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CA: ACIC Opposes Bill to Remove Link Between OMFS Pharmacy Services and Medi-Cal Schedule

SACRAMENTO, CA - The Association of California Insurance Companies (ACIC) announced its opposition to AB 2593 (Assemblyman Steve Bradford (D-Inglewood)), which ACIC believes would increase pharmacy costs and drive up costs for such services. Read more Source: PCI

CWCI Study Documents Ongoing Increases in Use of Network Physicians in California Workers’ Comp

A new California Workers’ Compensation Institute (CWCI) study shows the percentage of medical services to injured workers delivered by network physicians jumped sharply immediately after Medical Provider Networks (MPNs) were introduced into the workers’ compensation system in 2005, and that...

CA: WCAB Provides Guidance on Reimbursement of Lien for Repackaged Pharmaceuticals

Ramon Mendoza v. J. Buckbinder Industry, Inc., Insurance Company of the West Liens--Repackaged Pharmaceuticals--WCAB rescinded WCJ's finding that lien claimant California Pharmacy Management was entitled to partial reimbursement of its lien for repackaged drugs dispensed by treating physician...

CA: DWC Adjusts DMEPOS Section of Official Medical Fee Schedule

OAKLAND, CA - The Division of Workers' Compensation has posted an order adjusting the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to changes in the Medicare payment system as required by Labor Code section 5307.1...

California Workers' Comp Case Roundup (5/3/2013)

CALIFORNIA COMPENSATION CASES Vol. 78 No. 4 April 2013 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE © Copyright 2013 LexisNexis. All rights...

California: IBR Not Applicable to Pre-1/1/13 Medical Billing Disputes

The 4th District Court of Appeal has issued a decision raised to it on a question on the “retroactive” application of the Independent Bill Review provisions of SB 863 and whether the legislature intended to remove from the W.C.A.B. jurisdiction to address bill disputes that existed prior...

California Official Medical Fee Schedule: The Death of the Extraordinary Circumstances Exception Post-2004

In what appears to be a case of first impression, the WCAB panel in Jaime Torres Tavera v. T and P Farms, Zenith Insurance Company , 2015 Cal. Wrk. Comp. P.D. LEXIS --, reversed the WCJ’s finding and held instead that the extraordinary circumstances exception to the fee schedule applies only to...

California Official Medical Fee Schedule: Another Death of the Extraordinary Circumstances Exception Post-2004

Another WCAB panel finds that the extraordinary circumstances exception in the OMFS has died post-2004 In Garcia v. E Recycling of California, Zurich North America , 2015 Cal. Wrk. Comp. P.D. LEXIS –-, a WCAB panel rescinded the WCJ’s finding that the lien claimant Western Medical Center...

California OMFS: Yet Another Death of the Extraordinary Circumstances Exception Post-2004

A third WCAB panel finds that the extraordinary circumstances exception in the OMFS has died post-2004 In Murphy v. County of Fresno , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB rescinded the WCJ’s finding that the lien claimant Cedar-Sinai Medical Center was entitled to payment of fees in...

California: The OMFS as a Maximum Fee Schedule

Lien claimant found not entitled to excess fees In Holder v. Troy Christian Adventure Limousine , 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s finding that lien claimant David Payne, M.D., was not entitled to fees above those set forth in the Official Medical Fee Schedule...

California Workers’ Compensation: 2015 Year in Review

By Julius Young, Esq., Richard M. Jacobsmeyer, Esq., Barry D. Bloom, Co-Editors-in-Chief, Herlick, California Workers' Compensation Handbook This 2016 edition is the 35th edition of Herlick, California Workers’ Comp Handbook (hereinafter “Herlick”). The latest Herlick Handbook...