Medical Provider Networks

CA Providers: Good Luck Fighting MPN Payment Denials

Yesterday, daisyNews shared data on payment denials citing non-membership in Medical Provider Networks (MPNs) and, in multiple cases, showed that ...

CA: Suspicious MPN Payment Denials Are Rampant

In California, Medical Provider Networks (MPNs) theoretically allow employers and their comp insurers to ensure that injured workers receive appropriate care at reasonable co...

Data: PPOs Are Another “Cost Control” Measure That Hurts CA Employers

California employers pay more than almost any other state for comp coverage, with premiums set to rise again in September. California claims take twice as long and cost twice...

The Hartford’s Authorization Exposes “Pay to Treat” System

California employers pay insurers like The Hartford to ensure that when one of their employees sustains a work injury, the providers who treat them get paid. Instead, ...

The Hartford Denies Payment With Bogus MPN Claim

As daisyNews frequently explains, California's Medical Provider Network (MPN) system accomplishes nothing other than making treatment less accessible for injured worke...

NY WCB Is Right to Celebrate. What Can CA Learn?

New York's Workers' Compensation Board (NY WCB) recently issued a bulletin touting its accomplishments over the last several years. While it’s hard not to be skeptical of a g...

CA MPNs: The "Cost Control" Tool That Costs Employers More

In a workers’ comp claim, the treating physician is the single most consequential factor in health outcomes, the duration of disability payments, and employer liability. ...

CA: CNA "Authorization" Doesn't Authorize Anything

CNA sent a California provider a treatment authorization letter that may double as a setup for nonpayment. The letter purports to authorize care while simultane...

Zurich's MPN Violates CA Law (Again) - Tesla Should Be Asking Questions

To ensure injured workers' access to care, California has laws governing Medical Provider Networks (MPNs). Zurich Insurance North America continues to treat those laws as opt...

CA Pays 155% Medicare. Physicians Get 128%. Where's the Rest?

California's Official Medical Fee Schedule comprises multiple fee schedules governing reimbursement for different categories of workers' comp medical care. Below, we break do...

How Marriott Hides Its Doctors From Its Own Injured Workers

Imagine you're a Marriott employee who gets hurt on the job. California law allows Marriott to restrict your care to doctors in its Medical Provider Network (MPN). This means...

How CA’s Medical Provider Network (MPN) System Works and Why It Fails Injured Workers

What Is an MPN?An MPN is a network of physicians and specialists established by an employer or insurer, to which covered workers are restricted. The idea is to control...