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.

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 medical providers physicians who treated 30 or more injured workers within the preceding 12 months. 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 provider and the providers 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 providers 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 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 medical providers who treated 30 or more injured workers within the preceding 12 months. The bill would require the outreach reports to contain information about, among other things, the number of injured workers treated by the provider and the providers 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 providers 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 provides that an engineer or any other person having charge of a certain steam-powered boiler, engine, or apparatus who willfully, or from ignorance or gross neglect, creates, or allows to be created, such an undue quantity of steam as to burst or break the boiler, engine, or apparatus, or to cause any other accident whereby human life is endangered, is guilty of a felony.

This bill would make nonsubstantive changes to that provision.

Date of Hearing: July 12, 2017

ASSEMBLY COMMITTEE ON INSURANCE

Tom Daly, Chair

SBPCA Bill Id:SB 617

Author:(Bradford) – As Amended Ver:May 26, 2017

SENATE VOTE: 40-0

SUBJECT: Workers’ compensation: providers

SUMMARY: Requires the Administrative Director (AD) of the Division of Workers’ Compensation (DWC) to 1) prepare a report to the Legislature on alternatives to the “fee-for-service” payment system used to compensate physicians who provide services to workers’ compensation claimants, and 2) to issue reports containing specified data to physicians who treat 30 or more injured workers in any year. Specifically, this bill:

1. Requires the AD, with input from the Commission on Health and Safety and Workers’ Compensation (CHSWC), to issue a report to the Legislature on or before January 1. 2019, comparing alternative compensation systems to the current fee-for-service system used to compensate workers’ compensation physicians.
2. Specifies that the report compare the advantages and disadvantages of the current system, and alternative payment systems such as capitation, bundled payments, quality incentives, and value-based payment systems.
3. Requires the AD, commencing January 1, 2020 and annually thereafter, to issue a report to physicians who treat 30 or more workers’ compensation patients in a year. The report shall include specified data, including the number of utilization review (UR) and independent medical review (IMR) denials or modifications of treatment the physician recommended, and the physician’s ranking relative to other physicians.
4. Requires the report to include information on training offered by the DWC.
5. Authorizes the DWC to provide other information as determined by the AD.
6. Contains technical and conforming language.

EXISTING LAW:

1. Establishes a comprehensive system to provide workers’ compensation benefits to employees who suffer injuries or conditions that arise out of or in the course of employment.
2. Establishes the position of AD to administer and implement the workers’ compensation laws of the state.
3. Establishes a series of “fee schedules” that are used to determine the compensation for most service providers, including workers’ compensation physicians, who provide services that are paid for by employers in the course of providing benefits to injured employees.

FISCAL EFFECT: According to the Senate Appropriations Committee, the bill would result in costs to the DWC ”in the low hundreds of thousands of dollars” paid by special fund revenues.

COMMENTS:

1. Purpose. According to the author, one of the few areas of agreement among all of the stakeholders in the workers’ compensation system is that there are far too many medical disputes. These medical disputes can be costly, result in delays in medical treatment, and reduce the likelihood that an injured worker will ultimately return to work. Moreover, efforts to reduce medical disputes have been a significant topic of legislation, most notably with SB 863 (Chapter 363, Statutes of 2012) and SB 1160 (Chapter 868, Statutes of 2016).

Recent research from the California Workers’ Compensation Institute (CWCI) suggests that medical disputes in the workers’ compensation system are not widespread: rather, they are uniquely concentrated among a few providers. Specifically, according to the CWCI study, 9% of all UR decisions came from 10 individuals, and the top 4% of providers account for 64% of all UR decisions. While it is not clear why there is such concentration, it is probable that these outliers are unaware of their outlier status. The bill is designed to empower the AD to regularly educate these providers with performance and comparison information.

