August 20, 2009: Health Professions Education Foundation Awards $1.5 Million in Grants for Physicians to Improve Access to
Healthcare in Underserved Areas
August 19, 2009: Insurance Commissioner Poizner Announces Arrest of Diamond Bar Man in $1.4 Million Workers' Comp Fraud
Case
August 19, 2009: Crackdown on workers' comp billing fraud is dealt a setback
August 17, 2009: SECOND APPELLATE DISTRICT DIVISION ONE
in an unpublished decision of FRANK SNEDECOR v. WCAB held on 08/17/2009 WCAB did not address whether cervical fusion,
limited range of motion and whole person impairment under the AMA Guides may be equal, compared or analogized to factors
indicating the existence of spinal permanent disability under the 1997 schedule and section 4660(d). Since the WCAB did not reach
this issue and has extensive expertise and experience in such highly technical matters of workers’ compensation, the appellate court
conclude that the WCAB should determine the issue on remand. (See Brodie, supra, 40 Cal.4th at p. 1331; Zenith, supra, 159 Cal.App.
4th at p. 499; Genlyte, supra, 158 Cal.App.4th at p. 724.)
August 12, 2009: LA Times: O.C. woman gets 8 years in prison for recruiting patients for unnecessary surgeries
August 12, 2009: DPI: Insurance Commissioner Poizner today announced that he has appointed Sara Flocks, of San Francisco and
Lee Pearson, of Rancho Murieta to the Workers' Compensation Insurance Rating Bureau Governing Committee.
August 12, 2009: DWC: Division of Workers' Compensation announces appointment to workers’ compensation ethics advisory
committee
August 12, 2009: DWC: The Division of Workers’ Compensation now accepting applications for the upcoming qualified medical
evaluator examination
August 10, 2009: Another capper who pleaded guilty on Friday to in the largest medical fraud prosecution in the nation was
sentenced to eight years in state prison for recruiting over 90 healthy patients to undergo unnecessary and dangerous surgeries to
fraudulently bill medical insurance companies.
August 07, 2009: A capper in the largest medical fraud prosecution in the nation was sentenced today to 10 years in state prison for
recruiting over 170 healthy patients to undergo unnecessary and dangerous surgeries to fraudulently bill medical insurance companies.
August 07, 2009: Studies find spinal procedure no more effective than placebo
August 07, 2009: Las Encinas Hospital in Pasadena sued by ex-workers
August 04, 2009: COMMISSIONER POIZNER ANNOUNCES ARREST OF MILPITAS MAN FOR ALLEGED WORKERS’ COMP
FRAUD AGAINST CITY OF MENLO PARK
August 03, 2009: LaPlante v. WCAB (Wal-Mart Stores) in an unpublished decision After LaPlante petitioned this court for review,
the First Appellate District affirmed the WCAB’s reasoning in Benson and concluded “[t]he clear change in the statutory language
indicates intent to invalidate Wilkinson.” (Benson v. Workers’ Comp. Appeals Bd. (2009) 170 Cal.App.4th 1535, 1550, review den.
April 29, 2009.) Agreeing with the WCAB’s en banc decision, the court relied on the overall statutory scheme, the repeal of former
section 4750 upon which Wilkinson was established, and the express mandate under new section 4663, .)
July 29, 2009: The California Supreme Court denied a petition for review in the En Banc Decision of SB SURGERY CENTER v. W.
C.A.B. (SKILL MASTER STAFFING) Case Number S173368 "Tapia Case"
July 29, 2009: Division of Workers’ Compensation posts ZIP code locator
July 24, 2009: Commissioner Poizner RELEASES OPERATIONAL REVIEW Report OF CALIFORNIA INSURANCE GUARANTEE
ASSOCIATION.
July, 24, 2009: Division of Workers’ Compensation posts annual reports
July, 23, 2009: Division of Workers’ Compensation surveys EAMS users
July 23, 2009: Division of Workers’ Compensation posts qualified medical evaluator forms in Spanish
July 22, 2009: Division of Workers' Compensation appoints new members to the medical guidelines advisory committee
July 22, 2009: Division of Workers' Compensation appoints new members to the medical guidelines advisory committee
July 22, 2009: DOCTOR TO BE ARRAIGNED FOR MAKING FALSE STATEMENTS TO FRAUDULENTLY COLLECT
INSURANCE CLAIMING WORK-RELATED INJURY
July 22, 2009: The WCAB are rejecting liens and applications filed by Lien Claimants for failure to file a verification: §10770.5.
