An Early Look at the Impact of the New Med-Legal Fee Schedule (Research Update Report, Published July 2022)

An 18-page CWCI Research Update Report provides data on the utilization and payment of medical-legal services in California workers’ compensation before and after the implementation of the revised Medical-Legal Fee Schedule in April that took effect April 1, 2021.  The report takes a deep dive into the medical-legal process, reviewing changes that were made to the schedule, measuring the impact of the changes on the average amounts paid for various med-legal services and evaluations; and examining how the distribution of med-legal services changed after the new schedule took effect.  The study also measures changes in the amount of time elapsed to the receipt of med-legal services; identifies the distribution of med-legal services by claim characteristics (claim type, litigation status, diagnostic category); notes the distribution of med-legal services by provider specialty; measures changes in the average med-legal code count for claims with med-legal services, and the average and maximum total med-legal paid from 2015 through 2021.  In addition, the report uses several different metrics to examine changes in the QME population from 2019 through 2021.      $26