- Rupali Das, MD, MPH, FACOEM Executive Medical Director, Division of Workers’ Compensation, Department of Industrial Relations
- Destie Overpeck, Acting Administrative Director, Division of Workers’ Compensation
- Constantine J. Gean, MD, MBA, MS, FACOEM, Regional Medical Director, Liberty Mutual Insurance
- Bernyce Peplowski, DO, MS, Vice President, USHW CA & Chief Medical Officer, California Clinical Operations, US HealthWorks
- Cathryn Pine, Assistant Vice President and Director of Operations, California Claims Legal Department, Zenith
Description: Join this important webinar featuring the acting Administrative Director and the Medical Director of California’s Division of Workers’ Compensation as well as other experts.
As of January 1, 2013, California physicians must adjust to major reforms in the Workers’ Compensation system due to newly enacted SB 863. Changes include new methods for settling treatment disputes (Independent Medical Review – IMR) and billing (Independent Bill Review – IBR), as well as changes in permanent disability compensation to injured workers, MPN rules, and many other issues. In 2014, major changes will affect how physician services are paid.
Presenters will provide up-to-the minute information on the development of SB 863’s numerous regulations. We hope you can join us for this timely, essential, and unique WOEMA presentation.
This is a non-CME Webinar.
WOEMA Legislative Committee Broadens Agenda in 2012
WOEMA enters the 2012 legislative year hip-deep and ready to engage on a number of fronts. The past year yielded many developments to cheer, some to wince at, and some merely continuing on (and on and on). Here’s a quick look at some of the good, bad and familiarly ugly, and where WOEMA’s Legislative Affairs work moves from here:
WOEMA’s opioid guidance document – The Legislative Committee last year developed a user-friendly grid comparing seven well respected opioid prescribing guidelines. The work was done in response to a CWCI report highlighting the growing prescription of opioids in California, and in anticipation of legislation or rule-making to address the issue that will likely materialize this year. The published grid has been circulated to policymakers, including DWC officials, as well as to other provider organizations. [comparison grid]
Work Comp quality – In 2012, WOEMA will continue its search for specific quality measures that could be incorporated into Workers’ Comp system that improve outcomes and efficiencies. In a meeting with DWC Administrative Director Rosa Moran, WOEMA representatives proposed to develop recommendations in this area – an idea that AD Moran eagerly endorsed. In turn, she asked that WOEMA come up with recommendations for resolving treatment disputes in the courtroom, which represents a huge challenge for appeals judges. The Legislative Committee is exploring possible recommendations from a variety of sources, including the Quality Improvement project led by Peter Vasquez, MD, as well quality measures being pursued in other states. In December conference call, the committee learned from Lee Glass, MD, Associate Medical Director of Washington State’s Dept. of Labor and Industries (and an ACOEM member) about measures being implemented in that state, with an eye toward evaluating their suitability for importation elsewhere.
Cal-OSHA Lead Standard – A contingent of WOEMA members plan to participate in a second meeting of Cal-OSHA Lead Advisory Committee, which met last to year to consider revisions to the state’s lead standards. WOEMA continues to be a lead advocate (as it were) for stiffening the standards, including the lowering of threshold blood levels. WOEMA’s Legislative Committee has been conferring with officials from the California Department of Public Health (CDPH), to coordinate advocacy.
Worker’s Comp Fee Schedule – US Healthworks sponsored legislation in California in 2011 to compel DWC to transition its Official Medical Fee Schedule (OMFS) to an RBRVS-based schedule. WOEMA helped to successfully push that bill, SB 923 (De Leon), all the way to the Assembly Floor, where it stalled between pressure from:
- Stakeholders such as Labor, who insisted that conversion be cost neutral
- Other stakeholders, such as the CMA and specialty organizations, who insisted that the conversion include no pay cuts to any providers.
WOEMA continues to work closely with the bill’s sponsors to determine how to keep the bill moving this spring, while also continuing to push for the conversion at the regulatory level. WOEMA will continue to support appropriate cost-saving measures elsewhere in the Work Comp system to help accommodate adoption of a physician fee schedule that better recognizes the value of primary treatment.
Other initiatives – Going forward, the Legislative Committee plans to engage in some new initiatives, including developing possible internal policy or guidance to members on the trend toward marketplace consolidation of Occupational Medicine and other specialty practices into larger, typically hospital-owned, groups. In addition, WOEMA will push to have preventive health services included in small-business insurance policies offered through California’s pending Small Business Health Options (SHOP) exchange, a pending feature of federal health care reform.
As has come to be the case, one truly great feature of WOEMA’s policy work has been the evolution of the Legislative Committee’s informal weekly calls, which happen every Friday morning at 7:45 a.m. To our knowledge, these calls are one of few venues anywhere for regular policy discussions of Occupational Medicine. Depending on topic, the group often includes guests from in and around the WOEMA community, subject experts, and good allies, such as our friends at the CSAOHN. If you are interested in serving on the committee, please contact committee co-chairs Robert Blink, MD orScott Levy, MD.