Groups Opposing Bill to Create California Medical Provider Network Option for Workers

A piece of California legislation to establish a statewide medical provider network for employees is raising a few eyebrows.

Assembly Bill 1465 would require the administrative director of the state’s workers’ compensation system to establish a statewide medical provider network, called the California Medical Provider Network, and give employees the choice to treat within their employer’s MPN or the CAMPN.

The bill was introduced in late February by Assemblywoman Eloise Gomez Reyes, D-San Bernardino, and Lorena Gonzalez, D-San Diego. It was referred to the Assembly Committee on Insurance.

One coalition is now sounding a warning on the bill, saying it would undermine the system of providing medical care in California’s workers’ comp system and “lead to significant cost increases for employers and lower quality care for injured workers.”

The California Coalition on Workers’ Compensation, in partnership with American Property Casualty Insurance Association, California Chamber of Commerce, California Association of Joint Power Authorities, and Public Risk Innovation, Solutions, and Management, is opposing AB 1465.

“A bill like this not only rolls back previous reforms but threatens the stability of the workers’ comp system as we know it,” reads a recent email to CCWC members encouraging them to voice opposition to the bill.

Spokespersons for Reyes and Gonzalez were reached out to for comment.

The biggest concern in the bill is for those employers with MPNs, which are primarily large companies, said Mark Walls, vice president communications and strategic analysis for Safety National.

MPNs are believed to be keys to reducing costs and weeding out fraud in workers’ comp, Walls said.

“Anything that could undermine that, the employer community is rightfully concerned about it,” Walls said. “This bill is basically an end-around the MPNs.”

Setting up a statewide MPN would also no doubt be a big effort, he noted.

However, it’s not immediately clear how big of a financial impact giving workers a CAMPN would make.

“I don’t see any way that this would drive down costs, but it certainly could drive up costs,” Walls said. “Obviously the insurance community would be concerned about any type of legislation that could potentially increase claim costs in the state.”

One area where the bill has a potential for a monetary impact to the system is that the bill does away with PPO discounts that the employer MPNs can provide, which, according to Walls, could be a big problem.

“This could have a substantial impact on system costs which are currently being quantified,” Walls said. “Estimates are hundreds of millions of dollars in additional costs to the system if this bill were to pass.”

This article was first published on Insurance Journal.

Leave a Reply