Verification to Filing of Lien Claim or Application by Lien Claimant
and §10770.6. Verification to Filing of Declaration of Readiness By or on Behalf of Lien Claimant. /// Summary of Appeals Board
rules of practice and procedure became effective Nov. 17, 2008 - that the Board is enforcing now.
July 17, 2009: Filed 7/16/09 State Comp. Ins. Fund. v. WCAB WORKERS’ COMPENSATION APPEALS BOARD and BRICE
SANDHAGEN CA3
Opinion following remand by Supreme Court IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA (unpublished
decision) PDF
IN THE SUPREME COURT OF CALIFORNIA
STATE COMPENSATION INSURANCE v WORKERS’ COMPENSATION
APPEALS BOARD and BRICE SANDHAGEN, PDF
July 16, 2009: Division of Workers’ Compensation tames paper backlog at district offices
July 14, 2009: Commissioner Poizner Announces Santa Paula Man Arrested in Connection with Workers' Comp Insurance Fraud
Charges
July 10, 2009: Payments to Medi-Cal providers will not be cut, federal court rules
Healthcare providers for the nearly 7 million Californians dependent on state-funded treatment sued the state Department of Health Care
Services after the law took effect July 1, 2008. They persuaded a federal judge in Los Angeles to halt the reductions on Aug. 18, on
the grounds that the cuts violated federal law requiring states that receive Medicaid funds to meet certain standards of efficiency,
economy, quality of care and access.
July 08, 2009: INSURANCE COMMISSIONER STEVE POIZNER REJECTS Industry-backed REQUEST FOR ANY INCREASE in
Workers' Comp cost BENCHMARK
July 08, 2009: WASHINGTON – The nation's hospitals will give up $155 billion in future Medicare and Medicaid payments to help
defray the cost of President Barack Obama's health care plan, a concession the White House hopes will boost an overhaul effort that's
hit a roadblock in Congress.
July 08, 2009: J.C. Penney v. WCAB (Edwards), No. C059760 (Cal. App. 3rd Dist. 2009) (WCAB Nos. SAC338759, SAC360384)
CERTIFIED FOR PUBLICATION
July 06, 2009: Analysis of Labor Code Section 4609 dealing with PPO contracts in Workers' compensation - Download in Word
Document
July 01, 2009: Division of Workers’ Compensation responds to inquiries regarding payment for medical treatment
June 30, 2009: Adjustments to the DMEPOS section of the Official Medical Fee Schedule to conform to changes in the Medicare
payment system effective July 1, 2009 are posted on the DWC Web site
June 29, 2009: Insurance Commissioner Steve Poizner Announces Terrorism Financing Probe
June 25, 2009: Plan to sell part of California workers' comp insurer State Fund faces opposition
June 24, 2009: 2008 Annual Report of the Unlawfully Uninsured Employer Enforcement Program Labor Code Section 90.3(d)
June 23, 2009: Division of Workers’ Compensation new medical treatment utilization schedule regulations approved by Office of
Administrative Law New schedule becomes effective July 18, 2009 - Copy of New Reg
June 19, 2009: WORKERS' COMPENSATION Former State Fund official served search warrant in criminal probe
As many as eight other warrants are served in the conflict-of-interest probe, according to a state official, who says recipients are likely
to have included other former officials at the insurer.
June 18, 2009: Supreme Court makes age bias suits harder to win
June 18, 2009: INSURANCE COMMISSIONER STEVE POIZNER ANNOUNCES $30 MILLION IN GRANTS TO FIGHT
WORKERS’ COMPENSATION FRAUD
June 18, 2009: A state judge on Thursday ordered former HealthSouth CEO Richard Scrushy to pay about $2.8 billion to shareholders
who sued over accounting fraud at the rehabilitation chain.
