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.

Who has an MPN?

• Current list of approved medical provider networks by approval date
  
• Current list of approved medical provider networks by name of applicant
  

MPN rules

• Frequently asked questions about medical provider networks
• Medical provider network regulations effective Oct. 8, 2010
• California Code of Regulations, Title 8 sections 9767.1 – 9767.16

MPN forms

Medical provider network forms

• Cover page for medical provider network application
• Notice of medical provider network plan modification section 9767.8 effective Oct. 8, 2010
• Notice of medical provider network plan modification section 9767.8
• Independent medical review application (for injured workers who need to get an independent medical review)
  
• Solicitud de Revisión Médica Independiente

MPN notices

• Sample initial written employee notification re: Medical provider network version version
  
• Información Importante sobre Cuidado Médico si tiene una Lesión o Enfermedad de Trabajo version version
• Sample MPN implementation, termination/cessation of use, and change of MPN notices

MPN information

Memo to health care providers interested in joining an MPN

February 2013