Most Recent Articles

CA DWC Seeks Public Comment on MTUS Updates
Jul 16, 2018
CA DWC Seeks Public Comment on MTUS Updates
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-...
Football, Workers’ Comp, Traumatic Brain Injuries, and Utilization Review: WCAB Emphasizes UR Regulations
Mar 15, 2016
Football, Workers’ Comp, Traumatic Brain Injuries, and Utilization Review: WCAB Emphasizes UR Regulations
A recent court case highlights two connected battles unfolding in front of vastly different audiences. The high-profile battle takes place in headlines, on ESPN, and in the m...
A Year Later, San Bernardino Victims Face Work Comp Struggle
Dec 2, 2016
A Year Later, San Bernardino Victims Face Work Comp Struggle
A flurry of recent media attention brought light to the struggle for treatment endured by victims of last year’s San Bernardino terrorist attack.¹ On the first anniversary of...
Reform the Reforms: SB 489 Aims to Clean Up SB 1160
Apr 13, 2017
Reform the Reforms: SB 489 Aims to Clean Up SB 1160
Let’s start with some simple facts. Each two-year session of the California legislature can see as many as 5,000 bills introduced. Of those 5,000, Governor Brown will probabl...
Updates to California's Guidelines for the Medical Treatment Utilization Schedule (MTUS)
Apr 10, 2019
Updates to California's Guidelines for the Medical Treatment Utilization Schedule (MTUS)
The California Division of Workers’ Compensation (DWC) recently made two important announcements concerning the Medical Treatment Utilization Schedule (MTUS).First, th...
Maximus & DWC Drop Ball on IBR Eligibility
Oct 22, 2019
Maximus & DWC Drop Ball on IBR Eligibility
California workers’ comp billing and payment regulations are a minefield of complications. That said, some rules are fairly simple, and should be immutable. For exampl...
California - 3 Workers' Comp Authorization Myths, Debunked
Feb 18, 2020
California - 3 Workers' Comp Authorization Myths, Debunked
Providers who treat injured workers have one simple, reasonable request: correct reimbursement. In helping providers to obtain correct reimbursement, we answer a daily...
Ease Authorization Requirements for Workers' Comp During COVID-19
Apr 9, 2020
Ease Authorization Requirements for Workers' Comp During COVID-19
For California providers, obtaining authorization for workers’ compensation treatment requires substantial administrative resources. As COVID-19 strains those resources, prio...
CA: Authorization for Treatment Provided via Telehealth
Apr 24, 2020
CA: Authorization for Treatment Provided via Telehealth
When we published Telehealth Cheat Sheet: California Providers’ Guide, many providers reached out to us with questions regarding authorization requirements. For clarification...
Providers, Ignore Anthem's Incorrect Telehealth Claims (and don't ingest Lysol, either)
Apr 27, 2020
Providers, Ignore Anthem's Incorrect Telehealth Claims (and don't ingest Lysol, either)
On Friday, Anthem Workers’ Compensation sent an email to workers’ comp providers with misleading claims regarding telehealth compliance. The email misrepresents telehealth pr...
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Sep 21, 2021
Dollar Tree/Sedgwick Won’t Pay for Authorized Treatment
Authorization is, by definition, a promise.It’s the promise that, once a doctor obtains authorization from an employer to treat an injured worker, the employer will pa...
Zurich Refuses to Pay for Emergency Treatment
Oct 14, 2021
Zurich Refuses to Pay for Emergency Treatment
In a medical emergency, a doctor treats first and asks questions later. But in response to a medical emergency, Zurich refused to pay a doctor for suturing a lacerated finger...