June 18, 2009: Division of Workers’ Compensation to test vendor-developed forms to ensure they work properly in EAMS
June 18, 2009: STATEMENT BY Commissioner Poizner ON CREATION OF PROPOSED FEDERAL INSURANCE OFFICE
June 17, 2009: Blue Cross praised employees who dropped sick policyholders, lawmaker says
June 16, 2009: Commissioner Poizner Assigns Special Examiner to Oversee AIG's California Insurance Operations
June 16, 2009: Ex-Cedars-Sinai worker gets 4 years for stealing records
June 13, 2009: The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying
greater efficiencies and broader insurance coverage will justify the change
June 12, 2009: Commissioner Poizner Announces Up to $37.3 Million in Legal Settlements Arising from the 2003 Failure of Workers'
Comp Carrier Fremont Indemnity Company
June 12, 2009: Notice of rulemaking and public hearing for amendments to Health Care Organization (HCO) regulations
June 11, 2009: AMA wary of Obama call for public health insurance
June 09, 2009: CDI ANNOUNCES PROSECUTION OF UNITED/PACIFICARE PROCEEDS TO ADMINISTRATIVE HEARING
June 09, 2009: STATEMENT BY COMMISSIONER POIZNER ON COMPLETION OF WORKERS’ COMPENSATION HEARING
June 02, 2009: Division of Workers’ Compensation implements paper cleanup plan for district offices
June 02, 2009: Insurance Commissioner Poizner Calls for Swift Action by WCIRB to Address Challenges Identified by Audit -- Calls
for meeting on June 08, 2008 to address high cost of Workers' Compensation
May 30, 2009: June 2009 Work Comp Collections Newsletter
May 29, 2009: 24-VISIT CAP ON PHYSICAL MEDICINE
May 29, 2009: Annual Hospital Financial Data
May 27, 2009: Commissioner Poizner Announces Three Arrested in Connection with $5 Million Workers' Compensation Insurance
Fraud
May 26, 2009: Division of Occupational Safety and Health (DOSH)
H1N1 (Swine Flu) Guidance for Employers and Employees
May 22, 2009: Common Surgeries and Price Comparison is a new Web tool allowing healthcare consumers to view and compare the
price of 28 common elective inpatient procedures at hospitals across California.
May 20, 2009: Doctors Closer To Using Carpool Lanes In Emergency
May 20, 2009: Sutter Health cuts 121 information technology jobs
May 20, 2009: Silent PPOs' In Workers Comp
May 14, 2009: Commissioner Poizner Announces Bakersfield Woman Charged With Insurance Fraud For Second Time In Two Years
May 09, 2009: DOCTOR SENTENCED TO 16 YEARS IN PRISON FOR PERFORMING UNNECESSARY SURGERIES ON
HEALTHY PATIENTS IN $154 MILLION MEDICAL INSURANCE FRAUD SCHEME
May 08,2009: OCDA CHARGES SEVEN IN SECOND SWEEP OF CHIROPRACTORS, ATTORNEYS, AND LAW OFFICE
EMPLOYEES FOR INSURANCE OVERBILLING SCHEMES AND ILLEGAL PRACTICE OF LAW
May 07, 2009: Commissioner Poizner Announces Four Arrested, Charged with Conspiracy and $1.5 Million Grand Theft W.C.
Surgery Centers and W.C.S.C. & Associates
May 07, 2009: Commissioner Poizner Calls on State Fund to Move Expeditiously to Implement Recommendations
May 06, 2009: Collection Issue Booklet on Self-Procured Medical Treatment and Denied Cases - flowchart, case law, sample trial
briefs and more priced at $25.00
April 30, 2009: INSURANCE COMMISSIONER POIZNER ANNOUNCES ARRESTS OF SOUTH BAY FATHER AND
DAUGHTER FOR WORKERS’ COMP INSURANCE PREMIUM FRAUD
April 30, 2009: Husband and Wife Arrested and Charged with California's Largest Premium Insurance Fraud
April 27, 2009: EAMS recognized by Computer world Honors Program
April 27, 2009: Division of Workers' Compensation audit regulations approved and become effective May 20, 2009
April 22, 2009: Farr to introduce Medicare bill to fix underpayment to doctors
April 20, 2009: Review of 2008 En Banc Decision on Usual and Customary Fees
April 16, 2009: Commissioner Poizner Announces Arrest of Los Angeles Area Duo in $6.3 Million Workers' Comp Insurance Fraud
Scheme
April 15, 2009: Order Allow Amicus Brief (En Banc)
April 11, 2009: Collection Issue Booklet on Psychiatric Injury and Pain Management: flowchart, case law, sample trial briefs and
more priced at $25.00
April 10, 2009: CMA Sues WellPoint for Ingenix Price-Fixing Scheme
April 07, 2009: First Lesson on Utilization Review and Authorization for Medical Treatment
April 06, 2009: Re-Posted En Banc Case Law
"employer or insurer’s failure to provide required notice to an employee of rights under the MPN that results in a neglect or refusal to
provide reasonable medical treatment renders the employer or insurer liable for reasonable medical treatment self-procured by the
employee.
April 01, 2009: State law guarantees interpreters for health care services
April 01, 2009: Adjustments to the outpatient hospital and ambulatory surgical center services section of the Official Medical Fee
Schedule to conform to changes in Medicare payment system posted on the DWC Web site
April 01, 2009: Campaign aims to educate small employers about money available to bring employees back to the job or keep them
working following an injury
March 28, 2009 Letter to WCAB Regarding En Banc Decisions
March 25, 2009: SB 403, as introduced, Benoit. Workers' compensation: lien claims. An act to amend Section 4903.5 of the Labor
Code, relating to statutory time limit for filing liens in workers' compensation.
