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Posted on: Apr 19, 2021

The battle around Assembly Bill 1465 is heating up with many insurance and employer groups waging a full-blown scare tactic assault to prevent the establishment of a statewide MPN.

Their main contention is that the current system of piecemeal MPNs is working, reduces costs and provides adequate care for injured workers, but as we pointed to last week, those claims are simply false.

What it actually boils down to is control.

Gregory Grinberg, managing partner of Gale, Sutow & Associates’ S.F. Bay South office (an employer defense firm) confirmed as much in a piece published to their blog and in Work Comp Central last week.

“… The employer’s control of medical treatment through an MPN will be effectively eliminated, as an injured employee can treat in the CAMPN (California MPN), and the employer will have no control over who is in the CAMPN,” he wrote.

Essentially, they want to control where an employee can be treated so they can deny and delay care in hopes of saving a buck. The irony is that the current system actually leads to increased costs.

“The California Workers’ Compensation Institute (CWCI) did a comprehensive study of MPNs and found that they generated a negligible 2% in savings,” said Jacob Rosenberg, MD, Medical Director of IPM Medical Group and President of the California Society of Industrial Medicine and Surgery (CSIMS). “Those savings were more than offset by added frictional costs to the system, as a Journal of Occupational and Environmental Medicine (JOEM) study concluded.”

“Worse still, a recent study by the WCIRB demonstrated that delays in medical treatment, often the result of the broken MPN system, were a significant driver of downstream costs to employers,” said Daniel Rosenberg, Director of Revenue Cycle for Integrated Pain Management for IPM Medical Group, and a CSIMS member. “Injured workers who don’t receive treatment within the first 30 days are 40% more likely to have permanent disability awarded.”

While employer groups assert they simply want to control the quality of care being received through MPNs, the current system is broken, says Daniel.

“There is no way to determine what MPN covers an injured worker, and a recent study of pain management MPNs revealed that the majority of providers listed are retired, moved out of state, or are no longer accepting workers comp,” he said. “Yet injured workers are forced to stay within these invalid MPNs, delaying their care for months on end.”

Jacob noted that employers put their trust in carriers to curate networks of quality, affordable, providers, but the networks have broken that trust by chasing short term rate reductions at the expense of long-term cost savings, and ethical medical care.

“Let’s not mince words: fixing the MPN system is a humanitarian issue,” said Jacob. “A vote for AB 1465 is a vote for efficiency, and human decency.”