Medical Provider Networks

CA: AB-1278 Gives Networks Control of Workers' Comp

California's Medical Provider Network (MPN) system is an absolute debacle, leaving workers' comp doctors and injured workers in perpetual uncertainty. The system fails to all...

CA Bill Strips Workers’ Choice of Doctor

California Assembly Bill 1278, if passed, will severely limit an injured worker’s choice of physician — and force physicians into low-paying networks.Currently, a Medi...

Sedgwick: Sham MPN Impedes Care?

If you need proof that California’s Medical Provider Network (MPN) system is catastrophically flawed, look no further than the case of the injured worker below.Third-P...

Coventry Emails Expose PPO/MPN Mirage

A series of emails between a California doctor and Coventry expose the unvarnished truth about Preferred Provider Organizations (PPOs) and Medical Provider Networks (MPNs). <...

Marriott - Networks Pocket Doctors' Pay

Does the Marriott hotel chain know where the money really goes when it pays for its employees’ medical treatment?Self-insured and with its own in-house claims administ...

CA DWC Must Stop Pretending MPNs Work

A real friend tells the truth, even when it’s uncomfortable to hear. As advocates for a better workers’ comp system, we haven’t been shy about pointing out its shortco...

MPNs: How to Detect Dubious Payment Denials

In California workers’ comp, one of the biggest — but least talked about — challenges for providers is navigating the Medical Provider Network (MPN) system. MPNs were ...

Sedgwick Stiffs QME With False MPN Denial (Again)

It’s been said that insanity is best defined by doing the same thing repeatedly, but expecting different results. If that’s the case, Sedgwick Claims Management Services has ...

Employers Insurance: False MPN Payment Denial

California allows insurers and self-insured employers to establish Medical Provider Networks (MPNs) to direct injured workers’ care. While Employers Preferred Insurance Compa...

Gallagher Bassett: False MPN Denial

In yet another instance of a claims administrator improperly denying payment because the provider was (allegedly) not a member of the applicable Medical Provider Network (MPN...

AmTrust: False MPN Payment Denial

AmTrust North America, a Third-Party Administrator (TPA), offered a perfect example of what makes the Medical Provider Network (MPN) system so challenging for California work...

CA MPN List Updates Q4 2022

The California Division of Workers’ Comp (DWC) updated its list of Medical Provider Networks (MPNs). The DWC update:Added 2 new MPNsApproved 3 previously suspen...