March 24, 2009: Chief Counsel Destie Overpeck designated Division of Workers’ Compensation acting chief deputy administrative
director
March 22, 2009: Corrections on Article of "DENIED CLAIMS AND
SELF-PROCURED MEDICAL TREATMENT"
March 18, 2009: Insurance Commissioner Poizner CALLS FOR HEARING TO DETERMINE CAUSE OF SKYROCKETING
MEDICAL COSTS IN WORKERS’ COMP SYSTEM
March 17, 2009: California Division of Workers’ Compensation posts annual audit report on its Web site
March 17, 2009: Commissioner Poizner Announces Long Beach Insurance Agent Surrenders in Connection with Grand Theft and
Elder Abuse
March 17, 2009: San Mateo County to pay $6.8-million settlement over hospital billing
March 15, 2009: INSURANCE COMMISSIONER POIZNER HIGHLIGHTS STRENGTH OF STATE-BASED INSURANCE
OVERSIGHT, OPPOSITION TO OPTIONAL FEDERAL CHARTER
March 15, 2009: "Collection Issue Booklets" now available addressing specific collection issues, with case law, helpful hints, appeal
letters and sample Trial Brief: and or "How To Booklets"
March 14, 2009: How to Get Paid When Treating Outside an MPN
March 11, 2009: Recent Job Posting - WC Collectors
March 11, 2009: Wal-Mart to enter electronic medical records business
March 09, 2009: POST QUESTIONS, COMMENTS AND ANSWERS TO POSTINGS ON LIEN CLAIMANT ISSUES http:
//workcompliens.com/blog2/
March 08, 2009: UCI Medical Center to open new hospital
March 08, 2009: Why the world's biggest insurance company is still getting taxpayer funds AIG is 'too interconnected to fail,' some
experts say
March 06, 2009: Obama Says He Is Open to Altering Health Plan
March 02, 2009: Half of nation's hospitals running losses
Feb 27, 2009: AIDS doctor pleads guilty to healthcare fraud
Feb 27, 2009: Weak healthcare stocks drag market lower
Feb 26, 2009: California cracks down on workers' comp avoidance tactic
Feb 26, 2009: Division of Workers' Compensation seeks nominations for medical guideline advisory committee
Feb, 25, 2009: Tenet Healthcare posts $33-million loss
Feb 24, 2009: Former Southern California Insurance Agent Charged with $300,000 Grand Theft
Feb 23, 2009: Stimulus Package Provides $87 Billion for Medicaid Programs; $19 Billion for HIT
Feb 23, 2009: Schwarzenegger Signs Budget Deal; Medi-Cal Largely Unscathed
2009: THE GOVERNOR'S HEALTH CARE PLAN
Feb 20, 2009: Guilty Plea in O.C. Medical Insurance Scam
Feb 18, 2009: Division of Workers’ Compensation provides new Qualified Medical Evaluator forms
Feb 17, 2009: Division of Workers’ Compensation Judges Consider Consolidation of Vocational Rehabilitation Issues
Feb 11, 2009: Insurance Commissioner Steve Poizner Announces $15 Million Settlement with Blue Cross Over Rescission Practices
Feb 05, 2009: DWC Offices will be closed on furlough days
Feb 04, 2009: Division of Workers' Compensation issues 2nd 15-day notice of revisions to proposed medical treatment guideline
regulations
Feb 03, 2009: Labor Commissioner Secures Nearly $750,000 in Prevailing Wage Settlements, Debars Contractor
Jan 27, 2009: Division of Workers’ Compensation posts adjustments to outpatient hospital and ambulatory surgical center services
section of the Official Medical Fee Schedule
Jan 20, 2009: Division of Workers' Compensation Posts - Answers to frequently asked questions about the Electronic Adjudication
Management System (EAMS)
MARIA TAPIA ADJ 4564224 (LBO 0322121) 73 Cal. Comp. Cases 1338
The Appeals Board held that consistent with its en banc decision in Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases
1588: (1) an outpatient surgery center lien claimant (or any medical lien claimant) has the burden of proving that its charges are
reasonable; (2) the outpatient surgery center lien claimant’s billing, by itself, does not establish that the claimed fee is “reasonable”;
therefore, even in the absence of rebuttal evidence, the lien need not be allowed in full if it is unreasonable on its face; and (3) any
evidence relevant to reasonableness may be offered to support or rebut the lien; therefore, evidence is not limited to the fees accepted
by other outpatient surgery centers in the same geographic area for the services provided.
