SB 617: Workers’ compensation: providers.

Session Year: 2017-2018
House: Senate

Version:

Existing law establishes a workers compensation system, administered by the Administrative Director of the Division of Workers Compensation, to compensate an employee for injuries sustained in the course of his or her employment. The California Public Records Act requires state and local agencies to make public records available for inspection by the public, subject to specified criteria and with specified exceptions. Existing law exempts from disclosure specified records, including, among others, personnel, medical, or similar files when disclosure would constitute an unwarranted invasion of personal privacy.

This bill would require the administrative director, with input from the Commission on Health and Safety and Workers Compensation, to issue a report to the Legislature, on or before January 1, 2019, comparing potential payment alternatives for providers, as specified, to the current fee-for-service fee schedules.The bill would require the administrative director, on or before January 1, 2020, and annually thereafter, to issue outreach reports to physicians who treated 30 or more injured workers during the 12 months prior to July 1 of the previous year. The bill would require the outreach reports to contain information about, among other things, the number of injured workers treated by the physician and the physicians percentile rank in comparison to peers, and the number of utilization review decisions that resulted in a modification or denial of a request for authorization of medical treatment and the physicians percentile rank in comparison to peers. The bill would authorize the administrative director to use individually identifiable information for purposes of creating those reports. This bill would exempt the individually identifiable information in these reports from the California Public Records Act on the grounds that the disclosure of that information could constitute an unwarranted invasion of personal privacy. The bill would make the outreach reports privileged and exempt the outreach reports from subpoena in a civil proceeding, unless specified conditions are met.

Existing law makes an employer liable only for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment. Existing law also requires that apportionment of permanent disability be based on causation and requires a physician who prepares a report addressing the issue of permanent disability due to a claimed industrial injury to address in that report the issue of causation of the permanent disability.

This bill would require that heredity and genetics be excluded as bases of causation for purposes of determining the apportionment of permanent disability.

Discussed in Hearing