October 13, 2005

Christine Baker

CHSWC Releases RAND Study on Payment for Hardware Used in Complex Spinal Procedures

OAKLAND -- The Commission on Health and Safety and Workers' Compensation (CHSWC) has approved the release of a Working Paper on Payment for Hardware Used in Complex Spinal Procedures Under California's Official Medical Fee Schedule for Injured Workers. This Working Paper was prepared by RAND for CHSWC and the Division of Workers' Compensation (DWC), Department of Industrial Relations. The Working Paper updates analyses from a 2003 RAND report examining Official Medical Fee Schedule (OMFS) payments for workers' compensation spinal surgery discharges from acute care hospitals.

This analysis is part of a broader CHSWC-RAND study that examines the cost and quality issues affecting medical care provided to injured workers in California and assesses strategies to improve the quality and efficiency of that care. The study provides information concerning the hardware and instrumentation that are used in connection with spinal surgery; analyzes the adequacy of the standard allowance for complex spinal surgeries; and discusses options that the Administrative Director of the DWC may wish to consider in adopting a regulation establishing the maximum allowable fee, if any, for the hardware and instrumentation furnished in connection with complex spinal surgeries. In general, the study did not find support to continue the separate payment for hardware and instrumentation used in complex spinal surgeries.

CHSWC, created by the workers' compensation reform legislation of 1993, is charged with overseeing the health and safety and workers' compensation systems in California and recommending administrative or legislative modifications to improve their operation. CHSWC was established to conduct a continuing examination of the workers' compensation system and of the state's activities to prevent industrial injuries and occupational diseases and to examine those programs in other states.

The CHSWC Working Paper by RAND is available at Information about CHSWC may be accessed on the Internet at CHSWC's home page at Information may also be obtained by writing to CHSWC at 1515 Clay Street, Suite 901, Oakland, California, 94612, by calling (510) 622-3959, by faxing a request to (510) 622-3265, or by email at