Bulletin 97-7
April 10, 1997

Implementation of
"Instructions for Payment of Inpatient Hospital Bills"
Delayed By Court

A court action has been filed in the San Diego County Superior Court by Community Care Network, Inc., challenging the inpatient hospital fee schedule.

The fee schedule as set forth in Title 8, California Code of Regulations Sections 9790.1 and 9792.1 applies to inpatient services where the date of admission is on or after April 1, 1997. However, on March 31, 1997 the Community Care Network, Inc. obtained a temporary restraining order preventing the administrative director from "computing, administering, or implementing the 'Instructions for Payment of Inpatient Hospital Bills'" pending a hearing on April 9, 1997. At the hearing on April 9, 1997 the Superior Court Judge extended the temporary restraining order until May 9, 1997 when the Superior Court will rule on Community Care Network's request for a preliminary injunction.

The DWC has begun to receive questions from the community about how inpatient bills should now be paid. Although the Superior Court has not enjoined the regulations themselves, the Court's order restraining implementation of the "Instructions for Payment of Inpatient Hospital Bills" evidences the Court's intent that the status quo be maintained for the present time. Therefore, the DWC recommends that the workers' compensation community behave as though there were currently no maximum inpatient fee schedule in place. We will keep the workers' compensation community apprised of further developments as they occur.