a denial of the claim by the employer/insurer 
            can lead to opportunities to "game" the system.  However, it 
            is clear that the Labor Code section being amended by the bill 
            applies only where there has been an adjudication of a denied 
            claim, and the adjudication results in a finding that the 
            claim was valid.

           3)May the WCAB reduce the amount claimed in the lien?   Concern 
            has been expressed that the bill itself does not state that a 
            lien may be reduced if it is unreasonable.  However, it is 
            clear that Labor Code Section 4903.1, which is being amended 
            by the bill, is subject to Section 4903, which confers upon 
            the WCAB the authority to determine the amount of a lien.

          In order to ensure there is clarity on this issue, the author 








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                                                            2011
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            has agreed to adopt an amendment that provides that the bill's 
            provisions do not affect the rights of an insurer or employer 
            to utilization review of the treatment provided to the injured 
            worker.

           4)Double-jointing  .  This bill and SB 863 (Lieu) both amend Labor 
            Code Section 4903.1.  The amendments are not incompatible, but 
            in order to avoid chaptering out issues, the authors should 
            have double-jointing language prepared as final forms of the 
            bills develop by the time they reach the Assembly Floor.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California Professional Firefighters
          California Federation of Labor, AFL-CIO
           
            Opposition 
           
          California Association of Joint powers Authorities
          California Chamber of Commerce
          Allied Management Care
          Acclamation Insurance Management Services
          County of Los Angeles

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