3 – Medical Provider Networks (MPN)

MPN’s are new to the Workers’ Compensation Market. The new SB 899 created them to help hold the cost of claims to a minimum by managing the medical more efficiently.

When a company chooses to use a MPN, they can get “cradle to grave” control of the primary medical within the MPN for most workers’ compensation claims.

The text of SB 899 is available on the internet at:

http://www.workcompcentral.com/pdf/2004/misc/sb_899_bill_20040414_amended_sen.pdf

With a MPN, an attorney can become involved from the first day and can direct the employee as to the medical care and rehabilitation immediately but must stay within the confines of the MPN network.

Without an HCO or MPN, Currently the employer controls the first 30 days of care.

An injured employee can request 3 doctors within the MPN and if not satisfied with the evaluation can request an Independent Medical Review (IMR). If the IMR concludes that the MPN did everything correctly then additional Medical care will be provided by doctors within the MPN.

Pain is one of the problems Doctors are having with the MPN as they don’t believe with the new laws they will be able to adequately treat the inured workers.

The Applicant Attorney’s are even suggesting they may be illegal. Because they are so new, it will take time to iron out the challenges.

Medical Provider Networks are now becoming the rule for Employers. New Legislation could be detrimental to MPN’s if passed.