|Newsline No. 22-07|
|March 21, 2007|
Division of Workers' Compensation issues fourth 15-day notice of revisions to proposed utilization review enforcement regulations
The Division of Workers' Compensation (DWC) has modified its regulations for utilization review enforcement. A fourth 15-day notice of modification was distributed to interested parties and the revised regulations are posted on the DWC Web site. Members of the public may comment on the revisions until 5 p.m. on Thursday, Apr. 5, 2007.
The proposed utilization review (UR) enforcement regulations are authorized by Labor Code section 4610, which requires every employer to have and use a UR process, and sets out timelines and conditions to be met whenever a request for authorization of medical treatment will be delayed, modified or denied.
The revisions include deleting the statement that the routine investigations will include a review of a stratified sample of randomly selected requests for authorization so that at least 50 percent of the randomly selected requests for authorization are denied requests. Instead, the sample will consist of a randomly selected sample so that the sample will be statistically valid.
Further information and the modified proposals can be found at http://www.dir.ca.gov/dwc/DWCPropRegs/UREnforcementRegulations/UR_EnforcementRegulations.htm.