February 14, 2025 | Oakland, CA — MedLegalNews.com — Medical Provider Network update: The Division of Workers’ Compensation (DWC) is inviting stakeholders to provide feedback on a proposed update to the Medical Provider Network (MPN) regulations and rules for medical treatment billing. This update aims to streamline the MPN review process, enhance transparency, and clarify telehealth standards.
The proposed medical provider network update reflects DWC’s ongoing efforts to modernize California’s workers’ compensation framework. By refining network accessibility and standardizing telehealth protocols, the division aims to ensure injured workers receive timely, high-quality care from verified providers. These changes also encourage more consistent oversight, helping reduce administrative delays and improve coordination between insurers, physicians, and case managers.
Additionally, the proposed revisions support greater accountability among Medical Provider Network administrators. By tightening documentation and compliance requirements, DWC seeks to minimize fraudulent listings, outdated provider information, and network accessibility gaps. This ensures that injured workers can rely on accurate directories and that medical providers are properly credentialed and responsive to regulatory standards.
Key Changes in the Proposed Update
Medical Provider Network (MPN) Regulations (Title 8, Sections 9767.1 – 9767.19)
- Eliminates passcodes to improve transparency in provider networks.
- Requires additional provider documentation to ensure compliance and accuracy.
- Defines telehealth and remote service standards to reflect modern healthcare practices.
- Establishes clearer access standards for injured workers seeking medical treatment.
Together, these proposed changes aim to modernize the Medical Provider Network (MPN) framework, aligning it with current healthcare delivery methods and regulatory expectations. By removing unnecessary access barriers and strengthening provider accountability, DWC seeks to enhance the efficiency, accuracy, and fairness of medical care within California’s workers’ compensation system.
Medical Treatment Billing and Payment (New Section 9792.5.16)
- Clarifies contracting terms between medical providers and insurers.
- Outlines the roles and responsibilities of parties involved in billing and payment processes.
These proposed billing and payment updates are designed to reduce administrative disputes and promote timely reimbursements. By clearly defining contractual obligations and payment responsibilities, DWC aims to foster smoother coordination between insurers and medical providers, ensuring that injured workers receive uninterrupted access to necessary treatment without delays caused by billing conflicts.
How to Participate in the Public Comment Period
Stakeholders have until March 5, 2025, to submit written comments. Feedback can be emailed to DWCRules@dir.ca.gov.
By participating in this process, medical providers, insurers, and legal professionals can help shape regulations that impact access to care and provider reimbursement.
For official details and participation instructions, visit the DWC Proposed Regulations – Medical Provider Network Update page.
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FAQs: bout the Medical Provider Network Update
What is the purpose of the medical provider network update?
The medical provider network update aims to simplify the review process, enhance transparency, and ensure injured workers have improved access to quality medical care.
How does the medical provider network update affect telehealth services?
The update introduces clearer telehealth and remote service standards, helping providers deliver compliant and effective care under California’s workers’ compensation system.
What new billing rules accompany the medical provider network update?
Alongside the medical provider network update, DWC proposes new billing regulations that clarify contracting terms between providers and insurers for more efficient payments.
How can stakeholders share feedback on the medical provider network update?
Stakeholders can email comments to DWCRules@dir.ca.gov by March 5, 2025, to help refine the proposed medical provider network update before final adoption.