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Dr. Mumbauer's Press Release: Work Comp
Eric Mumbauer, DC chairman of the Industrial Relations Department for the California Chiropractic Association, said another provision in the proposed rules that threatens to limit access to care is the inclusion of Medicare’s multiple procedure payment reduction.
Under the DWC’s proposed rules, when multiple procedures are performed on the same day, the procedure with the highest relative value unit is paid at 100% and the additional procedures are paid at 50%.
Under current OMFS ground rules, the “cascade” for multiple procedures performed on the same day, the first procedure is paid at 100%, the second at 75%, the third at 50% and the fourth at 25%.
Dr. Mumbauer said the division's proposal does not represent the full retreat from the current cascade system that he would like to see. He also said larger clinics that pair medical doctors with chiropractors and physical therapists will be the only facilities who can afford to operate under the proposed RBRVS conversion.
“The doc-in-a-box operations are the only ones who have the financial backing to take that hit,” he said. “They see so much volume that they can afford to take the loss. The private, solo practitioner, it takes us out of the system.”
Dr. Mumbauer also said the manner in which the division is proposing to implement the multiple procedure payment reduction would not be specific to any discipline and could also lead to a reduction in payment for orthopedic surgeons. If an injured worker saw a chiropractor, physical therapist and orthopedic surgeon on the same day, the multiple procedure reduction would apply because the patient had three physician medical procedures, he said.
He said there is already a 24-visit cap on physical medicine services in the Labor Code and carriers have utilization review to determine whether procedures are medically necessary.
Dr. Mumbauer said with the increased awareness about the risks of opioids, employers and insurance companies should be looking to promote greater use of physical medicine, and the division should not employ a “Sherman riding through the South approach” to further restrict access to these types of procedures.
The division’s statement of reasons accompanying the proposed rules says it adopted the multiple procedure rules because there was “no evidence to justify deviating from the Medicare payment rules for workers’ compensation cases.”
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Dr. Mumbauer is the leading expert and specializes in the most up-to-date care for work related injuries. Serving the communities of the San Fernando Valley for 34 years treating conditions such as chronic low back and neck pain and rehabilitation following an accident or injury.
Our office is located at:
601 S Brand Blvd. Suite 103 San Fernando, CA 91340
Practice Phone #: (818) 365-0653
We also treat Spanish speaking patients (Se Habla Español)
¿Como mejora su salud el quiropráctico? El doctor en quiropráctica está especialmente entrenado para restaurar la salud de su columna vertebral. Junto con los ajustes a la columna vertebral y otros tratamientos, su quiropráctico hace énfasis en un estilo de vida saludable.