Senate Bills 1160 and 1175 introduced sweeping reform to workers’ compensation. Here’s a rundown of the biggest changes for interpreting and med-legal services.
Frequently Asked Question
Q: Are interpreting services of med-legal services affected by SB 1160 and SB 1175? How?
A: Yes. The 12-month timely bill submission reforms leveled by Senate Bill 1175 apply to providers of services, including interpreters, medical-legal services. Sections 7, 8 and 9 of Senate Bill 1160, which deal with lien reform, also apply to all providers of services.
Explanation
Timely Bill Submission
SB 1175, Section 1 amends Labor Code 4603, effective January 1, 2017. The amended Labor Code 4603 requires providers to submit bills for services to the claims administrator within 12 months of rendering services or the date of discharge from an inpatient facility:
“A provider of services provided pursuant to Section 4600, including, but not limited to, physicians, hospitals, pharmacies, interpreters, copy services, transportation services, and home health care services, shall submit its request for payment with an itemization of services provided and the charge for each service, a copy of all reports showing the services performed, the prescription or referral from the primary treating physician if the services were performed by a person other than the primary treating physician, and any evidence of authorization for the services that may have been received.”
Lien Reform
Section 7 of SB 1160 adds a new Labor Code – 4615 – that is applicable to criminally charged physicians. This new Labor Code 4615 automatically stays liens and any accrued interest when the provider of medical treatment or medical-legal services is charged with any of the following: fraud against the workers’ comp system, medical billing fraud, insurance fraud, fraud against medicare or against Medi-cal.
Section 8 of SB 1160 amends Labor Code 4903.05 to change the requirements when filing the required lien declaration. For all new liens filed on or after January 1st, 2017, the lien claimant must file a declaration affirming that the lien claimant satisfies at least one of the seven listed lien claimant requirements.
For liens filed prior to January 1st, 2017, all existing lien holders must also file a declaration retroactively affirming that the lien claimant satisfies at least one of the seven listed lien claimant requirements. This declaration must be filed on or before July 1st, 2017.
Section 9 of SB 1160 amends Labor Code 4903.8 to clarify that only the lien owner is entitled to lien payments and that the lien ownership cannot be assigned. Further, Labor Code 4903.8 requires evidence of lien ownership, “no payment shall be made on any lien claimant without evidence that he or is the owner of that lien.”
Additional Information
DaisyBill Resources
Webinar: Senate Bills 1160 and 1175
Webinar: Lien Declaration Requirement