Senate Bill 1160 introduced sweeping reform to workers’ compensation. Three sections of SB 1160 amend current lien requirements.
Frequently Asked Question
Q: What will be the new process of filing liens? And what do we need to do to keep our outstanding liens active?
A: Moving forward, lien claimants must file a declaration affirming that they satisfy brand new claimant requirements. Existing lien holders must file a declaration retroactively affirming that they meet these new requirements by July 1, 2017.
Explanation
Section 7 of SB 1160 adds a new Labor Code (4615), which is applicable to criminally charged physician. The new code automatically stays liens and any accrued interest when the provider of medical treatment or medical-legal services is charged with fraud against the workers’ comp system, medical billing fraud, insurance fraud, fraud against medicare, or fraud against medi-Cal.
Labor Code 4615 also requires the DWC to “promptly post” the names of the criminally charged provider of services on the DWC website.
Section 8 of SB 1160 amends Labor Code 4903.05 to place new restrictions on liens. For all new liens filed on or after January 1, 2017, the lien claimant must file a declaration affirming that they satisfy at least one of seven new lien claimant requirements.
For liens filed prior to January 1st, 2017, all existing holders must also file a declaration retroactively affirming that they satisfy at least one of the seven listed requirements. This declaration must be filed on or before July 1st, 2017.
The amended labor code reads as follows:
“For liens filed on or after January 1, 2017, any lien claim for expenses under subdivision (b) of Section 4903 that is subject to a filing fee under this section shall be accompanied at the time of filing by a declaration stating, under penalty of perjury, that the dispute is not subject to an independent bill review and independent medical review under Sections 4603.6 and 4610.5, respectively, that the lien claimant satisfies one of the following:
a. Is the employee’s treating physician providing care through a medical provider network
b. Is the agreed medical evaluator or qualified medical evaluator.
c. Has provided treatment authorized by the employer or claims administrator under Section 4610.
d. Has made a diligent search and determined that the employer does not have a medical provider network in place.
e. Has documentation that medical treatment has been neglected or unreasonably refused to the employee as provided by Section 4600.
f. Can show that the expense was incurred for an emergency medical condition, as defined by subdivision (b) of Section 1317.1 of the Health and Safety Code.
g. Is a certified interpreter rendering services during a medical-legal examination, a copy service providing medical-legal services, or has an expense allowed as a lien under rules adopted by the administrative director.”
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 she is the owner of that lien.”
Additional Information
California Labor Code § 4903.8
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