Preferred Provider Organization

CA's Fee Schedule Increase Was a Raise for PPOs, Not So Much for Physicians

The California Division of Workers’ Compensation (CA DWC) raised Physician Fee Schedule rates effective March 1, 2026. The agency increased the Conversion Factor used to calc...

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...

Former PPO Employee: "I Felt Like I Was 'Legally' Robbing" Doctors

Prime Health Services (PHS) operates like a high-pressure "call center," pushing employees to sign providers onto reimbursement discount contracts by making promises t...

CA: How to Challenge PPO Discounts

California providers, if you suspect a reimbursement discount is invalid, you have the right to demand proof of an applicable discount contract.As we detailed last wee...

daisyData: CA Providers Paid at Fractions of Fee Schedule Rates

As daisyNews recently demonstrated with current, verifiable data:California’s workers’ comp fee schedule is one of the lowest nationwide, andData from ov...

Taxpayers Beware: Anaheim Misreports Payment Data

Citizens of Anaheim, CA, may want to examine the city’s books closely, given the suspicious accounting of taxpayer dollars designated for the care...

CA Employers: Comp Premium Hike Based On Bad Data

While most states are lowering employers’ workers’ comp premiums, California is heading in the opposite direction. Insurance Commissioner Ricardo Lara approved a premium rate...

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 ...

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...