Revised MTUS Takes Effect 7/18/09

The revised Medical Treatment Utilization Schedule (CCR §§9792.20-9792.26) approved by the Office of Administrative Law last month and filed with the Secretary of State on June 18, takes effect at the end of this week (July 18). The revised schedule adds new sections on post-surgical physical medicine, elbow injuries, as well as the controversial chronic pain management section. During the regulatory development process, the Institute and others assailed the pain management guidelines for:

   • setting a vague definition of chronic pain ("any pain that persists beyond the anticipated time of healing");
   • failing to meet the required strength of evidence and rating methodology for establishing treatment guidelines; and
   • setting standards that contradict and supercede ACOEM — including a much more liberal standard for using opioids to treat chronic pain.

The final version of the regulations failed to address these concerns.

Due to the magnitude of the change in the Medical Treatment Utilization Schedule, CWCI will expand its ongoing research series tracking post reform outcomes in medical utilization to include areas featured in the new pain management guidelines, including opioid use, psychosocial evaluations, and other therapies and diagnostics.

For your reference, CWCI has posted the final regulations and the Final Statement of Reasons, including public comments and suggestions compiled as the regulations were being developed, in the Regs section of our website (www.cwci.org).

The Institute plans to review the changes in the MTUS, as well as other recently adopted regulatory changes, at a seminar this fall. Additional information and details on the seminar will be forwarded and posted on our website once the logistics are finalized.

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