Healthcare in Underserved Areas
August 19, 2009: Insurance Commissioner Poizner Announces Arrest of Diamond Bar Man in $1.4 Million Workers' Comp Fraud
Case
August 19, 2009: Crackdown on workers' comp billing fraud is dealt a setback
August 17, 2009: SECOND APPELLATE DISTRICT DIVISION ONE
in an unpublished decision of FRANK SNEDECOR v. WCAB held on 08/17/2009 WCAB did not address whether cervical fusion,
limited range of motion and whole person impairment under the AMA Guides may be equal, compared or analogized to factors
indicating the existence of spinal permanent disability under the 1997 schedule and section 4660(d). Since the WCAB did not reach
this issue and has extensive expertise and experience in such highly technical matters of workers’ compensation, the appellate court
conclude that the WCAB should determine the issue on remand. (See Brodie, supra, 40 Cal.4th at p. 1331; Zenith, supra, 159 Cal.App.
4th at p. 499; Genlyte, supra, 158 Cal.App.4th at p. 724.)
August 12, 2009: LA Times: O.C. woman gets 8 years in prison for recruiting patients for unnecessary surgeries
August 12, 2009: DPI: Insurance Commissioner Poizner today announced that he has appointed Sara Flocks, of San Francisco and
Lee Pearson, of Rancho Murieta to the Workers' Compensation Insurance Rating Bureau Governing Committee.
August 12, 2009: DWC: Division of Workers' Compensation announces appointment to workers’ compensation ethics advisory
committee
August 12, 2009: DWC: The Division of Workers’ Compensation now accepting applications for the upcoming qualified medical
evaluator examination
August 10, 2009: Another capper who pleaded guilty on Friday to in the largest medical fraud prosecution in the nation was
sentenced to eight years in state prison for recruiting over 90 healthy patients to undergo unnecessary and dangerous surgeries to
fraudulently bill medical insurance companies.
August 07, 2009: A capper in the largest medical fraud prosecution in the nation was sentenced today to 10 years in state prison for
recruiting over 170 healthy patients to undergo unnecessary and dangerous surgeries to fraudulently bill medical insurance companies.
August 07, 2009: Studies find spinal procedure no more effective than placebo
August 07, 2009: Las Encinas Hospital in Pasadena sued by ex-workers
August 04, 2009: COMMISSIONER POIZNER ANNOUNCES ARREST OF MILPITAS MAN FOR ALLEGED WORKERS’ COMP
FRAUD AGAINST CITY OF MENLO PARK
August 03, 2009: LaPlante v. WCAB (Wal-Mart Stores) in an unpublished decision After LaPlante petitioned this court for review,
the First Appellate District affirmed the WCAB’s reasoning in Benson and concluded “[t]he clear change in the statutory language
indicates intent to invalidate Wilkinson.” (Benson v. Workers’ Comp. Appeals Bd. (2009) 170 Cal.App.4th 1535, 1550, review den.
April 29, 2009.) Agreeing with the WCAB’s en banc decision, the court relied on the overall statutory scheme, the repeal of former
section 4750 upon which Wilkinson was established, and the express mandate under new section 4663, .)
July 29, 2009: The California Supreme Court denied a petition for review in the En Banc Decision of SB SURGERY CENTER v. W.
C.A.B. (SKILL MASTER STAFFING) Case Number S173368 "Tapia Case"
July 29, 2009: Division of Workers’ Compensation posts ZIP code locator
July 24, 2009: Commissioner Poizner RELEASES OPERATIONAL REVIEW Report OF CALIFORNIA INSURANCE GUARANTEE
ASSOCIATION.
July, 24, 2009: Division of Workers’ Compensation posts annual reports
July, 23, 2009: Division of Workers’ Compensation surveys EAMS users
July 23, 2009: Division of Workers’ Compensation posts qualified medical evaluator forms in Spanish
July 22, 2009: Division of Workers' Compensation appoints new members to the medical guidelines advisory committee
July 22, 2009: Division of Workers' Compensation appoints new members to the medical guidelines advisory committee
July 22, 2009: DOCTOR TO BE ARRAIGNED FOR MAKING FALSE STATEMENTS TO FRAUDULENTLY COLLECT
INSURANCE CLAIMING WORK-RELATED INJURY
July 22, 2009: The WCAB are rejecting liens and applications filed by Lien Claimants for failure to file a verification: §10770.5.
Verification to Filing of Lien Claim or Application by Lien Claimant
and §10770.6. Verification to Filing of Declaration of Readiness By or on Behalf of Lien Claimant. /// Summary of Appeals Board
rules of practice and procedure became effective Nov. 17, 2008 - that the Board is enforcing now.
