California’s Division of Workers’ Compensation seeks to update the state’s Medical Treatment Utilization Schedule (MTUS). The DWC wants to align the MTUS with recent and not-so-recent guidelines from the American College of Occupational and Environmental Medicine (ACOEM).

The Division will hold a public hearing regarding the proposed updates on Wednesday, July 18 at 10 am.

MTUS 101

The MTUS offers guidelines for effective medical treatment to providers and utilization review organizations. California Labor Code Section 5307.27 empowers the DWC to:

..adopt, after public hearings, a medical treatment utilization schedule, that shall incorporate the evidence-based, peer-reviewed, nationally recognized standards of care...and that shall address, at a minimum, the frequency, duration, intensity, and appropriateness of all treatment procedures and modalities commonly performed in workers’ compensation cases.

The MTUS is nominally located in California Code of Regulations (CCR) Sections 9792.20 through 9792.26. However, these regulations simply adopt and incorporate by reference “evidence-based, peer-reviewed, nationally recognized” ACOEM guidelines.

ACOEM guidelines are accessible from ReedGroup with the purchase of a commercial license, at a cost of $100 per year.

Proposed New Guidelines

According to a recent DWC Newsline, the proposed changes would update the MTUS by adjusting CCR Sections 9792.22 and 9792.24.5 (draft update available here). The changes would align the MTUS with ACOEM guidelines in four areas (links lead to ACOEM guidelines currently available via DWC website):

1. Traumatic brain injury guidelines effective November 15, 2017
2. Prevention guidelines effective May 1, 2011
3. General Approach to Initial Assessment and Documentation guidelines effective July 25, 2016
4. Cornerstones of Disability Prevention and Management guidelines effective May 1, 2011

Labor Code § 5307.27 requires the DWC to allow a 30-day public comment period, and to hold the public hearing. The hearing will take place at the Elihu Harris Building on 1515 Clay Street, Oakland. The DWC will accept comments until the day of the hearing, July 18.

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