IR # 97-44
Tuesday, August 19, 1997

Rick Rice
Dean Fryer
(415) 972-8835

DWC Certifies Tenth HCO

SAN FRANCISCO -- A Southern California occupational health care provider is the latest in a growing list of Health Care Organizations that have been certified by the Division of Workers' Compensation to provide medical services to workers injured on the job, the Department of Industrial Relations has announced.

Medex HealthCare Inc. of Los Angeles is the tenth HCO to be certified under the new program, which was created as part of the 1993 workers' compensation reform.

"The HCO program was designed to lower employers' workers' compensation costs and assure quality of medical care for injured workers through the use of managed care techniques," said acting DIR Director John Duncan in announcing the new certification.

"We are very pleased that this program, once the regulatory and administrative foundations were established, is now beginning to pick up steam and has already attracted some of the largest health care providers and insurance carriers in the state," he said.

Duncan noted that three of the largest providers, Kaiser Permanente, PacifiCare/FHP and MetraComp/United Health Care, are now certified HCOs and large carriers are now beginning to contract with them for services.

The reform legislation provided that employers participating in an HCO plan can obtain up to 365 days of control over the injured employee's medical care. Employers currently have medical control for a maximum of 30 days after the injury. Employees may enroll in a plan offered by the employer or they may choose not to participate by predesignating another doctor or medical facility to treat their work related injuries.

Employees who enroll in a certified HCO plan offered by the employer also benefit from knowing that it meets quality of care standards required by state regulations.

Three types of medical providers may apply for HCO certification: Knox-Keene Health Care Service Plans (HMOs); disability insurers licensed by the Department of Insurance; and any entity authorized as a Workers' Compensation Health Care Provider Organization (WCHCPO) by the Department of Corporations.

Medex is a WCHCPO which has contracted with a number of Southern California hospitals and physicians to provide care in a seven county service area that includes the counties of Los Angeles, Ventura, San Bernardino, Riverside, Orange, San Diego and Imperial.

Potential HCO applicants may obtain more information or an application by calling the DWC Managed Care Program office at (415) 975-0734.