CWCI Web-Based Seminar: Update on New MTUS Regs and Other Permanent Regulations

Six weeks ago, the Office of Administrative Law approved DWC’s final version of the Medical Treatment Utilization Schedule (MTUS) regulations, which took effect April 20. These changes were intended to clarify the process for evaluating medical evidence so that treating physicians, reviewing physicians and claims administrators can make better informed decisions and reduce the number of disputes over competing treatment recommendations.

In addition to the MTUS changes, in April the state also finalized regulations needed to implement other provisions of SB 863, including the adoption of a copy service fee schedule that takes effect July 1, and details on DIR’s $120 million a year Return to Work Fund. To help workers’ compensation claims, medical care and legal professionals become familiar with these changes; CWCI has scheduled a web-based training program on the morning of Wednesday, July 15. 

The program will be presented by CWCI Claims and Medical Director Brenda Ramirez and CWCI Senior Research Associate Stacy Jones. CWCI General Counsel Mike McClain will provide legal insight and moderate the program. The web-based program will run from 9 a.m. to 12:30, with two 15-minute breaks and will focus primarily on the MTUS regs, with discussions covering changes that:

• clarify the role of the MTUS as the primary source of guidance for treating physicians and physician reviewers in evaluating and treating injured workers
• establish the limited situations in which recommended treatment outside the MTUS may be warranted
• provide guidance in searching for appropriate recommendations in medical treatment guidelines and studies
• set the requirements for treating and reviewing physicians to properly support RFAs, UR decisions and IMR decisions regarding reasonable and necessary care
• establish the methodology that reviewing physicians should follow to evaluate the quality and strength of evidence used to support competing recommendations

Claims professionals who register for the web-based seminar can qualify for three post-designation training hours and if they convene in a classroom setting with an instructor, toward Department of Insurance claims certification requirements. Upon request, after completing the program CWCI will issue certificates for each individual enrollee.

The cost of the program is $125 for CWCI member company employees and $175 for nonmembers, with group rates for companies enrolling 5 or more employees (call 510-251-9470 for pricing). For more details or to register, go to the Seminar section of the CWCI website, http://www.cwci.org/. Confirmations, course materials and instructions for participating in the training session will be emailed to all enrollees. For those who are unable to participate on July 15, CWCI may offer this program on our website as an on-demand seminar at a later date.