Bulletin No. 62-05
October 6, 2005

Filing of revised utilization review plans with the administrative director

The utilization review regulations have been permanently adopted effective Sep. 22, 2005. DWC is requesting all claims administrators, or external utilization review organizations contracted by a claims administrator to perform utilization review, to review their utilization review plan to determine whether the plan complies with the requirements of the permanent regulations. If it is determined that a utilization review plan needs to be revised, a revised plan must be submitted to the administrative director within 90 days from the effective date of the permanent regulations. Please submit revised utilization review plans to:

Administrative Director
Division of Workers Compensation/Medical Unit
P.O Box 420603
San Francisco, CA 94142-0603

Attention: Utilization Review Plan

Please note that in lieu of filing a revised utilization review plan, a claims administrator may submit a letter identifying the external utilization review organization which has been contracted to perform the utilization review functions, provided that the utilization review organization has filed a current utilization review plan with the administrative director.

The Division of Workers’ Compensation will be reviewing the submitted utilization review plans to ensure that the plans are in compliance with the requirements of the permanent regulations. The permanent regulations can be found at http://www.dir.ca.gov/dwc/DWCPropRegs/UREmerRegs.htm.