Bill Text: CA AB361 | 2009-2010 | Regular Session | Chaptered

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Bill Title: Workers' compensation: treatment authorization.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Passed) 2009-10-11 - Chaptered by Secretary of State - Chapter 436, Statutes of 2009. [AB361 Detail]

Download: California-2009-AB361-Chaptered.html

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BILL NUMBER: AB 361	CHAPTERED
	BILL TEXT

	CHAPTER  436
	FILED WITH SECRETARY OF STATE  OCTOBER 11, 2009
	APPROVED BY GOVERNOR  OCTOBER 11, 2009
	PASSED THE SENATE  SEPTEMBER 4, 2009
	PASSED THE ASSEMBLY  SEPTEMBER 9, 2009
	AMENDED IN SENATE  SEPTEMBER 2, 2009
	AMENDED IN SENATE  JUNE 16, 2009
	AMENDED IN ASSEMBLY  MAY 14, 2009
	AMENDED IN ASSEMBLY  APRIL 28, 2009

INTRODUCED BY   Assembly Member Bonnie Lowenthal
   (Coauthors: Assembly Members Ammiano, Coto, and Torlakson)

                        FEBRUARY 23, 2009

   An act to add Section 4610.3 to the Labor Code, relating to
workers' compensation.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 361, Bonnie Lowenthal. Workers' compensation: treatment
authorization.
   Existing law establishes a workers' compensation system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for injuries
sustained in the course of his or her employment. Existing law
requires every employer to establish a medical treatment utilization
review process, in compliance with specified requirements, either
directly or through its insurer or an entity with which the employer
or insurer contracts for these services.
   Existing law authorizes an employer or insurer to establish or
modify a medical provider network for the provision of medical
treatment to injured employees, and to submit a medical provider
network plan to the administrative director for approval. Existing
law permits employers to enter into contracts for the provision of
medical services to injured employees with a health care organization
that has been certified by the administrative director for this
purpose.
   This bill provides that, regardless of whether an employer has
established a medical provider network or entered into a contract
with a health care organization, an employer that authorizes medical
treatment shall not rescind or modify the authorization for the
portion of the medical treatment that has been provided after that
treatment has been provided for any reason, including, but not
limited to, the employer's subsequent determination that the
physician who treated the employee was not eligible to treat that
injured employee. This bill provides that its provisions shall not be
construed to expand or alter the benefits available under, or the
terms and conditions of, any contract, including, but not limited to,
existing medical provider network and health care organization
contracts. The bill would also provide that its provisions shall not
be construed to impact the ability of the employer to transfer
treatment of an injured employee into a medical provider network or
health care organization.
   The bill would further provide that its provisions shall not be
construed to establish that a provider of authorized medical
treatment is the primary care physician for specified purposes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4610.3 is added to the Labor Code, to read:
   4610.3.  (a) Regardless of whether an employer has established a
medical provider network pursuant to Section 4616 or entered into a
contract with a health care organization pursuant to Section 4600.5,
an employer that authorizes medical treatment shall not rescind or
modify that authorization after the medical treatment has been
provided based on that authorization for any reason, including, but
not limited to, the employer's subsequent determination that the
physician who treated the employee was not eligible to treat that
injured employee. If the authorized medical treatment consists of a
series of treatments or services, the employer may rescind or modify
the authorization only for the treatments or services that have not
already been provided.
   (b) This section shall not be construed to expand or alter the
benefits available under, or the terms and conditions of, any
contract, including, but not limited to, existing medical provider
network and health care organization contracts.
   (c) This section shall not be construed to impact the ability of
the employer to transfer treatment of an injured employee into a
medical provider network or health care organization. This
subdivision is declaratory of existing law.
   (d) This section shall not be construed to establish that a
provider of authorized medical treatment is the physician primarily
responsible for managing the injured employee's care for purposes of
rendering opinions on all medical issues necessary to determine
eligibility for compensation.