PQME Alternalte Location Issue (California)

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PQME Alternalte Location Issue (California)

Postby theAxe on Wed Oct 07, 2009 10:45 am

Scenario:
Unrepped IW gets QME Panel and selects a Dr. S
Dr. S at location on panel can't see pt for 4 months and IW is given info for Dr. S other QME locations
IW sets PQME with Dr. S other QME location and sends written notice to CA advising of reason for changed location (no appt available w/in 90 days)

CA refuses to authorize PQME at other location because IW did not call other QMEs on the state Panel letter for possible timely appointment.

Question:
IW is to select QME of their choice from the panel of 3 - and the new QME regulations (effective 2/17/09) allow for exam at alternate location:
Per CC Section 34 (b) The QME shall schedule a appointment for a comprehensive medical-legal examination which shall be conducted only at the medical office listed on the panel selection form. However, upon written request by the injured worker and only for his or her convenience, the evaluation appointment may be moved to another medical office of the selected QME if it is listed with the medical director as an additional office location.

Can the CA demand that the IW select another QME from the list under the above scenario when the QME of his choice is available?

Is the written request referred to in section 34 (b) -noted above- to go to the CA or DWC or to who and is there any timeframe limitations on this request?

Does the written request need an approval response?
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Re: PQME Alternalte Location Issue (California)

Postby vampireinthenight on Thu Oct 08, 2009 8:09 am

Sounds like it violates 34(b), but if the IW really wants to go, they can probably argue it is more convenient because it is quicker. The QME might get in a little trouble for this, as it clearly is beign done for the QMEs convenience. I assume it is a greater distance for the IW to travel.
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Re: PQME Alternalte Location Issue (California) (California)

Postby jpod on Fri Oct 09, 2009 7:28 am

While I can not say why the CA cares, I believe the Med Unit and fellow QMEs care.

Remember there is a fairness issue on the ability of QMEs to be selected to "random" panels within a given locale. QMEs with multiple locations are not allowed to use a location outside of the locale from where the panel QMEs were pulled to grab more business when they are booked at the original location and can not meet the scheduling deadlines. The rule cited only applies if the QME was able to schedule within the statutory time frame.

I am pretty certain the Med Unit would be upset. I imagine local QMEs who will lose the potential opportunity to be pulled wouldn't be too happy either.
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