New workers’ comp laws to reduce treatment delays and fight fraud

Two newly-signed laws will help to improve California workers’ compensation, and build upon reform efforts that began in 2012. These new laws, signed by Governor Jerry Brown on October 2, concentrate on cracking down on fraud by health care professionals and reducing the delays applicants experience in obtaining medical evaluations.

“With today’s actions on legislation, the Governor once again demonstrated his steadfast commitment to improving California’s workers’ compensation system,” said California Labor and Workforce Development Agency Secretary David M. Lanier. ““The reforms enacted today will further improve treatment of injured workers and crack down on those that seek to profit through fraud and deceit at the expense of workers and employers alike.”

Laws SB 1160 and AB 1244 will both go into effect January 1, 2017.

• Under SB 1160, utilization reviews by a medical provider will be limited to the first 30 days following a work injury. It also mandates electronic reporting of utilization data by claims administrators to the Division of Workers’ Compensation (DWC). This will make monitoring of the claims process easier and enable more responsive addressing of potential problems.
• The second law, AB 1244, will require the DWC Administrator to suspend any medical provider from the workers’ compensation system if they have been convicted of fraud.

“Expedited and appropriate treatment in the critical first month of injury encourages the best outcome for injured workers and employers,” said Christine Baker, Director of the Department of Industrial Relations (DIR), in a recent press release. “In reforming the utilization review process used to contest care to injured workers and tightening controls on fraud, these new laws further the treatment and savings goals initiated by the Governor and the Legislature in 2012.”