Several laws recently went into effect on January 1, 2017. The following new legislation impacts the California workers’ compensation system.
Assembly Bill 1244 – Fraud and Abuse
A.B. 1244 is aimed at reducing workers’ compensation fraud perpetrated by medical professionals and unethical lawyers scamming the system. When caught overbilling, physicians and other healthcare providers were banned by California’s Medi-Cal and/or the federal Medicaid system.
Some of these cheaters moved their practice into the workers’ compensation system to continue billing businesses and workers. This new law automatically bars these con artists from workers’ compensation, prohibiting them from profiting from their scam.
Sadly, the legal profession has a small percentage of fraudsters too. These attorneys were signing up clients and settling their claims in distant cities, then pocketing the settlement money as fees. In many cases, the purported clients had no idea what was happening. S.B. 1160 tackles this unlawful behavior with additional requirements for workers’ compensation lawyers.
Attorneys must provide their clients with disclosures and sign a statement swearing they have interviewed their clients and informed them where their claim is to be filed. The State Bar can suspend the licenses of attorneys found lying.
Senate Bill 1160 – Expedited Treatment and Medical Provider Liens
S.B. 1160 tackles liens filed by criminally convicted medical practitioners and delays in treatment for injured workers. The new legislation creates additional requirements for lien holders to ensure the legitimacy of the liens.
This law also eliminates or reduces the need for a utilization review (UR) for routine care and treatment within the first 30 days following a worker injury. Speedy payment through a timely billing requirement is also included.
Injured workers will be receiving lower mileage reimbursement rates again this year. The California Workers’ Compensation Institute (CWCI) once again takes its cue from the Internal Revenue Service (IRS) which announced a 5-cent reduction in business mile reimbursement rates for 2017.
The new rate is 53.5 cents per mile as of the first of January, 2017. This applies to medical treatment-related travel and travel for evaluations of worker injuries. Mileage rate changes have been the norm over the past decade. These fluctuations are based on automobile operating costs as determined by an annual study. Mileage reported for 2016 is to be reimbursed at the former 54-cent rate.
Questions and concerns about these and any other state workers’ compensation laws, rules, and regulations should be posed to an experienced and knowledgeable California workers’ compensation attorney.