July 17, 2009: Filed 7/16/09 State Comp. Ins. Fund. v. WCAB WORKERS’ COMPENSATION APPEALS BOARD and BRICE
SANDHAGEN CA3
Opinion following remand by Supreme Court IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA (unpublished
decision) PDF
IN THE SUPREME COURT OF CALIFORNIA
STATE COMPENSATION INSURANCE v WORKERS’ COMPENSATION
APPEALS BOARD and BRICE SANDHAGEN, PDF
July 16, 2009: Division of Workers’ Compensation tames paper backlog at district offices
July 14, 2009: Commissioner Poizner Announces Santa Paula Man Arrested in Connection with Workers' Comp Insurance Fraud
Charges
July 10, 2009: Payments to Medi-Cal providers will not be cut, federal court rules
Healthcare providers for the nearly 7 million Californians dependent on state-funded treatment sued the state Department of Health Care
Services after the law took effect July 1, 2008. They persuaded a federal judge in Los Angeles to halt the reductions on Aug. 18, on
the grounds that the cuts violated federal law requiring states that receive Medicaid funds to meet certain standards of efficiency,
economy, quality of care and access.
July 08, 2009: INSURANCE COMMISSIONER STEVE POIZNER REJECTS Industry-backed REQUEST FOR ANY INCREASE in
Workers' Comp cost BENCHMARK
July 08, 2009: WASHINGTON – The nation's hospitals will give up $155 billion in future Medicare and Medicaid payments to help
defray the cost of President Barack Obama's health care plan, a concession the White House hopes will boost an overhaul effort that's
hit a roadblock in Congress.
July 08, 2009: J.C. Penney v. WCAB (Edwards), No. C059760 (Cal. App. 3rd Dist. 2009) (WCAB Nos. SAC338759, SAC360384)
CERTIFIED FOR PUBLICATION
July 06, 2009: Analysis of Labor Code Section 4609 dealing with PPO contracts in Workers' compensation - Download in Word
Document
July 01, 2009: Division of Workers’ Compensation responds to inquiries regarding payment for medical treatment
June 30, 2009: Adjustments to the DMEPOS section of the Official Medical Fee Schedule to conform to changes in the Medicare
payment system effective July 1, 2009 are posted on the DWC Web site
June 29, 2009: Insurance Commissioner Steve Poizner Announces Terrorism Financing Probe
June 25, 2009: Plan to sell part of California workers' comp insurer State Fund faces opposition
June 24, 2009: 2008 Annual Report of the Unlawfully Uninsured Employer Enforcement Program Labor Code Section 90.3(d)
June 23, 2009: Division of Workers’ Compensation new medical treatment utilization schedule regulations approved by Office of
Administrative Law New schedule becomes effective July 18, 2009 - Copy of New Reg
June 19, 2009: WORKERS' COMPENSATION Former State Fund official served search warrant in criminal probe
As many as eight other warrants are served in the conflict-of-interest probe, according to a state official, who says recipients are likely
to have included other former officials at the insurer.
June 18, 2009: Supreme Court makes age bias suits harder to win
June 18, 2009: INSURANCE COMMISSIONER STEVE POIZNER ANNOUNCES $30 MILLION IN GRANTS TO FIGHT
WORKERS’ COMPENSATION FRAUD
June 18, 2009: A state judge on Thursday ordered former HealthSouth CEO Richard Scrushy to pay about $2.8 billion to shareholders
who sued over accounting fraud at the rehabilitation chain.
