IR# 95-20
Monday, August 20, 1995

Richard Stephens

State Workers' Comp Agency Warns of Misleading Promotional Materials

SAN FRANCISCO --The Department of Industrial Relations is warning California employers, workers, and insurance carriers that several medical provider organizations and groups have been distributing promotional materials that misleadingly incorporate the title of "HCO" into their name.

"This implies an affiliation with or an endorsement by the California Department of Industrial Relations, when, in fact, they are not certified as 'Health Care Organizations' under the State Labor Code, " said Casey L. Young, Administrative Director of the Division of Workers' Compensation.

Health care organizations were created by workers' compensation reform legislation enacted in 1993 in an effort to bring managed care techniques into the state's workers' compensation system. Under the law, qualified medical provider organizations and disability insurers can apply to the Division of Workers' Compensation for certification as HCOs. Once certified, employers can offer their employees the opportunity to enroll in one of the plans for treatment of job related injuries and illnesses and retain the ability to manage enrolled employees' care for up to one year.

"DWC has only certified three workers' compensation health care organizations at this time. Any other organization purporting to be a certified workers' compensation HCO is making misleading or false statements," Young said.

The three certified HCOs are: FHP Life HCO of Costa Mesa, MetraComp of Long Beach, and Greaney Medical Group/WorkCare of Anaheim. Several additional HCO applicants, however, are very close to attaining HCO certification.

Certified HCOs have met DWC's standards for access and quality of medical care. Other groups have not been certified to meet those standards and do not offer the opportunity to manage employees' care for an extended period.

Anyone who has questions about the certification status of any organization offering medical services under workers' compensation is encouraged to contact DWC's Managed Care Unit at (415) 557-9744.