1. Fee-for-service. Workers’ compensation is essentially the last bastion of third-party payor, fee-for-service medicine. What was historically the standard methodology for paying physicians and other health care providers is anachronistic everywhere – private health insurance, Medi-Cal, medicare – except workers’ compensation. While there may be reasons to treat workers’ compensation payments differently than in other medical treatment contexts, there is ample justification for a comprehensive evaluation of potential benefits of re-structuring the workers’ compensation payment structure. The bill proposes that evaluation.

REGISTERED SUPPORT / OPPOSITION:

Support

California Association of Joint Powers Authorities

Western Occupational and Environmental Medicine Association (WOEMA)

Opposition

None received.

Analysis Prepared by: Mark Rakich / INS. / (916) 319-2086

 THIRD READING  

Bill No: SB 617

Author:

Amended: 5/26/17

Vote:

SENATE LABOR & IND. REL. COMMITTEE: 4-0, 4/26/17

AYES: Bradford, Stone, Jackson, Mitchell

NO VOTE RECORDED: Atkins

SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/25/17

AYES: Lara, Bates, Beall, Bradford, Hill, Nielsen, Wiener

NOES:

SUBJECT:

SOURCE: Author

DIGEST:

This bill requires that the Division of Workers’ Compensation (DWC) issue annual reports to physicians who treat 30 or more injured workers annually and also requires the administrative director of the DWC to issue a report on potential alternatives to the current fee-for-service fee schedule.

ANALYSIS:

Existing law:

1. Establishes a workers’ compensation system that provides benefits to an employee who suffers from an injury or illness that arises out of and in the course of employment, irrespective of fault. This system requires all employers to secure payment of benefits by either securing the consent of the Department of Industrial Relations (DIR) to self-insure or by securing insurance against liability from an insurance company duly authorized by the state.
2. Provides that except as expressly permitted, a person or public or private entity not a party to a claim for workers’ compensation benefits cannot obtain individually identifiable information obtained or maintained by the DWC on that claim. “Individually identifiable information” is defined as any data concerning an injury or claim that is linked to a uniquely identifiable employee, employer, claims administrator, or any other person or entity. This prohibition on individually identifiable information extends to Public Records Act (PRA) requests and subpoenas, as specified.
   (Labor Code §138.7)
3. Provides that exemptions to the prohibition on obtaining individually identifiable information include maintaining the workers’ compensation information system database and publishing the names of claims adjusters for the purposes of an annual report. (Labor Code §138.7(b))

This bill:

1. Permits the DWC to use individually identifiable information in the creation of physician outreach reports discussed below.
2. Requires that, on or before January 1, 2020, and annually thereafter, the DWC must issue outreach reports to physicians who see 30 or more injured workers in the 12 months prior to July 1 of the previous year. The reports must include all of the following:
   1. The number of injured workers treated by the provider and the provider’s percentile rank in comparison to his or her peers.
   2. The number of utilization review (UR) decisions that resulted in a modification or denial of a request for authorization of medical treatment and the provider’s percentile rank in comparison to his or her peers.
   3. The number of independent medical review decisions requested due to a UR decision that resulted in a modification or denial, the number of independent review decisions that resulted in the UR modification or denial being overturned, and the provider’s percentile rank in comparison to his or her peers.
   4. Any educational or training resources offered by the DWC.
   5. Any additional report information as determined by the administrative director.
3. Exempts physician outreach reports from PRA requests and civil subpoenas, as specified.
4. Requires the administrative director, with input from the Commission on Health and Safety and Workers’ Compensation, issue a report to the Legislature, on or before January 1, 2019, comparing potential payment alternatives for providers to the current fee-for-service fee schedules, as well as recommend potential pilot programs.

Comments

Need for this bill? One of the few areas of agreement among all of the stakeholders in the workers’ compensation system is that there are far too many medical disputes. These medical disputes can be costly, result in delays in medical treatment, and reduce the likelihood that an injured worker will ultimately return to work. Moreover, efforts to reduce medical disputes have been a significant topic of legislation, most notably with SB 863 (De León, Chapter 363, Statutes of 2012) and SB 1160 (Mendoza, Chapter 868, Statutes of 2016).

