CWCI Schedules Workers’ Comp Treatment Utilization Guideline Seminars

January 22, 2004

The California Workers’ Compensation Institute will hold a one-day seminar in March in San Francisco and in Long Beach to educate industry professionals on practical issues surrounding implementation of the new Evidence-Based Medicine (EBM) utilization guidelines required by the 2003 workers’ comp reforms.

In mandating introduction of medical utilization guidelines into California workers’ comp, state lawmakers projected savings of $1 billion to $4.5 billion a year, so the pressure is on the community to understand and implement the guidelines. As of January 1 treatment protocols by medical specialty societies became admissible as evidence before the Appeals Board, and this week, DWC announced that effective March 22, the practice guidelines of the American College of Occupational and Environmental Medicine (ACOEM) will be given the presumption of correctness in regard to the extent and scope of workers’ compensation medical care in California.

The CWCI seminar will help the community gear up to implement the guidelines by briefly reviewing their purpose, history, and development, then providing hands-on information for claims personnel, utilization and bill review staff, medical case managers, attorneys, hearing reps and anyone who needs to understand the practical aspects and implications. Continuing education units will be available for claims examiners, attorneys, hearing reps, registered nurses, and QMEs. The seminar will cover the following areas:

*How Evidence-Based Medicine will impact California workers’ comp treatment decisions, with an analysis of EBM recommendations vs. current treatment and disability patterns, and a review of treatments not covered by ACOEM guidelines.

*Developing appropriate strategies and practices to incorporate utilization guidelines into medical management – issues and ideas for medical directors, claims staff, UR personnel and attornies.

*Case studies on knee and low-back cases to illustrate how utilization guidelines will apply to common industrial injuries.

2004 emergency regs, including fee schedules (physician fees, inpatient hospital services, outpatient hospital and ambulatory surgi-center services; pharmacy, lab, durable medical equipment and ambulance charges); second surgical opinions; and lien filing fees.
CWCI will present the seminar from 9 a.m. to 3:30 p.m. on Monday, March 8 at Hotel Nikko in San Francisco and on Friday, March 12 at the Long Beach Marriott. Early registration is strongly encouraged, as space is limited and payment must be received by March 1 to guarantee a space and qualify for the early-bird tuition. Early-bird tuition, including all course materials and lunch, is $295 for CWCI nonmembers, $195 for CWCI members, and $175 for CWCI member company employees who register 3 or more attendees together with a single payment. If payment is received after March 1, the registration can only be accepted if space permits and will be charged a $100 late fee. Details and registration forms on the seminar are available online at www.cwci.org or by calling Mel Long at (510) 251-9470.

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