Bill > AB1048

This bill aims to improve transparency and fairness in California's workers' compensation system by requiring employers and payors (entities responsible for paying for medical services) to provide more detailed information to medical providers. Specifically, when an employer adjusts, changes, or denies a medical service bill based on a contract, they must now include information about that contract in their explanation of review (EOR) or explanation of benefits (EOB), including how the provider can obtain a copy of the contract. This aims to prevent the improper selling or leasing of provider contracts and ensures providers understand the basis for any discounted rates. The bill also clarifies that simply disclosing the name of a medical provider network is not enough to satisfy this requirement. Furthermore, it mandates that requests for authorization of medical services by a physician must be signed by that physician and can be submitted via mail, fax, or electronic methods. If a contract is not provided to a rendering provider or their agent within 30 business days of their request, the bill will be reprocessed and paid according to the official medical fee schedule.