over whether an injured contents of the petition worker is properly treating to adjudicate this issue outside the network. as well as the timeframes for service that the provisions of and other procedural Note Sec. 4603.2(a)(2) would issues created by this appear to preclude change. transition of care back into the MPN if the injured 8 CCR § 9767.9 worker is authorized to (transfer of care treat outside the MPN. regulations) will need to The reference to the be revised to reflect the continuity of care new procedures in Sec. provisions in Labor Code 4603.2(a)(2) § 4616.2 is misplaced as this is not a continuity of There is a Note care issue. disconnect between the provisions of Sec. Amendments to the MPN 4603.2(a)(2) and new statutes state that a failure lien provisions in Sec. to provide notice is 4903.1(b). The latter insufficient grounds to suggests that the obtain treatment outside employer has no liability the MPN unless the failure for payment (except for to provide notice resulted narrow circumstances) in a denial of care. even if the physician properly submits a first The network treatment report and it is issue is eligible for an adjudicated that the expedited hearing. treatment outside the MPN is proper.
over whether an injured worker is properly treating outside the network. Note that the provisions of Sec. 4603.2(a)(2) would appear to preclude transition of care back into the MPN if the injured worker is authorized to treat outside the MPN. The reference to the continuity of care provisions in Labor Code § 4616.2 is misplaced as this is not a continuity of care issue. Amendments to the MPN statutes state that a failure to provide notice is insufficient grounds to obtain treatment outside the MPN unless the failure to provide notice resulted in a denial of care. The network treatment issue is eligible for an expedited hearing. contents of the petition to adjudicate this issue as well as the timeframes for service and other procedural issues created by this change. 8 CCR § 9767.9 (transfer of care regulations) will need to be revised to reflect the new procedures in Sec. 4603.2(a)(2) Note There is a disconnect between the provisions of Sec. 4603.2(a)(2) and new lien provisions in Sec. 4903.1(b). The latter suggests that the employer has no liability for payment (except for narrow circumstances) even if the physician properly submits a first report and it is adjudicated that the treatment outside the MPN is proper.
SB863_ImplementationGuidev11072012.docx