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Thread Title: only one MPN doctor
Created On Tuesday December 23, 2008 3:07 PM


lifefeast
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Posts: 71
Joined: Oct 2005

Tuesday December 23, 2008 3:07 PM

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I have a case where the applicant has been receiving treatment with a ortho doctor outside the MPN. We sent the required MPN notices.

The PTP issued a report indicating that he was not part of the MPN and would recommend a Dr. Morales who is within the MPN.

The app atty now files a DOR alleging a defective MPN notice since there is only one pain management doctor in the area.

But the applicant was previously treating with an ortho doctor so the applicant should go to an ortho doctor with only Darvocet and acetaminophen.

Is there a requirement of a certain number of doctors to be in the MPN for every specialty? I don't beleive the app atty has a leg to stand on unless I am missing something. Thanks in advance!

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rider001
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Posts: 53
Joined: Aug 2005

Tuesday December 23, 2008 3:59 PM

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9767.1
(21)
(C) If the listing described in either (A) or (B) does not provide a minimum of three physicians of each specialty, then the listing shall be expanded by adjacent counties or by 5-mile increments until the minimum number of physicians per specialty are met.

9767.14
(a) The Administrative Director may suspend or revoke approval of a MPN Plan if:
(1) Service under the MPN is not being provided according to the terms of the approved MPN plan.
(2) The MPN fails to meet the requirements of Labor Code section 4616 et seq. and this article.
(3) False or misleading information is knowingly or repeatedly submitted by the MPN or a participating provider or the MPN knowingly or repeatedly fails to report information required by this article.

(4) The MPN knowingly continues to use the services of a provider or medical reviewer whose license, registration, or certification has been suspended or revoked or who is otherwise ineligible to provide treatment to an injured worker under California law.

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