EK HEALTH

by Steve Kline, Esq.
EK Health Services' Legal Counsel

By my calculation, Governor Jerry Brown signed 14 workers' compensation related bills into law and vetoed five. While none were as sensational as the reforms by former Governor Gray Davis in 2003 or Governor Arnold Schwarzenegger on April 19, 2004, they still make incremental changes that will go into effect on January 1, 2012.

Let’s look at a few of the bills where decisions were made:

AB 378: (Assembly member Jose Solorio, Santa Ana) This is the signature bill of the Legislative session for workers' compensation. This bill adds pharmacy goods to the “list of medical goods or services for which it is unlawful for a physician to refer a person under this provision, except in prescribed circumstances.” It also requires “any compounded drug product to be billed by the compounding pharmacy or dispensing physician at the ingredient level”.

Billing at the ingredient level means that a cap has been placed on compound drugs so that maximum amount charged is at 83% of generic for lowest price generic equivalent until the administrative director adopts a fee schedule. Only actual practice will determine whether this legislative cost containment feature will succeed. The pill mills are looking for holes in the process,

AB 211: (Assembly member Gil Cedillo, Los Angeles) The Legislature passed and the Governor vetoed a modification to the Supplemental Job Displacement Benefit Vouchers (SJDB). The proposal was to change the current graduated structured benefit system to a flat amount of $6000 with specificity as to how it could be used and with some services how much could be spent. The bill was going to change the timing for the issuance of the SJDB to the termination of temporary disability as opposed to the current time of after the permanent disability award. Also part of the vetoed bill was the expiration of the SJDB after a certain timing.

AB 1426: (Assembly member Jose Solorio, Santa Ana) Let’s get rid of positions that are vacant and have little or no purpose. This legislation eliminated the position of court administrator. Any duties and responsibility were transferred to the administrative director’s office.  The first and last court administrator was Keven Star who brought the Electronic Adjudication Management System (EAMS).

AB 584: (Assembly member Paul Fong, Cupertino) The Governor followed the ink stains of Governor Schwarzenegger in vetoing the bill that would have mandated that California utilization review only be done by licensed California physicians. The Governor saw no reason to handle workers' compensation utilization review any differently than utilization review for managed care which also does not limit the reviewers to California licensed physicians.

AB 585:   (Assembly member Paul Fong, Cupertino) Mr. Fong, however was successful in getting a workers' compensation bill signed that would extend the cancer presumption statutes to firefighters who worked for a National Aeronautics and Space Administration installation. The primary one in California, being in Mountain View that is located in his district.

As I am writing this article, it has just been announced the California Supreme Court has denied a review of the Olgivie decision from the Court of Appeal that was written about last month. This means that the vocational rehabilitation expert’s full employment act has been confirmed. It’s all about job, jobs, and jobs.

Thanks for your attention.