Recent research from the California Workers’ Compensation Institute (CWCI) suggests that medical disputes in the workers’ compensation system are not widespread: rather, they are uniquely concentrated among a few providers.

Specifically, CWCI’s research shows that out of a population of 43,000 providers:

• In 2015-16, 9% of all utilization review (UR) decisions came from 10 individuals and the top 4% of providers account for 64% of all UR decisions.
• In 2015-16, 11% of all Independent Medical Review (IMR) decisions came from 10 individuals, and the top 4% of providers (499 individuals) account for 72% of all IMR decisions. 250 providers account for 58% of all IMR decisions.

Unfortunately, it is not clear why there is such a concentration among a small number of providers. Moreover, there are some confusing trends among this provider population. For example, the provider with the largest number of IMR decisions in 2016 was ranked 313 in 2015.

As discussed above, the strict protections on the use of individually identifiable information mean that it is likely illegal for the DWC to reach out to these providers and find out why there is such a concentration of medical disputes among such a small provider group. For example, it is possible that the providers may be unaware that their treatment requests generate significant medical disputes compared to their peers, and they may be unaware that the DWC offers training resources that would reduce the number of medical disputes. Moreover, in the case of individuals who generate significant numbers of medical disputes due to fraudulent schemes, communication from the DWC could inhibit or dissuade providers from continuing their participation in such schemes.

SB 617 requires that the DWC issue reports to medical providers who see 30 or more injured workers in a year that would state the number of injured workers the provider treated, the number of UR decisions that resulted in treatment being modified or denied, the number of IMR decision which upheld the modification or denial of the UR decision, and how the providers compare to their peers. SB 617 also allows the DWC to include additional information, such as educational resources or a questionnaire.

Additionally, some stakeholders have noted that the current fee-for-service fee schedule may be a source of friction and disputes in the workers’ compensation system. Alternative payment systems have been tested in other healthcare systems, but have not been explored in the California workers’ compensation system in nearly 20 years. SB 617 requires that the administrative director issue a study to the Legislature on potential alternatives to the current fee-for-service fee schedule.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee, the DIR would likely incur annual costs in the low hundreds of thousands of dollars to implement the provisions of this bill (special funds).

SUPPORT: (Verified 5/25/17)

None received

OPPOSITION: (Verified 5/25/17)

None received

ARGUMENTS IN SUPPORT: The author argues that the recent research conducted by CWCI shows an extreme concentration of medical disputes among a small number of providers in the workers’ compensation system. Further, the author argues that this concentration is not easily explained, may be a significant cost driver to the entire workers’ compensation system, and is a sign of dysfunction within the workers’ compensation system. Further, the author argues that existing legal prohibitions on the DWC to conduct outreach to providers does not serve the larger goals of the workers’ compensation well. The author believes that, by requiring outreach to providers who treat a large number of injured workers, SB 617 will begin the vital process of reaching out to these providers and shedding light on while such a large number of medical disputes are concentrated in such a small number of providers.

Prepared by:

5/27/17 18:21:11

**** END ****

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2017 - 2018 Regular Session

SB 617 (Bradford) - Workers’ compensation: providers

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on May 25, 2017

Bill Summary:

SB 617 would (1) require the Division of Workers’ Compensation (DWC) to issue annual reports to physicians who treat 30 or more injured workers annually, and (2) require the administrative director of DWC to issue a report to the Legislature of potential alternatives to the current fee-for-service fee schedule.

Fiscal Impact:

The Department of Industrial Relations would likely incur annual costs in the low hundreds of thousands of dollars to implement the provisions of the bill (special fund).

Author Amendments:

Amendments (1) narrow the scope of the bill to physicians, rather than all medical providers in the workers’ compensation system, and (2) streamline the timeline for compiling the reports in order to decrease staffing needs for the creation and dissemination of the outreach reports.

