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California approves changes to the scheduling fee schedule



The California Office of Administrative Law on Tuesday approved proposed changes to the state Department of Occupational Compensation Schedule for medical-legal fee, which substantially revised the current compensation system for occupational compensation assessments. All medical-legal valuations that occur on or after April 1 will be covered by the new fee schedule.

The medical-legal contribution scheme, which has not been updated since 2006, describes the necessary remuneration for qualified medical evaluators whose task is to evaluate the workers 'eligibility for workers' benefits. For the past 15 years, QME has been paid an hourly rate – typically from about $ 250 per hour ̵

1; to review medical records, write medical-legal reports and testify in trials. and an additional $ 3 per page to review items in excess of 200 pages. Under the proposal, a QME employee to conduct a comprehensive medical-legal evaluation will pay $ 2,015, plus the fee per page if applicable.

Although the proposed changes received hundreds of comments expressing concern – including fears that payers would pay thousands to doctors for reviewing potentially redundant or inappropriate medical records – the OAL approved the changes as they were written and released in late February.

While the amendment officially enters into force tomorrow, the Department of Work Compensation noted that QMEs currently scheduled for April may not meet the new certification requirements under the fee schedule and that the parties must agree on the handling of these evaluations.

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