Bill > AB1048

This bill aims to improve transparency and efficiency within California's workers' compensation system by requiring employers to provide more detailed explanations of review (EORs) when denying or adjusting medical treatment claims. Specifically, if a denial or adjustment is based on a contract, the EOR must now include information about that contract and how the medical provider can obtain a copy, clarifying that simply stating the medical provider network is not sufficient. Furthermore, if the contract isn't provided within 30 business days of the provider's request, the bill will be reprocessed and paid according to the official medical fee schedule. The bill also mandates that requests for authorization of medical services must be signed by the physician and can be submitted via mail, fax, or electronic methods, streamlining the process for obtaining necessary medical care for injured workers.

Budget and Finance, Business and Industry, Labor and Employment

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB1048