On May 20, 2021, the California legislature passed AB-1465 in a unanimous 16-0 vote. AB-1465 amends the Labor Code to add and repeal (as of January 1, 2025) Section 77.9, related to workers’ compensation. Section 77.9 requires that the Commission on Health and Safety and Workers’ Compensation submit to the Legislature and the Department of Industrial Relations (DIR) Division of Workers’ Compensation (DWC), a study on medical provider networks. The study, to be delivered no later than January 1, 2023, must compare data for injury claims in which workers were treated by a medical provider network (MPN) with the same data for those treated by doctors not part of an MPN.
The study is required to contain, at a minimum:
(1) An examination of injury claims in which a worker was treated by a medical provider network compared to injury claims in which a worker was treated by a provider who is not part of a medical provider network to determine the length of time between injury and initial treatment in the two systems and the reason for potential delays before workers receive initial treatment.
(2) An examination of injury claims in which a worker was treated by a medical provider network compared to injury claims in which a worker was treated by a provider who is not part of a medical provider network to determine the frequency and causes of delays after a worker receives initial treatment.
(3) An examination of injury claims in which a worker was treated by a medical provider network compared to injury claims in which a worker was treated by a provider who is not part of a medical provider network to determine the distance, in miles, between the injured worker and the treating provider, including primary care physicians and specialty physicians.
(Labor Code Section 77.9 (a))
SRTK will continue to closely monitor these legislative developments. As always, if you have questions about what these regulations or other developments may mean for you or your cases, please contact our offices.