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Home / Insurance / Reviews in California result in fines of nearly $ 100,000 for companies reviewing usage

Reviews in California result in fines of nearly $ 100,000 for companies reviewing usage



The California Division of Workers’ Compensation fined nine organizations that provide usage reviews for the treatment of injured workers a total of $ 95,750 for violations discovered during the 2021 audits.

At the same time, while the division identified 75 violations in audit reviews by 36 claim administrators last year, it waived all penalties due to the high scores received by the auditors.

In 2021, the DWC reviewed 10 usage review organizations, including five in California, two in Tennessee, and one each in Florida, Nevada, and Wisconsin. The review of 574 requests for authorization found 51 late responses, 61 responses that were incorrect and two that were not properly distributed.

In total, the division identified 372 violations with potential penalties of $ 1

02,350. Since certain fines may waive audit subjects receiving 85% or more, the total amount that DWC will collect is $ 95,750.

WorkCompCentral is a sister magazine to Business Insurance. More stories here.


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