MPNs Must Include Chiropractors!
It is no secret at all that your tireless and consistent blogger is a fan of Medical Provider Networks. He has screamed his approval from the mountaintop of this blog for all to hear. But, realistically, the MPN is not a panacea: every armor has weak points.
One such gap in the defense was touched on in the recent case of Garcia v. Zenith Insurance Company (2011) 39 CWCR 293. There, a Workers’ Compensation Judge had awarded applicant treatment outside of the MPN because the MPN did not include chiropractors. Citing California Code of Regulations 9767.5, the WCJ let the applicant proceed with a non-MPN chiropractor.
The WCAB denied defendant’s petition for reconsideration.
Are you using an MPN? Does it have “at least three physicians of each specialty…”? Are there physicians within “60 minutes or 30 miles” of where your employees live or work? These are all questions to ask, and regularly — the MPN is not a magic want but a scalpel to be used to great effect but only when wielded with precision and skill.
In any case, the good people at Zenith are no doubt working on their MPN right now, looking for honest chiropractors to add to their lists.
Your humble blogger wishes you a happy new year – enjoy the revelry and stay safe. I will be at your service, bright and early, on Tuesday, January 3rd, 2012. See you next year!