Jurisdiction
Cal. LAB § 5307.27
California Statutes
(
a) The administrative director, in consultation with the Commission on Health and Safety and Workers’ Compensation, shall adopt, after public hearings, a medical treatment utilization schedule, that shall incorporate the evidence-based, peer-reviewed, nationally recognized standards of care recommended by the commission pursuant to
Section 77.5, and that shall address, at a minimum, the frequency, duration, intensity, and appropriateness of all treatment procedures and modalities commonly performed in workers’ compensation cases. Evidence-based updates to the utilization
schedule shall be made through an order exempt from Sections 5307.3 and 5307.4, and the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with
Section 11340) of Part of Division of Title of the Government Code), but the administrative director shall allow at least a 30-day period for public comment and a public hearing. The administrative director shall provide responses to submitted comments prior to the effective date of the updates. All orders issued pursuant to this subdivision shall be published on the Internet Web site of the Division of Workers’ Compensation. (
b) On or before July 1, 2017, the medical treatment utilization
schedule adopted by the administrative director shall include a drug formulary using evidence-based medicine. Nothing in this
section shall prohibit the authorization of medications that are not in the formulary when the variance is demonstrated, consistent with subdivision (
a) of
Section 4604.5. (
c) The drug formulary shall include a phased implementation for workers injured prior to July 1, 2017, in order to ensure injured workers safely transition to medications pursuant to the formulary. (
d) This
section shall apply to all prescribers and dispensers of medications serving injured workers under the workers’ compensation system.