-- END --

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2017 - 2018 Regular Session

SB 617 (Bradford) - Workers’ compensation: providers

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

SB 617 would (1) require the Division of Workers’ Compensation (DWC) to issue annual reports to physicians who treat 30 or more injured workers annually, and (2) require the administrative director of DWC to issue a report to the Legislature of potential alternatives to the current fee-for-service fee schedule.

Fiscal Impact:

The Department of Industrial Relations (DIR) indicates that it would incur first-year costs of $483,000, and $460,000 annually in the out-years to implement the provisions of the bill (special fund).

Background:

In California’s workers’ compensation system, an employer or insurer cannot deny treatment. When an employer or insurer receives a request for medical treatment, it can either (1) approve the treatment or, (2) if it believes that a physician’s request for treatment is medically unnecessary or harmful, then it must send the request to Utilization Review (UR).

UR is the review process for medical treatment recommendations by physicians to determine whether the request for medical treatment is medically necessary. The full UR process varies, but generally involves initial review by a non-physician, with higher level review(s) being conducted by one or more physicians. Only a licensed physician who is competent to evaluate the specific clinical issues involved in the medical treatment services may modify, delay, or deny a request for medical treatment. If the UR physician does modify, delay, or deny the medical treatment, then the injured worker can appeal the decision to Independent Medical Review (IMR), but the UR decision must come first.

The Workers’ Compensation Information System (WCIS) is a database run by DWC that serves as a warehouse of employer data on workplace injuries and medical bills. DWC uses these data to determine the effectiveness of the workers’ compensation system. Additionally, researchers use the WCIS to study the system in order to better understand how laws and regulations impact injured workers and employers. To the extent that information reported into WCIS is erroneous or incomplete, its effectiveness as a research tool to evaluate the workers’ compensation system is reduced.

Medical disputes within the workers compensation system can be costly, result in delays in medical treatment, and reduce the likelihood that an injured worker will ultimately return to work. Recent research from the California Workers’ Compensation Institute (CWCI) suggests that medical disputes in the workers’ compensation system are not widespread; on the contrary, they are generally concentrated among a few providers. Specifically, CWCI’s research shows that out of a population of 43,000 providers:

• In 2015-16, 9 percent of all UR decisions came from 10 individuals. The top 4 percent of providers accounted for 64 percent of all UR decisions.
• In 2015-16, 11 percent of all IMR decisions came from 10 individuals, and the top 4 percent of providers (499 individuals) accounted for 72 percent of all IMR decisions.

Clearly, then, there is concentration among a small number of providers; however, it is unclear why this is so. Moreover, there are some confusing trends within this provider population. For example, the provider with the largest number of IMR decisions in 2016 was ranked 313 in 2015.

The strict protections on the use of individually identifiable information result in it likely being illegal for DWC to reach out to these providers and find out why there is such a concentration of medical disputes among such a small provider group. For example, it is possible that the providers may be unaware that their treatment requests generate significant medical disputes compared to their peers, and they may be unaware that DWC offers training resources that would reduce the number of medical disputes. Moreover, in the case of individuals who generate significant numbers of medical disputes due to fraudulent schemes, communication from the DWC could inhibit or dissuade providers from continuing their participation in such schemes.

Proposed Law:

This bill would do the following:

• Permit DWC to use individually identifiable information in the creation of physician outreach reports discussed below.
• Require that, by January 1, 2020, and annually thereafter, DWC must issue outreach reports to physicians who see 30 or more injured workers in the prior 12 months. The reports must include all of the following:
  • The number of injured workers treated by the provider and the provider’s percentile rank in comparison to his or her peers.
  • The number of UR decisions that resulted in a modification or denial of a request for authorization of medical treatment and the provider’s percentile rank in comparison to his or her peers.
  • The number of IMR decisions requested due to a UR decision that resulted in a modification or denial, the number of independent review decisions that resulted in the UR modification or denial being overturned, and the provider’s percentile rank in comparison to his or her peers.
  • Any additional report information as determined by the administrative director.
• Exempt physician outreach reports from PRA requests.
• Require the administrative director, with input from the Commission on Health and Safety and Workers’ Compensation, issue a report to the Legislature by January 1, 2019, comparing potential payment alternatives for providers to the current fee-for-service fee schedules, as well as recommend potential pilot programs.
• Exempt the outreach reports from subpoena in a civil proceeding, unless specified conditions are met.

