SB1160: The Road to Exemption
Featured in the Executives in Workers' Compensation (EWC) Magazine.
By Glenn Crafts, DC, QME, Assistant Vice President, Utilization Review & Quality Assurance
Once upon a time, health care providers roamed workers’ compensation freely and without restraint, treating without limitations--that is, until SB 228 became effective in 2004 and the implementation of what is now known as utilization review (UR) based on Evidence Based Medicine (EBM). Costly medically unnecessary treatment was being rendered with reckless abandon across multiple specialties. A “playbook” was needed to rein in the questionable providers and help ensure that only medically necessary care was given, and more importantly, contain unreasonable costs burdening the claims administrator.
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