Online DWC Approved QME Continuing Education

WCAB court cases and ever changing California law ensure that the medical legal landscape is always shifting! We continually update our courses to add relevant and new information.

What's New!      Updated 12/1/19
DWC Audit by the California State Auditor
As you may recall, the DWC has been audited for the first time in its history by the California State Auditors Office. The results of the audit are now published. You may read the summary and full report here: https://www.auditor.ca.gov/reports/2019-102/index.html   

In Summary:  
The Auditor's Office did an excellent job of summarizing the QME's functions and the DWC Medical Unit's oversight of the QME system. There are some key findings, many of which we in the QME community were already aware of: 

The DWC has not adequately ensured that there are enough QMEs to keep up with the demand for their services, noting that from fiscal years 2013–14 through 2017–18, the total number of QMEs decreased by 12 percent while requests for QMEs increased 37 percent.

- By not ensuring an adequate number of QME’s, the DWC may be causing delays to the injured workers’ access to benefits while increasing costs to employers.
 
- The DWC inappropriately used its own QME reappointment process to discipline some QMEs the Division alleged to have committed overbilling violations, which raises due process concerns. The DWC lacks sufficiently detailed, written policies and procedures for investigating and resolving complaints.

- The DWC has not continuously reviewed QME reports for quality and has not tracked when workers’ compensation judges have rejected QME reports that failed to meet minimum standards. “Low-quality QME reports can delay injured workers’ receipts of benefits and add expenses for employers involved in disputes.”

Recommendations within the Auditors Report:
- To address the decrease in the number of appointed QMEs the Legislature should amend state law to specify that the DWC review and, if necessary, update the fee schedule for compensating QMEs at least every two years based on inflation. Implement a plan for recruitment for needed specialists QMEs by 2020. 

- Revise state law to increase the number of QMEs on the panels DWC provides.

- DWC should, by April 2020, develop and implement separate written policies and procedures that define and specify its internal processes for disciplining and reappointing QMEs.

- Implement a plan to continuously review QME reports for quality and report its findings to its administrative director annually.

DWC Response and Auditor's Reply:
The DWC has responded officially to the Auditor's report and the Auditor's Office has replied to that response. You may read these comments here: https://www.auditor.ca.gov/reports/2019-102/response.html#comments
 

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MLFS Update: 
At this point there is no news in regard to needed revision of the MLFS. AB 1832 appears to be stalled, while the DWC's last proposal was not well received by the QME community. The Auditor's report clearly restates the need for adjustment to the MLFS, but does not articulate how just an adjustment be made. The debate will no doubt continue into 2020, at which point the MLFS will not have been adjusted for inflation in 14 years!

As Always: The issues regarding the MLFS Complexity Factors remains concerning and QME's are urged to fully document the complexity factors involved in billing. Your descriptions of the complexity factors should be rock solid to avoid any conflict with the Medical Unit. If you have any questions regarding a specific case or complexity factor issue, please contact the Medical Unit personally before issuing your report.

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- California AB 1832 has stalled in the State Legislature
Assembly-members Rudy Salas and Eloise Gomez-Reyes have introduced AB 1832. Effectively AB 1832 would constitute an increase in the MLFS which has not  been adjusted since 2006. Since its introduction, there has been no action taken by the Assembly and the bill has effectively stalled. To read the full text of the bill and to track its progress, click HERE.

You are urged to contact your State representatives regarding their needed support of AB 1832.
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Another New Proposed Fee Schedule.
The DWC responded to the introduction of AB 1832 with a proposed new Medlegal Fee Schedule. A forum was opened and hundreds of pages of public comments were made.

Read the DWC Proposal and the Forum Contents  HERE.

The DWC is proposing a flat rate type schedule which would sadly reduce payments to QME's for most reports. This proposal stands in direct contrast to AB 1832, proposing in effect a pay cut to QME's when a pay increase is needed to stem the exodus of QME's from the system.

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- New Course Approval - AMA Guides Examples
We are happy to announce that our new course covering AMA Guides 5th Edition text examples has been approved by the DWC Medical Unit. The course discusses AMA Guides 5th Edition examples for the Upper and Lower Extremities and the Spine.
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- All of our courses have been re-compiled using the latest HTML5 website code. These latest improvements will make our courses play smoothly on a wide array of PC's and mobile devices. Check out our Sample videos which are also compiled using this same code! Course 1 Sample
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- Our 12 Hour Report Writing Course was approved by the DWC Medical Unit and has been well received. This course satisfies the DWC Medical Unit report writing course requirement for New QME appointment.

DWC Medical Unit QME Educational Provider #1240 
All course are approved by the DWC Medical Unit to 5/22/2021

DWC Medical Unit Report Writing Course Provider #18 
DWC Report Writing Course Approval to 8/20/20
 

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- All of our 6 hour courses have been re-approved by the DWC Medical Unit until 5/6/21.

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- The DWC Medical Unit has released a new version of the Physician's Guide to Medical Practice in the California Workers' Compensation System
Download Here

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QME Examination Review:
If you would like to take any of our current courses in preparation for sitting the QME Examination, please email us! We offer a discount for using our courses for examination preparation!