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Chronic Pain Treatment Guidelines Take Effect

Date: June 26, 2009, Volume: 09-5, Number: 02 On July 18, 2009, the new Chronic Pain Treatment Guidelines will take effect as part of the Medical Treatment Utilization Schedule (“MTUS”) under Labor Code 5307.27. The regulations governing these new treatment guidelines are 34 pages long. However, the actual guidelines span some 127 pages with an […]

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Supreme Court Rules on Smith/Amar

Date: May 11, 2009, Volume: 09-5, Issue: 01 Today, the California Supreme Court issued its decision in the Smith/Amar cases. Please recall these cases involved the issue of whether after a stipulated award for future medical care, if an employer applies utilization review and therefore raises the reasonableness issue of specific care, is that action […]

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WCAB Decisions in Almaraz/Guzman II

Date: September 3, 2009, Volume: 09-6, Issue: 03 On Thursday, September 3, 2009, the WCAB issued its en banc decisions in the long-awaited cases of Almaraz/Guzman ALMARAZ/GUZMAN II: The WCAB has handed down a 51 page 4 to 3 “split decision,” with the majority of Commissioners essentially validating what they did back in February, but […]

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WCAB Decision in Ogilvie

Date:  September 3, 2009, Volume: 09-6, Issue: 04 On Thursday, September 3, 2009, the WCAB issued its en banc decision in Ogilvie: OGILVIE II: “DFEC is now alchemy.” Filed at the same time as its companion decision in Almaraz/Guzman, this en banc decision is in many ways parallel. A number of pages in these opinions […]

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The New CMS Policies on Prescription Drug Set-Aside Guidelines

As everyone is now likely aware, CMS has set forth new policies effective June 1, 2009 for the methodology of pricing future prescription drug treatment costs and expenses contained within MSA proposals, submitted on and after that date. As is the case, CMS issues rules through its memoranda, reflecting policies and procedures. Fortunately, these are […]

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