9767.9 (b) (California)

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9767.9 (b) (California)

Postby rider001 on Fri Mar 27, 2009 4:49 pm

I was just wondering if there was any case law contrary to 9767.9 (b) which states:
Untill the injured covered employee is tranfered into the MPN, the employee's physician may make referals to providers within or outside the MPN.

I have came across a lot of defenses and objections to treatment which was referred by a nonMPN treator. I have heard and seen other lien claimants bite on these defenses.

However, I am of the opinion that without a judical order compelling the claimant into the MPN, treatment can be referred to non mpn providers. Without the judical order there is no way to assertain if all of the conditions of 9767.5, 9767.6, 9767.10, 9767.12, 9767.14 have been met.

Any thoughts?
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Re: 9767.9 (b) (California)

Postby jakelast@aol.com on Sat Mar 28, 2009 9:00 am

There is no requirement for a judicial order for an employee to be transferred into an MPN and the process is supposed to occur as set out in the statute and regs. If the employee contests the transfer, then the employer may have to demonstrate compliance with the transfer of care provisions but the actual transfer occurs without judicial intervention.

However until the employee is actually transferred into the MPN, there is no limitation on whom the PTP can refer an employee to for additional treatment and or consultation. The only limitation on that issue would be if the PTP was in the MPN and then continues as the PTP after leaving the MPN. The rules require the physician to continue to operate as if he/she were in the MPN including fee agreements and following MPN rules for providing care.
Jake Jacobsmeyer
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