More Updated Medical Provider Network Forms Now Available

On August 29, the DWC issued a newsline (http://www.dir.ca.gov/dwc/dwc_newsline.html) alerting the community that new Medical Provider Network regulations had been approved by OAL and took effect August 27, and providing a summary of the revisions that were made. 

Included in those regulations were changes to several forms. The rollout of the revised forms began last week (see CWCI Bulletin 14-13) with the posting of three fillable forms:

• the new Provider Complaint Form (DWC 9767.16.5)
• the DWC Petition for Suspension or Revocation Part A (DWC 9767.17.5); and
• the MPN Response to Petition for Suspension or Revocation Part B (DWC 9767.17.5)

Please be advised that the rollout of the revised forms is continuing, and the Division has just posted the updated versions of two more fillable forms:

• the Cover Page for MPN Application or Plan for Reapproval (DWC 9767.4)
• the Notice of MPN Plan Modification (DWC 9767.8)

All five of the updated fillable forms are posted under Medical Provider Network – MPN Forms on the DWC forms page at http://www.dir.ca.gov/dwc/forms.html.

In addition, DWC has posted current lists of approved MPNs by approval date and by the name of the applicant along with a list showing the DWC Assignment of Unique Medical Provider Network Identification Numbers (Sorted by Name of MPN Applicant) on the Medical Provider Networks page of its website (http://www.dir.ca.gov/dwc/mpn/DWC_MPN_Main.html). 

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