News

Qualified Medical Evaluator (QME) Regulations – Telehealth Extended until July 17, 2022

Title 8, California Code of Regulations Section 46.3 Emergency Regulations Adopted – Expires July 17, 2022 Filed with Secretary of State January 18, 2022 Effective January 18, 2022 “The emergency regulation will help reduce physician and injured workers’ exposure to the COVID-19 virus, reduce the use of personal protective equipment and allow injured workers and physicians flexibility in...

HHS awards grants to address health care worker burnout, improve mental health, well-being

Modern Healthcare (1/20, Goldman, Subscription Publication) reports HHS has chosen the 45 “grantees for $103 million to address health care worker burnout and improve employees’ mental health and well-being, the department announced Thursday.” The grants “will fund projects including hiring resiliency trainers to support health care staff, establishing health system-wide wellness programs...

DWC Proposed QME Emergency Regulation in Response to Continued COVID-19 Pandemic is in Effect

The Division of Workers’ Compensation (DWC) announces its emergency regulation for Medical-Legal Evaluations became effective on January 18, 2022 and will expire on July 19, 2022 with two possible 90 day extensions (in accordance with Government Code section 11346.1(h)). The emergency regulations can be found on the DWC website. DWC filed the emergency regulation with the state’s Office of...

DWC Accepting Applications for QME Exam in April 2022

The California Division of Workers’ Compensation is accepting applications for the qualified medical evaluator examination that will be held from April 16-23. The division said it will offer in-person, computer-based testing through Pearson VUE. CPS HR consulting, the vendor managing the QME exam, will notify applicants about the registration and scheduling process, the division said. The...

Qualified Medical Evaluator (QME) Regulations – Telehealth Update!

The proposed Qualified Medical Evaluator emergency regulation section 46.3 will be submitted to OAL on December 28, 2021, so that the regulations will be in place to assist in the continued operation of the Qualified Medical Evaluator program during the COVID-19 crisis. The regulations will not become effective until filing with the Secretary of State after OAL approves them. OAL has up to 10...

DWC Emergency Regulations for Medical-Legal Reporting in Response to COVID-19 are in Effect through March 12, 2021

The Division of Workers' Compensation(DWC) announces its  emergency regulations 36.7 and 46.2 for medical-legal evaluations, which became effective on May 14, 2020, will expire on March 12, 2021. The expiration date is in accordance with Executive Orders N-40-20 and N-66-20.   There are two possible 210-day extensions if those Executive Orders remain in effect. The emergency regulations...

DWC Proposed Amendments to Medical-Legal Fee Schedule (QME)

The Division of Workers’ Compensation (DWC) has posted proposed amendments to the Medical-Legal Fee Schedule to its online forum where members of the public may review and comment on the proposals. The draft regulations include: A 25% increase in the multiplier for setting fees for evaluations. Standardization of the fee that can be charged for a missed appointment. Flat fees for...

Telehealth Reimbursement Place of Service Code

Place of Service Code Set to 02 for Telehealth Place of Service Codes for Professional Claims Database (updated October 2019) Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity where service(s) were rendered. Check with individual payers (e.g., Medicare, Medicaid, other private insurance) for reimbursement policies...

What is a QME?

Qualified medical evaluators (QMEs) are qualified physicians who are certified by the Division of Workers' Compensation - Medical Unit to examine injured workers to evaluate disability and write medical-legal reports. The reports are used to determine an injured worker's eligibility for workers' compensation benefits. QMEs include medical doctors, doctors of osteopathy, doctors of chiropractic,...

Speaking opportunities for MLE members

Date Time Requested Topic Organization City State On Site Attendees Remote Attendees Attendee Type1 3/25/2020 9:00am ET Back and Neck Injuries: Return To Work (1hr) The Main Street America Group- WEBINAR       20 Adjuster - WC 3/25/2020 12:00pm ET Post Traumatic Stress Disorder Cases in Workers' Compensation (2hr) The Main Street America Group- WEBINAR       20...