Most Recent Articles
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-...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
Nov 11, 2021
The Hartford Ignores TWO California Laws
By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...