SB 403

Bill Subjects

Abstract

Existing law establishes a workers' compensation system, administered by the Administrative Director of the Division of Workers' Compensation, to compensate an employee for injuries incurred in the course of employment. Existing law requires the administrative director, after public hearings, to adopt and revise periodically an official medical fee schedule that establishes reasonable maximum fees paid for medical services other than physician services, drugs and pharmacy services, health care facility fees, home health care, and all other treatment, care, services, and specified goods. Existing law authorizes a health care provider or licensed health facility and a contracting agent, employer, or carrier to contract for reimbursement rates different from those in the fee schedule. Existing law authorizes the Workers' Compensation Appeals Board to determine and allow certain expenses, including certain reasonable expenses incurred by or on behalf of the injured employee for medical and hospital treatment, as liens against any award of compensation. This bill, commencing March 1, 2010, would prohibit a lien claim for expenses incurred by or on behalf of the injured employee for medical and hospital treatment from being filed more than one year from the date the health care provider, or the health care provider's agent, was sent an explanation of benefits or explanation of review paying a bill pursuant to the official medical fee schedule or a preferred provider organization (PPO) agreement. The bill would provide that this prohibition shall apply without regard to whether the injury occurs before, on, or after March 1, 2010.