Doctors and attorneys for injured employees have targeted the largest workers’ compensation fund carriers in California over a controversial change in the provider contract that has occurred within that state.
State Compensation Insurance Fund is a nonprofit organization that provides the last resort worker’s compensation insurance. Its most recent revisions to its new contract for the medical provider network (MPN) has received significant criticism since its implementation.
State Fund continues to stand by the alterations that it has made, claiming that patients will find an advantage in the changes, which were all done by the law of California.
That said, the California Applicants’ Attorneys Association (CAAA) and the California Society of Industrial Medicine and Surgery (CSIMS) argue that this newly revised contract is riddled with legal and ethical issues that place workers at risk when they are employed by an organization that is among the approximately 180,000 State Fund policyholders.
The CSIMS called the new contract “heavy-handed” as an effort to contract medicine. It said that there were “grave concerns” about the revisions. Carlyle Brakensiek, the vice president of CSIMS, said that the new contract, which had previously been known as the SCIF MPN General provisions and Criteria, could potentially lead doctors to limit injured employees’ treatment rights.
He added that it may weaken patient care and cause medical practitioners to be at an increased risk of medical malpractice claims.
On the other hand, State Fund continues to defend the changes that it made and Gina Simons, its communications director, said that “Our MPN is, in fact, still in place with DWC approval.”