Newsline No. 10-10 printer image Printer friendly

March 4, 2010


Division of Workers' Compensation issues notice of rulemaking and public hearing for adoption of electronic medical treatment billing standards and standardized paper billing forms

Medical e-billing regulations will encourage electronic billing and faster payments to doctors

The Division of Workers' Compensation (DWC) has issued a notice of rulemaking to carry out provisions requiring the adoption of standardized paper billing forms and electronic billing standards. The regulations also propose amendments to conform the current medical billing and payment provisions to statutory amendments. This rulemaking is the next step in the division’s 12-point plan to help control medical and administrative costs announced last fall.

“Implementing electronic billing eliminates unnecessary paper from the workers’ comp system and brings us into the 21st century. Our goal is to ensure doctors are paid promptly and accurately for services they provide, which will also help lessen the burden of liens on the system.” said DWC acting Administrative Director Carrie Nevans. “Our 12-point plan allows us to monitor costs more effectively and take decisive action as needed.”

The proposed regulations satisfy Labor Code section 4603.4 requirements and amend title 8, California Code of Regulations section 9792.5, and would adopt new sections 9792.5.0, 9792.5.1, 9792.5.2, and 9792.5.3. The use of standardized billing forms for paper billing would be mandatory 90 days after adoption of the regulations. Claims administrators would be required to accept submission of electronic bills 18 months after adoption of the regulations. The use of electronic billing by medical providers is optional under the statute and the proposed regulations.

The proposal regulations have been forwarded to the Office of Administrative Law for publication in the California notice registry and are posted on the DWC Web site at:

Public hearings on the regulations have been scheduled for:

Date: April 23, 2010
Time: 10:00 a.m. to 5:00 p.m. or until conclusion of business
Place: Elihu Harris State Office Building – Auditorium
1515 Clay Street
Oakland, California  94612

Date: April 26, 2010
Time: 10:00 a.m. to 5:00 p.m. or until conclusion of business
Place: Ronald Reagan State Building – Auditorium
300 South Spring Street
Los Angeles, California 90013

Members of the public may comment on the proposed regulations until 5 p.m. on April 26, 2010.