California Workers' Comp
Jul 24, 2025
Diabolical Discounts: Rampant Anthem PPO Carnage
Preferred Provider Organization (PPO) Anthem Blue Cross is enabling egregious abuse of California providers at scale. Since June, dozens of claims administrators have ...
Jul 23, 2025
Alert: Innovative Claim Solutions' Misleading “ePay” Message
Third-Party Administrator (TPA) Innovative Claim Solutions (ICS) sent a misleading message to providers, counterfactually claiming to be “phasing out” paper checks—and potent...
Jul 18, 2025
Diabolical Discounts: Berkshire Hathaway's Reimbursement Roulette (Part 1)
A sad fact about California workers’ comp: once a doctor joins a Preferred Provider Organization (PPO), there’s no predicting how devastating the impact on practice revenue w...
Jul 16, 2025
Sedgwick: CA Doctors Still Waiting for Purloined PPO Reimbursement
In January, Sedgwick Claims Management Services, Inc. admitted to shortchanging a California orthopedic practice by hundreds of thousands of dollars—thanks to bogus Preferred...
Jun 26, 2025
CA RFA Hell: Affirmative Cites the Most Cynical Excuse Yet to Deny Care
What’s the most absurd, bureaucratic, procedurally abusive excuse a claims administrator ever used to deny care to an injured worker?We’ve seen our share of bad-faith ...
Jun 24, 2025
CA OMFS Update: Physician Services (Q3 2025)
California’s Division of Workers’ Compensation (CA DWC) issued a third-quarter update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Sche...
Jun 20, 2025
City of Riverside Pays MD $31 by Triple-Stacking PPOs
This week’s Diabolical Discounter is the City of Riverside. This self-insured public employer slashed a doctor’s reimbursement for a municipal worker’s Evaluation and Managem...
Jun 19, 2025
DWC Data: Texas Delivers, California Dodges
The Texas Division of Workers’ Compensation (TX DWC) and the California Division of Workers’ Compensation (CA DWC) each hold a sacred public trust to oversee the treatment of...
Jun 17, 2025
CA Advances New Med-Legal Law. Will CA DWC Ignore It?
On June 2, the California Assembly unanimously passed Assembly Bill 1293, which aims to improve the state’s Medical-Legal process for resolving disputes between injure...
Jun 16, 2025
CA DWC Ignores IBR Law That Protects Doctors
California’s Division of Workers’ Compensation (CA DWC) is violating state law daily by failing to timely assign payment disputes to Independent Bill Review (IBR).Maxi...
Jun 13, 2025
Diabolical Discounts: CA Employers Are Getting Ripped Off
In California, doctors who treat injured workers are seeing their revenue collapse due to exploitative discount reimbursement schemes. California Senate Bill 863, whic...
Jun 10, 2025
Report: CA DIR Director Hagen Resigning
According to Workers’ Comp Executive, California Department of Industrial Relations (DIR) Director Katrina Hagen is stepping down after five years. The Californ...