Related Legislation:

SB 1160 (Mendoza, Chapter 868, Statutes of 2016), created an expedited utilization review process for medical care provided in the first 30 days of a workers’ compensation claim.

Staff Comments:

As noted above, this bill would require the administrative director of DWC to issue outreach reports to medical providers that treat 30 or more injured workers in the prior 12 months. This would require staff to develop procedures to create an objective comparison of doctors across the workers compensation system, extract, review and verify the data and then create the reports and distribute the information annually. DIR estimates that this would require an additional $483,000 initially and $460,000 ongoing to fund the necessary staff resources to implement these requirements.

-- END --

SENATE COMMITTEE ON LABOR AND INDUSTRIAL RELATIONS

Senator Steven Bradford, Chair

2017 - 2018 Regular

Bill No: SB 617 Hearing Date: April 26, 2017

Subject: Workers’ compensation: providers

KEY ISSUE

Should the Legislature require that the Division of Workers’ Compensation (DWC) issue annual reports to physicians who treat 30 or more injured workers annually?

Should the Legislature require the administrative director of the DWC to issue a report to the legislature of potential alternatives to the current fee-for-service fee schedule?

ANALYSIS

Existing law:

1. Establishes a workers’ compensation system that provides benefits to an employee who suffers from an injury or illness that arises out of and in the course of employment, irrespective of fault. This system requires all employers to secure payment of benefits by either securing the consent of the Department of Industrial Relations to self-insure or by securing insurance against liability from an insurance company duly authorized by the state.
2. Except as expressly permitted, a person or public or private entity not a party to a claim for workers’ compensation benefits cannot obtain individually identifiable information obtained or maintained by the DWC on that claim. “Individually identifiable information” is defined as any data concerning an injury or claim that is linked to a uniquely identifiable employee, employer, claims administrator, or any other person or entity. This prohibition on individually identifiable information extends to Public Records Act (PRA) requests and subpoenas, as specified.
   (Labor Code §138.7)
3. Exemptions to the prohibition on obtaining individually identifiable information include maintaining the workers’ compensation information system database and publishing the names of claims adjusters for the purposes of an annual report. (Labor Code §138.7(b))

This bill:

1. Permits the DWC to use individually identifiable information in the creation of physician outreach reports discussed below.
2. Requires that, on or before January 1, 2020, and annually thereafter, the Division of Workers’ Compensation (DWC) must issue outreach reports to physicians who see 30 or more injured workers in the prior 12 months. The reports must include all of the following:
3. The number of injured workers treated by the provider and the provider’s percentile rank in comparison to his or her peers.
4. The number of utilization review decisions that resulted in a modification or denial of a request for authorization of medical treatment and the provider’s percentile rank in comparison to his or her peers.
5. The number of independent medical review decisions requested due to a utilization review decision that resulted in a modification or denial, the number of independent review decisions that resulted in the utilization review modification or denial being overturned, and the provider’s percentile rank in comparison to his or her peers.
6. Any additional report information as determined by the administrative director.
7. Exempts physician outreach reports from PRA requests.
8. Requires the administrative director, with input from the Commission on Health and Safety and Workers’ Compensation, issue a report to the Legislature, on or before January 1, 2019, comparing potential payment alternatives for providers to the current fee-for-service fee schedules, as well as recommend potential pilot programs.

COMMENTS

1. Need for this bill?

One of the few areas of agreement among all of the stakeholders in the workers’ compensation system is that there are far too many medical disputes. These medical disputes can be costly, result in delays in medical treatment, and reduce the likelihood that an injured worker will ultimately return to work. Moreover, efforts to reduce medical disputes have been a significant topic of legislation, most notably with SB 863 (Chapter 363, Statutes of 2012) and SB 1160 (Chapter 868, Statutes of 2016).

