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A Few Thoughts on Proposed MPN Regs

December 23rd, 2013

So the DWC is looking to change up the MPN regulations, as you can see here.  Your humble blogger had a chance to look at these proposed changes, and while change is, of course, natural and good, some of the proposed regulations had your humble blogger raising an eyebrow.  Here are my thoughts (worth every penny you paid for them):

  1. Medical Provider Network Medical Access Assistants (9767.1(a)(16)) must be in the United States.  Now, Senate Bill 863 requires all MPNs “to provide one or more persons within the United States to serve as medical access assistants to help an injured employee find an available physician.”  The regulations seem to have interpreted this as requiring the PERSON to be in the United States.

    Your humble blogger, in reading the text of SB-863, sees this as providing the person –meaning that you can call from the United States to get access to this person during regular hours.  The private sector, in an effort to keep costs down, often outsources call centers to other parts of the world.  The regulations should interpret the law to allow maximum flexibility for the defendants while providing the same benefit to an injured worker.  If a person in Alabama or Texas or New York, all places as foreign to the true Californian as Turkey, England, and India, can be trained to provide an injured Californian with a California doctor, why not someone in Turkey, England, and India?

    Furthermore, the regulations require the assistants to be available in English and Spanish.  By allowing the call centers to be set up internationally, there would be more access to more languages.  California is a fairly diverse place, with Sacramento having the most languages spoken per capita in the United States.  It’s probably fair to say that there is going to be an injured worker somewhere in California that doesn’t speak Spanish or English, and still needs medical treatment.  At that point, he or she will be out of luck.

  2. Section 9767.5 sets access standards for an MPN, and yet it continues to allow an MPN to provide at least three available physicians 30 minutes/15 miles from the employee’s residence or house.  However, as we saw in the panel opinion of Miguel Robles v. Evolution Fresh, Inc., the regulations exceed the authority of the Labor Code, because section 4616(a)(1), the MPN is to provide physicians within the area of applicant’s employment and not his residence.  So, based on the writ denied Robles opinion, having 100 available physicians 2 miles from applicant’s home and 31 miles from applicant’s place of work a valid MPN does not make.

The regulations should incorporate the Robles decision, so as not to mislead defendants, particularly self-insured defendants into thinking they have an MPN immune to attack.

More thoughts to follow, dear readers, but it will be interesting to see what other comments come out of the comments, that are due Thursday by 5 p.m.

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