Existing law establishes a workers’ compensation system, which provides for comprehensive medical-legal evaluations to assist in the resolution of contested claims. Under existing law, fees for medical-legal evaluations are charged at a rate not to exceed a physician’s regular fee, or the fee schedule set by the Administrative Director of the Division of Workers’ Compensation, whichever is lower. Existing law requires that the schedule set fees for procedures according to relative values and a conversion factor, allowing for modifiers, as specified. Existing law requires the medical-legal fee schedule to be revised at the same time the fee schedule for medical treatment is revised.

This bill would authorize the administrative director to adjust the fee schedule every 2 years based on an evaluation of certain medical practice costs, including increases in the conversion factor and the per-page cost of reviewing records, as specified. The bill would require the administrative director to update the fee schedule at the time they adopt and revise the reasonable maximum fees for, among other things, drugs and pharmacy services provided to an injured employee.