Recent research from the California Workers’ Compensation Institute (CWCI) suggests that medical disputes in the workers’ compensation system are not widespread: rather, they are uniquely concentrated among a few providers.

Specifically, CWCI’s research shows that out of a population of 43,000 providers:

• In 2015-16, 9% of all utilization review (UR) decisions came from 10 individuals and the top 4% of providers account for 64% of all UR decisions.
• In 2015-16, 11% of all Independent Medical Review (IMR) decisions came from 10 individuals, and the top 4% of providers (499 individuals) account for 72% of all IMR decisions. 250 providers account for 58% of all IMR decisions.

Unfortunately, it is not clear why there is such a concentration among a small number of providers. Moreover, there are some confusing trends among this provider population. For example, the provider with the largest number of IMR decisions in 2016 was ranked 313 in 2015.

As discussed above, the strict protections on the use of individually identifiable information mean that it is likely illegal for the DWC to reach out to these providers and find out why there is such a concentration of medical disputes among such a small provider group. For example, it is possible that the providers may be unaware that their treatment requests generate significant medical disputes compared to their peers, and they may be unaware that the DWC offers training resources that would reduce the number of medical disputes. Moreover, in the case of individuals who generate significant numbers of medical disputes due to fraudulent schemes, communication from the DWC could inhibit or dissuade providers from continuing their participation in such schemes.

SB 617 would require that the DWC issue reports to medical providers who see 30 or more injured workers in a year that would state the number of injured workers the provider treated, the number of UR decisions that resulted in treatment being modified or denied, the number of IMR decision which upheld the modification or denial of the UR decision, and how the providers compare to their peers. SB 617 would also allow the DWC to include additional information, such as educational resources or a questionnaire.

Additionally, some stakeholders have noted that the current fee-for-service fee schedule may be a source of friction and disputes in the workers’ compensation system. Alternative payment systems have been tested in other healthcare systems, but have not been explored in the California workers’ compensation system in nearly 20 years. SB 617 would require that the administrative director issue a study to the Legislature on potential alternatives to the current fee-for-service fee schedule.

2. Potential Amendments:

As discussed above, the outreach reports required by SB 617 could be used to disseminate education and training information that may be of use to high-volume providers, but is not explicitly listed as an information item that should be listed on the report. Similarly, while individually identifiable informational is partially shielded from civil subpoenas, SB 617 does not explicitly state that the reports are shielded. To address these discrepancies, the Committee may wish to consider the following amendments:

1. On page 6, between lines 26 and 27 insert:
   (4) Any educational or training resources offered by the division.
2. On page 6, line 27, strike (4) and insert (5).
3. On page 6, between lines 33 and 34, insert:
   (c) Outreach reports created pursuant to subdivision (a) are privileged and are not subject to subpoena in a civil proceeding unless, after reasonable notice to the division and a hearing, a court determines that the public interest and the intent of this section will not be jeopardized by disclosure of the information. This section shall not operate to restrict access to information by any law enforcement agency or district attorney’s office or to limit admissibility of that information in a criminal proceeding.

3. Proponent Arguments:

The author argues that the recent research conducted by CWCI shows an extreme concentration of medical disputes among a small number of providers in the workers’ compensation system. Further, the author argues that this concentration is not easily explained, may be a significant cost driver to the entire workers’ compensation system, and is a sign of dysfunction within the workers’ compensation system. Further, the author argues that existing legal prohibitions on the DWC to conduct outreach to providers does not serve the larger goals of the workers’ compensation well. The author believes that, by requiring outreach to providers who treat a large number of injured workers, SB 617 will begin the vital process of reaching out to these providers and shedding light on while such a large number of medical disputes are concentrated in such a small number of providers.

4. Prior Legislation:

SB 1160 (Mendoza), Chapter 868, Statutes of 2016, created an expedited utilization review process for medical care provided in the first 30 days of a workers’ compensation claim.

SUPPORT

None received.

OPPOSITION

None received.

-- END --