June 18, 2009: Division of Workers’ Compensation to test vendor-developed forms to ensure they work properly in EAMS
June 18, 2009: STATEMENT BY Commissioner Poizner ON CREATION OF PROPOSED FEDERAL INSURANCE OFFICE
June 17, 2009: Blue Cross praised employees who dropped sick policyholders, lawmaker says
June 16, 2009: Commissioner Poizner Assigns Special Examiner to Oversee AIG's California Insurance Operations
June 16, 2009: Ex-Cedars-Sinai worker gets 4 years for stealing records
June 13, 2009: The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying
greater efficiencies and broader insurance coverage will justify the change
June 12, 2009: Commissioner Poizner Announces Up to $37.3 Million in Legal Settlements Arising from the 2003 Failure of Workers'
Comp Carrier Fremont Indemnity Company
June 12, 2009: Notice of rulemaking and public hearing for amendments to Health Care Organization (HCO) regulations
June 11, 2009: AMA wary of Obama call for public health insurance
June 09, 2009: CDI ANNOUNCES PROSECUTION OF UNITED/PACIFICARE PROCEEDS TO ADMINISTRATIVE HEARING
June 09, 2009: STATEMENT BY COMMISSIONER POIZNER ON COMPLETION OF WORKERS’ COMPENSATION HEARING
June 02, 2009: Division of Workers’ Compensation implements paper cleanup plan for district offices
June 02, 2009: Insurance Commissioner Poizner Calls for Swift Action by WCIRB to Address Challenges Identified by Audit -- Calls
for meeting on June 08, 2008 to address high cost of Workers' Compensation
May 30, 2009: June 2009 Work Comp Collections Newsletter
May 29, 2009: 24-VISIT CAP ON PHYSICAL MEDICINE
May 29, 2009: Annual Hospital Financial Data
May 27, 2009: Commissioner Poizner Announces Three Arrested in Connection with $5 Million Workers' Compensation Insurance
Fraud
May 26, 2009: Division of Occupational Safety and Health (DOSH)
H1N1 (Swine Flu) Guidance for Employers and Employees
May 22, 2009: Common Surgeries and Price Comparison is a new Web tool allowing healthcare consumers to view and compare the
price of 28 common elective inpatient procedures at hospitals across California.
May 20, 2009: Doctors Closer To Using Carpool Lanes In Emergency
May 20, 2009: Sutter Health cuts 121 information technology jobs
May 20, 2009: Silent PPOs' In Workers Comp
May 14, 2009: Commissioner Poizner Announces Bakersfield Woman Charged With Insurance Fraud For Second Time In Two Years
May 09, 2009: DOCTOR SENTENCED TO 16 YEARS IN PRISON FOR PERFORMING UNNECESSARY SURGERIES ON
HEALTHY PATIENTS IN $154 MILLION MEDICAL INSURANCE FRAUD SCHEME
May 08,2009: OCDA CHARGES SEVEN IN SECOND SWEEP OF CHIROPRACTORS, ATTORNEYS, AND LAW OFFICE
EMPLOYEES FOR INSURANCE OVERBILLING SCHEMES AND ILLEGAL PRACTICE OF LAW
May 07, 2009: Commissioner Poizner Announces Four Arrested, Charged with Conspiracy and $1.5 Million Grand Theft W.C.
Surgery Centers and W.C.S.C. & Associates
May 07, 2009: Commissioner Poizner Calls on State Fund to Move Expeditiously to Implement Recommendations
May 06, 2009: Collection Issue Booklet on Self-Procured Medical Treatment and Denied Cases - flowchart, case law, sample trial
briefs and more priced at $25.00
April 30, 2009: INSURANCE COMMISSIONER POIZNER ANNOUNCES ARRESTS OF SOUTH BAY FATHER AND
DAUGHTER FOR WORKERS’ COMP INSURANCE PREMIUM FRAUD
April 30, 2009: Husband and Wife Arrested and Charged with California's Largest Premium Insurance Fraud
April 27, 2009: EAMS recognized by Computer world Honors Program
April 27, 2009: Division of Workers' Compensation audit regulations approved and become effective May 20, 2009
April 22, 2009: Farr to introduce Medicare bill to fix underpayment to doctors
April 20, 2009: Review of 2008 En Banc Decision on Usual and Customary Fees
April 16, 2009: Commissioner Poizner Announces Arrest of Los Angeles Area Duo in $6.3 Million Workers' Comp Insurance Fraud
Scheme
April 15, 2009: Order Allow Amicus Brief (En Banc)
April 11, 2009: Collection Issue Booklet on Psychiatric Injury and Pain Management: flowchart, case law, sample trial briefs and
more priced at $25.00
April 10, 2009: CMA Sues WellPoint for Ingenix Price-Fixing Scheme
April 07, 2009: First Lesson on Utilization Review and Authorization for Medical Treatment
April 06, 2009: Re-Posted En Banc Case Law
"employer or insurer’s failure to provide required notice to an employee of rights under the MPN that results in a neglect or refusal to
provide reasonable medical treatment renders the employer or insurer liable for reasonable medical treatment self-procured by the
employee.
April 01, 2009: State law guarantees interpreters for health care services
April 01, 2009: Adjustments to the outpatient hospital and ambulatory surgical center services section of the Official Medical Fee
Schedule to conform to changes in Medicare payment system posted on the DWC Web site
April 01, 2009: Campaign aims to educate small employers about money available to bring employees back to the job or keep them
working following an injury
March 28, 2009 Letter to WCAB Regarding En Banc Decisions
March 25, 2009: SB 403, as introduced, Benoit. Workers' compensation: lien claims. An act to amend Section 4903.5 of the Labor
Code, relating to statutory time limit for filing liens in workers' compensation.
