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California: Division proposes to switch physician fee schedules
The Division of Workers' Compensation proposed changes to physician fee schedules and treating physician forms.
The draft regulations are part of the division's 12-point plan to monitor and help control medical costs. The division proposed to switch from California's current physician fee schedule to a schedule based on the Resource-Based Relative Value Scale. In the RBRVS system, physician fees are determined by the resource costs needed to provide services and are divided into three components: physician work, practice expense and professional liability insurance. The proposed treating physician forms and regulations will allow all physicians who treat injured workers to submit reports directly to the claims administrator. The updated forms also clarify when a physician is requesting treatment authorization. The updated forms include: 1) the proposed request for authorization form (DWC Form RFA); 2) the revised treating physician progress report (DWC Form PR-2); 3) the functional improvement report for physical medicine providers (DWC Form FIR); and 4) an optional proof of service form (DWC Form PSMR). The proposed changes are in Title 8, California Code of Regulations, Sections 9785, 9785.2 (DWC Form PR-2), and 9792.6. The new reporting forms can be found at proposed Sections 9785.5 (DWC Form RFA), 9785.6 (DWC Form FIR), and 9785.7 (DWC Form PSMR). The deadline for comments has passed. However, an online public forum is available at www.dir.ca.gov/dwc/DWCWCABForum/PhysicianFeeSchedule. For more information, visit www.dir.ca.gov. Read more at the WORKERSCOMP ForumTM homepage.
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