Save Workers' Comp for California's Injured Workers

Existing Law

• Existing law, through the enactment of SBs 228 and 899, required California to adopt evidence-based medicine guidelines for Workers’ Compensation by 12/04 in an effort to control over-utilization of medical services, set parameters for effective care and reduce treatment costs.

• Existing law provides that until the medical treatment utilization schedule is adopted by the Administrative Director, the guidelines set forth in the American College of Occupational and Environmental Medicine (ACOEM), a private company operated by and for the benefit of Western Medicine practitioners, guidelines shall be presumptively correct and that this presumption is applicable regardless of the date of the injury. These ACOEM Guidelines have been found to be inferior and insufficient for fair, equitable and competent use in the Workers' Compensation System.

The Problem

• An unintended consequence of Workers' Comp Reform Legislation has been the effective removal of Acupuncture from the Workers’ Compensation System -- creating a loophole for insurance carriers to deny coverage of Acupuncture treatments under Workers’ Compensation specifically because of the presumption relating to ACOEM, and

• The DIR’s failure to follow through on their fiduciary responsibility that required the Administrative Director of the Workers’ Compensation System to adopt the medical treatment utilization schedule/guidelines, and

• The Administrative Director of the Workers’ Compensation Division has recently recommended the permanent adoption of the ACOEM Guidelines into the System, the results of which will be disastrous to Acupuncture and to California's Iinjured Workers, and

• Acupuncture has been a significant part of Workers’ Compensation for many years, but as a result of the reform legislation, Acupuncture is not being covered by Workers’ Compensation unless performed by a Western Medicine physician (who are not even required to be licensed to practice Acupuncture!).

• Acupuncture has been proven to not only be an extremely effective treatment for California's Injured Workers, but cost effective health care as well, saving a great deal of money for the state.

The Solution

• AB 2287 would define Acupuncture as a treatment predicated on the Acupuncture and ElectroAcupuncture Evidence-Based Treatment Guidelines (December, 2004), developed and published in accordance with the requirements of California Workers’ Compensation reform legislation (which required the Administrative Director of the Workers’ Compensation System to adopt a medical treatment utilization schedule/guidelines as specified not later than December, 2004).

• This legislation would incorporate these guidelines into the Workers’ Compensation System as required by statute.