Newsline No. 32-10 printer image Printer friendly

June 8, 2010


Division of Workers' Compensation posts proposed revision to inpatient hospital fee schedule regulations for pre-rulemaking public comment

The Division of Workers' Compensation (DWC) has posted an online forum for members of the public to review and comment on drafts of revisions to the inpatient hospital fee schedule regulations which includes modification of when and how additional allowance is permitted for implantable hardware used in complex spinal surgeries. These draft revisions to the regulations are part of the division’s 12-point plan to monitor and help control medical costs in California’s workers’ compensation system.

The forum can be found at and members of the public may comment until June 22, 2010.

A separate reimbursement for implantable medical devices, hardware, and instrumentation for certain 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.

The proposed revisions to the inpatient hospital fee schedule regulations provides for the following: