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New CA DWC Regs To Control Medical Costs To Be In Effect Nov. 15, 2011

01 Dec, 2010 WorkersCompensation.com

                               Sacramento, CA (CompNewsNetwork) - The Division of Workers' Compensation (DWC) has adopted new regulations updating the Workers' Compensation Information System (WCIS) reporting requirements as part of its 12-point plan to monitor medical costs more effectively. The final regulations, which require the electronic reporting of claims information to DWC, were approved by the Office of Administrative Law (OAL) and filed with the secretary of state on Nov. 15, 2010, and become effective on Nov. 15, 2011.

"The historic 2004 workers' compensation reforms reduced and stabilized medical costs,” said acting Administrative Director Carrie Nevans. "Accurate electronic reporting to the WCIS by claims administrators, including medical billing data reports, will allow DWC to identify key cost indicators in the system and formulate policies to keep costs under control, helping ensure the uptick in medical costs we saw in 2007 and 2008 does not continue."

The new rules will increase the time for filing the first report of injury (from five business days to 10), relax several data edits to allow easier transmission of claim information with fewer submission rejections, and clarify the process for medical lien reporting. In addition, the regulations have updated the two WCIS implementation guides (the California EDI Implementation Guide for First and Subsequent Reports of Injury and the California EDI Implementation Guide for Medical Bill Payment Records).

The regulations, found in the California Code of Regulations, title 8, sections 9701 and 9702, are authorized by Labor Code section 138.6. 

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