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Division of Workers' Compensation - Medical provider networks

A medical provider network (MPN) is an entity or group of health care providers set up by an insurer or self-insured employer and approved by DWC's administrative director to treat workers injured on the job. Under state regulations, each MPN must include a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. MPNs are required to meet access to care standards for common occupational injuries and work-related illnesses. The regulations also require MPNs to follow all medical treatment guidelines established by the DWC and allow employees a choice of provider(s) in the network after their first visit. Additionally, MPNs must offer an opportunity for second and third opinions if the injured worker disagrees with the diagnosis or treatment offered by the treating physician. If a disagreement still exists after the second and third opinion, an injured worker in the MPN may request an independent medical review (IMR). The MPN program became effective Jan. 1, 2005 and employees can be covered by an MPN once a plan has been approved by the DWC administrative director.


Independent medical review application (for injured workers who need to get an independent medical review)
New image Solicitud de Revisión Médica Independiente

Medical provider network update ** PLEASE DESCRIBE THIS IMAGE **

Who has an MPN?

Current list of approved medical provider networks by name of applicant word image version acrobat image version
Current list of approved medical provider networks by approval date word image version ** PLEASE DESCRIBE THIS IMAGE ** version

MPN rules

Medical provider network termination notice - Title 8, section 9767.16

Final medical provider network regulations
Final independent medical review regulations

Sample initial written employee notification re: Medical provider network word image version acrobat image version
Información Importante sobre Cuidado Médico si tiene una Lesión o Enfermedad de Trabajo word image version acrobat image version

DWC is providing this sample "Initial written employee notification re: medical provider network" for MPN applicants to adapt and use. The employee notification submitted with the MPN application must comply with the requirements of 8 CCR 9767.12. This version has been updated to the permanent regulations adopted 9/15/05. Please remove or add the bracketed sentences depending on their applicability to the MPN. Also be sure to fill in the blanks with the appropriate information. The notification must also be provided in Spanish. DWC will post a Spanish version of this notification shortly.

Summary chart of key changes under the permanent medical provider network (MPN) regulations
word image version acrobat image version

Frequently asked questions (FAQs)

Medical provider network forms

Memo to health care providers interested in joining an MPN acrobat image version

Cover page for medical provider network application fillable image

Notice of medical provider network plan modification section 9767.8 fillable image

News and other info

Jan 21, 2009 Division of Workers' Compensation posts active forum topics regarding updated notice to employees’ poster and medical provider network notice regulations acrobat image version

June 2009

 
 
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