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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 3.6. Independent Medical Review

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§9768.3 Qualifications of Independent Medical Reviewers

(a) To qualify to be on the Administrative Director's list of Independent Medical Reviewers, a physician shall file a Physician Contract Application pursuant to section 9768.5 that demonstrates to the satisfaction of the Administrative Director that the physician:

(1) Is board certified. For physicians, the Administrative Director shall recognize only specialty boards recognized by the appropriate California licensing board.

(2) Has an unrestricted license as a physician in California under the appropriate licensing Board;

(3) Is not currently under accusation by any governmental licensing agency for a quality of care violation, fraud related to medical practice, or felony conviction or conviction of a crime related to the conduct of his or her practice of medicine;

(4) Has not been terminated or had discipline imposed by the Industrial Medical Council or Administrative Director in relation to the physician's role as a Qualified Medical Evaluator; is not currently under accusation by the Industrial Medical Council or Administrative Director; has not been denied renewal of Qualified Medical Evaluator status, except for non-completion of continuing education or for non-payment of fees; has neither resigned nor failed to renew Qualified Medical Evaluator status while under accusation or probation by the Industrial Medical Council or Administrative Director or after notification that reappointment as a Qualified Medical Evaluator may or would be denied for reasons other than non-completion of continuing education or non-payment of fees; and has not filed any applications or forms with the Industrial Medical Council or Administrative Director which contained any untrue material statements;

(5) Has not been convicted of a felony crime or a crime related to the conduct of his or her practice of medicine; and

(6) Has no history of disciplinary action or sanction, including but not limited to, loss of staff privileges or participation restrictions taken or pending by any hospital, government or regulatory body.

NOTE

Authority cited: Sections 133 and 4616, Labor Code. Reference: Section 4616.4, Labor Code.

HISTORY

1. New section filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 12-31-2004 order, including amendment of subsections (a) and (a)(3), transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).

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