March 24, 2009: Chief Counsel Destie Overpeck designated Division of Workers’ Compensation acting chief deputy administrative
director
March 22, 2009: Corrections on Article of "DENIED CLAIMS AND
SELF-PROCURED MEDICAL TREATMENT"
March 18, 2009: Insurance Commissioner Poizner CALLS FOR HEARING TO DETERMINE CAUSE OF SKYROCKETING
MEDICAL COSTS IN WORKERS’ COMP SYSTEM
March 17, 2009: California Division of Workers’ Compensation posts annual audit report on its Web site
March 17, 2009: Commissioner Poizner Announces Long Beach Insurance Agent Surrenders in Connection with Grand Theft and
Elder Abuse
March 17, 2009: San Mateo County to pay $6.8-million settlement over hospital billing
March 15, 2009: INSURANCE COMMISSIONER POIZNER HIGHLIGHTS STRENGTH OF STATE-BASED INSURANCE
OVERSIGHT, OPPOSITION TO OPTIONAL FEDERAL CHARTER
March 15, 2009: "Collection Issue Booklets" now available addressing specific collection issues, with case law, helpful hints, appeal
letters and sample Trial Brief: and or "How To Booklets"
March 14, 2009: How to Get Paid When Treating Outside an MPN
March 11, 2009: Recent Job Posting - WC Collectors
March 11, 2009: Wal-Mart to enter electronic medical records business
March 09, 2009: POST QUESTIONS, COMMENTS AND ANSWERS TO POSTINGS ON LIEN CLAIMANT ISSUES http:
//workcompliens.com/blog2/
March 08, 2009: UCI Medical Center to open new hospital
March 08, 2009: Why the world's biggest insurance company is still getting taxpayer funds AIG is 'too interconnected to fail,' some
experts say
March 06, 2009: Obama Says He Is Open to Altering Health Plan
March 02, 2009: Half of nation's hospitals running losses
Feb 27, 2009: AIDS doctor pleads guilty to healthcare fraud
Feb 27, 2009: Weak healthcare stocks drag market lower
Feb 26, 2009: California cracks down on workers' comp avoidance tactic
Feb 26, 2009: Division of Workers' Compensation seeks nominations for medical guideline advisory committee
Feb, 25, 2009: Tenet Healthcare posts $33-million loss
Feb 24, 2009: Former Southern California Insurance Agent Charged with $300,000 Grand Theft
Feb 23, 2009: Stimulus Package Provides $87 Billion for Medicaid Programs; $19 Billion for HIT
Feb 23, 2009: Schwarzenegger Signs Budget Deal; Medi-Cal Largely Unscathed
2009: THE GOVERNOR'S HEALTH CARE PLAN
Feb 20, 2009: Guilty Plea in O.C. Medical Insurance Scam
Feb 18, 2009: Division of Workers’ Compensation provides new Qualified Medical Evaluator forms
Feb 17, 2009: Division of Workers’ Compensation Judges Consider Consolidation of Vocational Rehabilitation Issues
Feb 11, 2009: Insurance Commissioner Steve Poizner Announces $15 Million Settlement with Blue Cross Over Rescission Practices
Feb 05, 2009: DWC Offices will be closed on furlough days
Feb 04, 2009: Division of Workers' Compensation issues 2nd 15-day notice of revisions to proposed medical treatment guideline
regulations
Feb 03, 2009: Labor Commissioner Secures Nearly $750,000 in Prevailing Wage Settlements, Debars Contractor
Jan 27, 2009: Division of Workers’ Compensation posts adjustments to outpatient hospital and ambulatory surgical center services
section of the Official Medical Fee Schedule
Jan 20, 2009: Division of Workers' Compensation Posts - Answers to frequently asked questions about the Electronic Adjudication
Management System (EAMS)
MARIA TAPIA ADJ 4564224 (LBO 0322121) 73 Cal. Comp. Cases 1338
The Appeals Board held that consistent with its en banc decision in Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases
1588: (1) an outpatient surgery center lien claimant (or any medical lien claimant) has the burden of proving that its charges are
reasonable; (2) the outpatient surgery center lien claimant’s billing, by itself, does not establish that the claimed fee is “reasonable”;
therefore, even in the absence of rebuttal evidence, the lien need not be allowed in full if it is unreasonable on its face; and (3) any
evidence relevant to reasonableness may be offered to support or rebut the lien; therefore, evidence is not limited to the fees accepted
by other outpatient surgery centers in the same geographic area for the services provided.
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