Regulatory Compliance

California

CorVel is a pioneer in industry-leading technology to automate and streamline the management of workers’ compensation claims for California employers. Our continued investments in systems and a focus on customer service provide the only integrated risk management solution in the industry.

We provide immediate intervention for your employees through Advocacy 24/7 and access to our innovative telehealth services. Early interaction with a doctor can facilitate expedited prescriptions and referrals for additional care services. Telehealth is just one of the ways CorVel is here for your employees. By connecting your employees to appropriate care from the onset of an injury, we deliver better care in a timely manner.

California Regulatory Updates 06/01/2025

Effective Date: 06/01/2025

Issue: Workers’ Compensation Medical Treatment Guidelines

Summary: The Administrative Director of the California Division of Worker’s Compensation issued an Order, which adopts and incorporates by reference the Chronic Pain
Guideline (ACOEM December 19, 2024) into the Medical Treatment Utilization Schedule (“MTUS”) from the ACOEM Practice Guidelines for the treatment and evaluation of patients who have chronic pain. This guideline addresses a general approach to patients with chronic pain and the psychological and behavioral aspects of chronic pain. This guideline also addresses a few specific chronic pain disorders (i.e., complex regional pain syndrome, fibromyalgia, neuropathic pain).

Guidance for the treatment and evaluation of chronic pain disorders not specifically addressed in the guidelines is contained in the Clinical Topics guidelines and/or Opioid Guideline.

A copy of the Administrative Director Order can be found here: DWC Evidence-Based Updates to the Medical Treatment Utilization Schedule (MTUS)

California Medical Fee Schedule updates 07/01/2025

Effective Date: 07/01/2025

Subject: California DWC Adjusts OMFS for Physician Services/Non-Physician Practitioner Services

Description: The California DWC has posted an order adjusting the Physician Services/Non-Physician Practitioner Services section of the Official Medical Fee Schedule (OMFS) to conform to the CY 2025 Quarter Two changes in the Medicare payment system. The update order is effective for services rendered on or after April 1, 2025. The order adopting the above Workers’ Compensation Claims Bulletin | April 2025 OMFS adjustments is posted on the physician services and non-physician practitioner services
fee schedule webpage. A copy of the DWC announcement can be found here.

DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services) | California Department of Industrial Relations

Subject: Workers’ Compensation California DWC Posts Adjustment to OMFS for Ambulance Services

Description: The California Division of Workers’ Compensation (“DWC”) has issued an order, which makes an adjustment to the Official Medical Fee Schedule (“OMFS”) for the Ambulance Services Section. The changes are needed to conform to the CY 2025 Quarter Two changes in the Medicare payment system as required by Labor Code section 5307.1. The Quarter Two update adopts the Medicare revised ZIP code files; other provisions of the CY 2025 Ambulance Fee Schedule are unchanged.

The update order is effective for services rendered on or after April 1, 2025, and can be found at the DWC OMFS Ambulance Fee Schedule webpage.

A copy of the DWC announcement can be found here:

DWC Posts Adjustment to Official Medical Fee Schedule (Ambulance Services) | California Department of Industrial Relations

California Regulatory Updates 10/08/2024

AB 2337 – Workers’ Compensation: Electronic Signatures. An Act to Amend Sections 17 and 5003 of the Labor Code, Relating to Workers’ Compensation.

Issues: Workers’ Compensation: Any Proposal

Summary:

This measure includes electronic signatures as valid signatures for purposes of the workers’ compensation system.

Most Recent Update:

09/22/2024 – Signed by Governor Gavin Newsom (D)

California Regulatory Updates 08/06/2024

AB 1870 – Notice to Employees: Legal Services. An Act to Amend Section 3550 of the Labor Code, Relating to Workers’ Compensation.

Issues: Workers’ Compensation: Any Proposal

Summary:

This measure requires the notice that employers must make available to employees regarding workers’ compensation to include information concerning an injured employee’s ability to consult a licensed attorney to advise them of their rights under workers’ compensations laws, and that in most instances, attorney’s fees will be paid from an injured employee’s recovery. This measure takes effect January 1, 2025.

Most Recent Update:

07/14/2024 – Signed by Governor Gavin Newsom (D)

AB 171 – Budget Act of 2023. An Act Relating to the Budget Act of 2023.

Issues: Workers’ Compensation: Any Proposal

Summary:

This measure makes various changes regarding payroll, and workers’ compensation. This measure would take effect immediately.

Most Recent Update:

07/02/2024 – Signed by Governor Gavin Newsom (D)

California Regulatory Updates 07/11/2024

SB 1205 – Workers’ Compensation: Medical Benefits. An Act to Add Section 4600.03 to the Labor Code, Relating to Workers’ Compensation.

Issues: Workers’ Compensation: Any Proposal

Summary:

This measure entitles workers’ to transportation, lodging, and meal expenses when receiving treatment under workers’ compensation, as well as a day (or proportion thereof) of temporary disability indemnity for each day of wages lost receiving treatment. It prohibits employers from discriminating against workers for receiving treatment during customary working hours. It allows the employer to require the employee to first exhaust leave before providing temporary disability indemnity leave.

Most Recent Update:

06/26/2024 – Hearing Held; Passed Committee; Referred to Senate Appropriations Committee

Participation in a California Medical Provider Network (MPN) gives employers better control over care of the injured worker for the duration of the claim, while providing quality medical services, provider discounts and faster claim closure. In California the MPN must meet certain requirements including providing adequate numbers and types of physicians, being able to treat injuries in a timely manner and having treatment readily available at reasonable times to all employees.

We are here to help.
CorVel received certification for our California MPN in January 2005. We stay active in the regulatory environment and closely monitor changes that impact our customers. Learn more about our comprehensive suite of workers’ compensation solutions or contact a local representative.

Effective January 1, 2017, the definition for claims will include claims for which medical treatment costs are incurred regardless of whether the cost of medical treatment, including first aid, is paid by an employer or insurer, or regardless of whether a workers’ compensation claim form (DWC1) is filed. The change will be in effect for both new and renewing policies and was mandated by the Workers Compensation Insurance Rating Bureau (WCIRB) in conjunction with the California Department of Insurance.

These adopted changes further indicate any/all claims including those involving first aid as defined in the California Labor Code, in which indemnity losses or medical losses are incurred or allocated loss adjustment expenses are paid must be reported individually. These changes do not currently impact self-insured employers in the state because they are governed by the Office of Self Insured Plans, and not the WCIRB, which does not address self-insured employers.

We are here to help.
CorVel’s systems, services, and reporting are in compliance with the newly redefined classification for medical only claims in California. Learn more about our workers’ compensation solutions or contact a local representative.

We are here to help.
Learn more about CorVel’s workers’ compensation solutions or contact a local representative for additional information.

California Services

Workers’ compensation claims administration
Industry leading savings for medical bill review
Full visibility for pharmacy data to manage costs
State-approved utilization management
Local PPO network development