Report 2019-102 Recommendation Responses
Report 2019-102: Department of Industrial Relations: Its Failure to Adequately Administer the Qualified Medical Evaluator Process May Delay Injured Workers' Access to Benefits (Release Date: November 2019)
Recommendation for Legislative Action
To ensure that DWC maintains a sufficient supply of QMEs and appropriately compensates these individuals, the Legislature should amend state law to specify that DWC review and, if necessary, update the medical-legal fee schedule at least every two years based on inflation. DWC's review of the medical-legal fee schedule should be separate from its review of the Official Medical Fee Schedule.
Description of Legislative Action
AB 404 (Salas, 2021) would require the DWC to review the medical-legal fee schedule every two years and update, if necessary, to increase the conversion factor by the percentage increase in the most recent federal Medicare Economic Index. This bill is pending in the Senate Appropriations Committee.
- Legislative Action Current As-of: November 2021
California State Auditor's Assessment of Annual Follow-Up Status: Legislation Introduced
Description of Legislative Action
AB 1815 (Daly/Salas, 2020) would have required the DWC Administrative Director to adopt and revise the medical-legal fee schedule at least every two years and to do so separate and apart from adopting and revising the medical fee schedule . This bill failed passage due to the adjournment of the 2019-20 Regular Legislative Session.
- Legislative Action Current As-of: November 2020
California State Auditor's Assessment of 1-Year Status: Legislation Proposed But Not Enacted
Description of Legislative Action
AB 1815 (Daly/Salas) would require the DWC Administrative Director to adopt and revise the medical-legal fee schedule at least every two years and to do so separate and apart from adopting and revising the medical fee schedule.
- Legislative Action Current As-of: May 2020
California State Auditor's Assessment of 6-Month Status: Legislation Introduced
Description of Legislative Action
AB 1832 (Salas, 2019) would require the Administrative Director of the Division of Workers' Compensation to increase the conversion factor for the fee scheduled quarterly, as necessary, to reflect any increase in the Bureau of Labor Statistics Consumer Price Index for medical care, as specified. The bill would also require the administrative director, on or before January 15, 2020, to assign a reasonable relative value, greater than zero, for a missed or failed appointment for a comprehensive or follow-up medical-legal evaluation and for a review of medical records associated with a missed or failed appointment. As of January 2020, this bill is pending in the Assembly Insurance Committee.
- Legislative Action Current As-of: January 2020