UAPD Sponsors Utilization Review Bill (AB 933)
Current law allows insurance companies to use utilization review companies that hire doctors without California licenses to delay or deny care to injured workers. AB 933, introduced by Assemblymember Paul Fong (pictured at right) will make a California license a requirement for doctors performing utilization review in California. The bill is sponsored by the California Society of Industrial Medicine and Surgery, the California Society of Physical Medicine and Rehabilitation, and the Union of American Physicians and Dentists (AFSCME, AFL-CIO).
Read Dr. Weinmann's Health Care Journal of Northern California about AB 933 http://hcjnc.com/index.php?
Read Continuing Coverage of AB 933 at http://politicsofhealthcare.
Governor Schwarzenegger's Gift to Insurance Companies Hurts Injured Workers and Should be Made Illegal
by Robert L. Weinmann, MD
Current law since passage of SB 899 allows insurance companies to use utilization review companies that hire doctors without California licenses to delay or deny care to injured workers.
Here's how it works: the injured worker seeks care from a doctor who must be licensed to practice in California. The insurance company turns over the treating doctor's prescriptions for diagnosis and treatment to a Utilization Review (UR) company which employs UR doctors for opinions as to whether or not to implement the recommendations of the treating doctors. The UR doctor reviews paperwork only -- no interview or hands-on examination of the patient is required. Incredibly, the UR doctor is NOT required to be licensed in California. If the UR doctor makes a mistake, if he denies care that should have been approved, the injured worker is harmed. Meanwhile as a non-California licensed doctor the UR doctor is not subject to discipline by the Medical Board of California since he doesn't have a California license! The UR doctor is also not subject to discipline in the state in which he is licensed because that state does not have authority in California.
In 2008 the Hon. Sally Lieber authored legislation (AB 2969) to make this practice illegal. The bill passed the legislature. Governor Schwarzenegger vetoed it.
On 2/26/09 the Hon. Paul Fong introduced AB 933 to make the practce illegal. The insurance companies and big business have alredy squawked mightily -- as though they cared about injured workers -- saying that the non-California licensed doctors are needed because there are not enough doctors in California to do the job. This argument is false. The truth is that there are more doctors with California licenses applying for these jobs than are needed so that one UR company actually admits it has a waiting list of applicants!
Here are four references:
1) "How to practice medicine without a license," San Francisco Chronicle, 8/29/08
2) "Insurance industry sabotages injured workers in California (Schwarzenegger's veto)," California Progress Report, 10/05/08
3) "Schwarzenegger's gift to insurance companies could harm patients," Healthcare Journal of Northern California, Jan/Feb 2009
4) "Politicsofhealthcare.blogspot.com"
The Governor will need encouragement to sign AB 933 (Fong) into law. He will need to resist the blandishments of the manufacturing and insurance associations. AB 933 (Fong) is sponsored by the California Society of Industrial Medicine and Surgery, the California Society of Physical Medicine and Rehabilitation, and the Union of American Physicians and Dentists (AFSCME, AFL-CIO).