Workers’ compensation: medical treatment.

Plain English Breakdown

The official source material does not provide information on consequences for non-compliance by doctors once they are part of the network.

Workers' Compensation Medical Treatment

This law requires the creation of a statewide medical provider network database for treating injured workers in the San Joaquin Valley region, with specific criteria for physicians and deadlines for implementation.

What This Bill Does

• Requires the Administrative Director to create a database of doctors willing and able to treat injured workers in the San Joaquin Valley.
• Makes it necessary for employees to first seek treatment from their employer's or insurer’s network unless there is no available care within 30 days.
• Sets criteria for physicians to be included in the network, such as being in good standing with the Medical Board of California and agreeing to follow official medical fee rules.
• Requires the Administrative Director to put this system into place by January 1, 2027.

Who It Names or Affects

• Injured workers in the San Joaquin Valley region
• Doctors who want to be part of the network for treating injured workers
• Employers and insurers with networks for medical treatment

Terms To Know

Administrative Director

The person in charge of managing the Division of Workers’ Compensation.

Medical Board of California

An agency that oversees and regulates medical professionals to ensure they meet certain standards.

Limits and Unknowns

• This bill only applies to specific counties in the San Joaquin Valley region.
• It is unclear how this will affect doctors and workers outside of these designated areas.

Official Summary Text

AB 1498, as introduced, Soria.
Workers’ compensation: medical treatment.
Existing law establishes a workers’ compensation system, administered by the Administrative Director of the Division of Workers’ Compensation, to compensate an employee, as defined, for injuries sustained in the course of employment. Existing law requires an employer to provide medical treatment that is reasonably required to cure or relieve an employee from the effects of the injury. Existing law allows employers to create networks of medical treatment providers to send employees to for treatment. Existing law sets out criteria for these networks and exceptions for when an employee may be treated outside of the network.
This bill would require the administrative director to establish a statewide medical provider network database, consisting of physicians who are willing and able to treat injured employees in the San Joaquin Valley region. The
bill would require an employee to first seek treatment within their employer’s or insurer’s network, unless the employer’s or insurer’s network is unable to treat the employee within 30 days of the request for medical treatment. The bill would require physicians, in order to be included in the network, to, among other things, be in good standing with the Medical Board of California and agree to comply with the official medical fee schedule, as specified. The bill would require the administrative director to implement the network on or before January 1, 2027.
The bill would state the Legislature’s intent to address the shortage of available medical treatment for workplace injuries in the central valley region.
This bill would make legislative findings and declarations as to the necessity of a special statute for the Counties of Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, and Tulare.

Current Bill Text

Download Bill PDF