RBRVS bill advances to final committees
California legislators this week broke for summer recess, deferring several pieces of Workers’ Compensation until mid-August and the waning weeks of the session. These include two bills on which WOEMA has been actively engaged:
SB 923 (De Leon), sponsored by US HealthWorks, would compel the Division of Worker’s Compensation to adopt an RBRVS-based physician fee schedule by 2013. WOEMA has been aggressively lobbying the bill for several months, helping it to advance through the Senate policy and fiscal committees, Senate Floor, and the Assembly Insurance Committee, where Dr. Paul Papanek gave strong supporting testimony.
So far, the bill has travelled a tightrope. In its current form, SB 923 does not set conversion factors, billing ground rules, or any other factor that would suggest DWC arrive at any particular level of reimbursement for any group of codes. However, specialty physician, other provider groups and the CMA are seeking protections for current procedural payments, while labor and employer groups have remained neutral precisely because the bill does not ask that more dollars overall be spent on physician services.
WOEMA continues to work closely with the bill’s sponsors in shepherd SB 923 through the legislative process.
Link to SB 923
AB 378 (Solorio) is an attempt to end the over-prescription and over-dispensing of compounds, convenience packs, and medical foods. The bill sensibly requires that DWC develop a fee schedule for compounds, with most of the discussion centering on how compounds should be reimbursed until DWC can actually do the work. Although WOEMA supports the bill, we are working with the author’s office and our fellow physician organizations to change a provision that would cap reimbursement for any office-dispensed product at 120 percent of cost. AB 378 is a complicated bill but it will almost surely advance out of the Legislature, as there is general recognition that the sharp growth in the use of compounds is not explained by medical need.
Link to AB 378
Meanwhile, WOEMA’s Legislative Committee continues to work on a range of initiatives, including:
- Creating a guidance document for members on opioid prescribing, with a comparison of the various guidelines from other states and provider organizations.
- Exploring how occupational health data can be incorporated into electronic health records and “meaningful use” criteria.
- Exploring how workplace wellness and prevention measures can be incorporated into policies offered through the small-employer SHOP Exchange, which California must launch by 2014 as part of implementing federal health care reform.
WOEMA physicians Paul Papanek,MD, Scott Levy, MD, Anne Searcy, MD, Roman Kownacki, MD and Gregg Sorensen, MD, along with Executive Director Kerry Parker and lobbyist Don Schinske briefed California Insurance Commissioner Dave Jones on these issues in Sacramento on July 17. At the meeting, Commissioner Jones, Deputy Commissioner Janice Rocco, and SDI Senior Counsel Chris Citko identified several project on the list that the Department may be willing to help with.