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It's HERE: Bold Legislation to Curb WC Middlemen

8 Apr 2019 8:08 AM | Anonymous

iPTCA & CPTA Announce Work Comp Legislation to Control the Middlemen.

SB 537 (TPA/Middlemen Workers' Compensation Reform Bill)
will be heard in the Senate Labor, Public Employment and Retirement Committee on Wednesday April 10, 2019 at 9:30 am, State Capitol, Room 2040.

SB 537 would:

  • Provide that contracted Workers' Comp reimbursement rates shall not be less than the applicable Medicare fee schedule payment
  • Prevent middlemen from illegally meddling with treatment decisions made by treating physicians and PTs
  • Force middlemen to post the names of contracted PT clinics and their phone numbers on the MPN internet directory
  • Prohibit middlemen from upcoding PTs' bills
  • Allow the Administrative Director to investigate and punish middlemen for non-compliance with Labor Code statutes

Watch your email for calls to action to support this much needed legislation.

This legislation will focus on limiting the interference that TPAs & Middlemen (bill review companies) can exert on the work comp system along with providing limits to how much they can discount the fee schedule.

Many PTs are not even aware of the extent of the changes in the work comp fee schedule as the middlemen have rigorously guarded how much they take out and pressured clinics to accept low paying contracts while also increasing your administrative burden.

Learn just how much the fee schedule has changed since 2014 by downloading the Excel workbook 2019 Calculator...for your locality.

Members just need to log in at, choose MEMBERS > MEMBER ONLY > CALCULATORS to download the Excel calculator for their locality to be able to run their own examples. There are also two short videos on how to get the most out of the workbook.



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