OAL Disapproves Proposed Changes to UR/IMR Regs

This week the Office of Administrative Law (OAL) rejected the proposed changes to Utilization Review (UR) and Independent Medical Review (IMR) regs submitted by the DWC on June 6. The proposed regs included changes to primary treating physician (PTP) reporting duties; IMR procedures; procedures for investigating UR violations; and procedures for changing a PTP.  In addition, the proposal called for additional penalties for UR and IMR violations.

In rejecting the proposed changes, OAL cited DWC’s failure to comply with the clarity standard of Government Code §11349.1(a)(3), and for incorrect procedure, as detailed in the Disapproval Decision, which is posted here.

Under Government Code §11349.4(a), DWC has 120 days to revise the proposal to address the issues identified by OAL and resubmit the proposed regs, which the Division plans to do.  Once the changes are made, DWC will issue the revised regs in a DWC Newsline.  The revised regs will be subject to a new public comment period, but the Division plans to resubmit the regs in time to meet the originally requested effective date of January 1, 2026. 

The Institute will continue to monitor these regs and post updates in the Regulation section of our website as they become available.

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