California Workers’ Comp Division Holding Regulations Hearing on Medical Provider Suspension

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The California Division of Workers’ Compensation on Friday issued a notice of public hearing on proposed regulations to implement the provider suspension process required under Assembly Bill 1244.

AB 1244, which went into effect Jan. 1, introduced new changes to the workers’ comp system and requires the division’s administrative director to suspend any medical provider, physician or practitioner from participating in the workers’ compensation system in cases in which one or more of the following is true:

The provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ comp system, fraud or abuse of a patient, or related types of misconduct;
The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or
The provider’s license or certificate to provide health care has been surrendered or revoked.

The regulations provide for a hearing process should the provider wish to contest the suspension order.

Emergency regulations became effective on Jan. 6 for 180 days. They were readopted on July 6 for 90 days, and readopted for the final time on Oct. 5 and will remain effective until Jan. 4, 2018.

A public hearing has been scheduled for 10 a.m. on Dec. 11 in the Auditorium of the Elihu Harris State Office Building, 1515 Clay Street, Oakland, Calif., 94612. The public may also submit written comments on the regulations until 5 p.m. that day.