Most Recent Articles
Mar 22, 2016
DWC Cracking Down on Late Responses to Requests for Authorization
On February 10th, 2016, the DWC issued DIR Newsline 2016-19 reminding claims administrators that adhering to Utilization Review (UR) timelines is mandatory and that failure t...
Jan 9, 2018
DWC 2018 Drug Formulary Webinar Transcript Available
Last month, Division of Workers’ Compensation (DWC) hosted a detailed live webinar on the newly effective drug formulary. For those who could not attend the webinar, the DWC ...
Dec 12, 2017
Provider Alert: California Prescription Drug Formulary Effective January 2018
Last week, California’s Office of Administrative Law approved the Division of Workers’ Compensation (DWC)’s proposed evidence-based drug formulary. Through the formulary, the...
Mar 29, 2018
“Secret Settlements” - Double Standard for IMR Rules
Since the introduction of Independent Medical Review (IMR), claims administrators working on behalf of employers and insurers haven’t always played fair. In seeking to uphold...
Aug 11, 2017
How MPNs Are Hurting Workers’ Comp
Last week on the blog, we argued that the RFA system in California workers’ comp is broken – it’s failing providers, and it’s restricting injured employees’ access to care. O...
Jan 19, 2018
DWC 2018 Drug Formulary Webinar Video Available
The Division of Workers' Compensation (DWC) posted a video replay of their recent webinar on the newly effective drug formulary. The DWC hosted the webinar in December, follo...
Jul 25, 2017
Comments Open For Revised Workers’ Comp Drug Formulary
When state legislators proposed a workers’ comp drug formulary back in 2015, they knew it would take some time to work out all the kinks. But legislators may not have foresee...
Jul 20, 2017
Reminder: Consultation Codes Not Payable Without Authorization
Here’s an uncontroversial statement: Workers’ comp is constantly changing. In fact, rules and regulations change so quickly that many medical billers and providers struggle t...
Sep 13, 2018
CA Drug Formulary Update Effective October 1
California’s Division of Workers’ Compensation (DWC) issued an update to Medical Treatment Utilization Schedule (MTUS) drug formulary, effective October 1, 2018. The formular...
Oct 12, 2018
CA: Employers 100% Responsible for UR Mistakes
In a much-anticipated ruling, California’s Supreme Court ruled that a secondary injury derived from an incorrect Utilization Review (UR) decision is compensable under workers...
Feb 9, 2018
What’s New for Workers’ Comp in 2018: CA Senate Bill 1160
In 2016 California passed Senate Bill 1160, which heralded significant workers’ compensation reform. SB 1160 outlined major changes to authorization, utilization review, lien...
Sep 22, 2016
Work Comp News: Final MTUS and More
The DWC finalizes the MTUS regulations in response to reports of widespread opioid abuse:Updates the Chronic Pain Medical Treatment Guidelines.Adopts Opioids Tr...