California DWC

LA Metro Transit Authority: 12,879 Audit Complaints Filed

The Los Angeles County Metropolitan Transit Authority (LA Metro), a public self-insured employer, fails to fulfill one of its most basic (but essential) legal obligations to ...

DWC's Updated IBR Form - F Is for Fail

California’s Division of Workers’ Compensation (DWC) recently updated Form IBR-1, which providers use to request an Independent Bill Review (IBR)—but did so without publicizi...

CA OMFS Update: Physician Services (Q3 2024)

California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...

Anthem's THM Network Closes, Stiffs Providers

Workers’ comp providers—in particular ancillary providers like physical therapists (PTs)—take note: if you have treated injured workers through Anthem’s Transparent Health Ma...

DWC MPN Meeting Accomplishes Nothing

Last week, California’s Division of Workers’ Compensation (DWC) held an informal stakeholder meeting to discuss its proposed changes to the regulations governing Medical Prov...

acūrrō Reprocesses Underpaid CA Bills

Sometimes, seeking correct reimbursement for treating injured workers doesn’t require a battle between providers and payers. Claims administrators and their vendors ca...

CA MPNs Harm Employers, Injured Workers & Providers

California’s Medical Provider Network (MPN) system is an unmitigated failure, causing genuine harm to injured workers, health care providers, and employers. The Divisi...

CA DWC: Claims Administrators' IBR Wingman

In California, claims administrators can expect little or no repercussions for failing to comply with workers’ comp payment laws and regulations. Meanwhile, the Divisi...

Sedgwick: 17,225 Audit Complaints Sent to DWC

Sedgwick Claims Management, Inc. continues to defy California law and regulations for properly responding to Second Review appeals. And why wouldn’t they, without any consequ...

Sedgwick Denies/Ignores Hundreds of Appeals

Sedgwick's persistent failure to pay providers in accordance with state workers' comp fee schedules and its refusal to respond compliantly to providers’ appeals are glaring v...

daisyData: CA e-EOR Most / Least Compliant Claims Admins

California mandates that all (repeat: all) workers’ comp claims administrators accept electronic bills from providers and respond to those e-bills with electronic Explanation...

CA DWC Website Deletions Enrich Claims Administrators

Given the complexity of workers’ comp (and the myriad ways claims administrators improperly deny requests for treatment and payment), knowledge is a precious resource for pro...