Newsline No. 63-09 printer image Printer friendly

Dec. 21, 2009

 

Division of Workers' Compensation seeks input for upcoming stakeholder meetings

The Division of Workers’ Compensation (DWC) has scheduled a stakeholder meeting to discuss the issues related to drafting regulations regarding reimbursement for spinal surgeries. The meeting will be held Tuesday, Jan. 19, 2010, from 1:00 p.m. to 4:00 p.m. in Room 11 at the Elihu M. Harris State Office Building, 1515 Clay Street, Oakland, California. 

A separate reimbursement for implantable medical devices, hardware, and instrumentation for six different diagnostic related groups (DRGs) is set forth in Labor Code section 5318. The statute also provides that the pass-through section would only be operative until the administrative director adopts a regulation specifying separate reimbursement, if any, for implantable medical hardware or instrumentation for complex spinal surgeries. Effective Jan. 1, 2004, the administrative director adopted the inpatient fee schedule (California Code of Regulations, title 8, sections 9789.20 et seq.), which incorporated the Labor Code section 5318 pass-through.  (See section 9789.22(f).) Changes to the current regulations are part of DWC’s 12-point plan to monitor and help control medical costs in California’s workers’ compensation system.

The division is interested in hearing comments, suggestions, and options regarding the spinal implant pass-through from interested parties at the stakeholder meeting. Please RSVP to Maureen Gray at mgray@dir.ca.gov or (510) 286-0676.

To submit questions or issues for discussion, please e-mail them to Maureen Gray at mgray@dir.ca.gov or fax them to (510) 286-0687.    

Additionally, in light of concerns expressed by the insurance industry, the DWC will be conducting a stakeholder meeting in January to discuss revisions to the benefit notices. If you are interested in joining the benefit notice stakeholder group, please contact Maureen Gray at mgray@dir.ca.gov or (510) 286-0676.

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