Home > Medical Provider Network > Another Chip in the MPN Defense

Another Chip in the MPN Defense

From time to time, your humble author mentions the wonderful defensive maneuver of establishing a Medical Provider Network.  Therefore, instead of recapping the many benefits of the MPN, I will modestly allow my dear readers to click the link and review my old posts on the subject.  But, as beneficial as it, applicant’s attorneys, lien claimants, and applicant-friendly Workers’ Compensation Judges try regularly to chip away at the MPN’s effectiveness.  With that preface, I mention the recent writ denied case of Charter Oak Unified School District v. Workers’ Compensation Appeals Board (Salvador Cerda).

Applicant sought treatment from a doctor within the MPN, but the treatment was administered at a different address, for a different entity, and under a different tax ID number than what was listed in the MPN.  While the case-in-chief settled, the lien claim of the treating physician proceeded on the question of whether membership in the MPN is specific to the treator or to the location/entity.

The Workers’ Compensation Appeals Board found that the membership in the MPN pertains to the individual physician, and a different address/ entity name/ tax ID number does not negate membership.  That decision being made, the lien claimant’s other argument of an invalidly noticed MPN was rendered moot.

In reading this case, it is important to note that the prospect of contracting around the effect of this decision is a promising one.  In establishing the MPN, a contract clause could be inserted to the effect that the treating physicians will only treat at their registered facilities, and not at other offices.

By no means does this negate the benefits of the MPN, but it important to keep our eyes open for further encroachment on the few effective cost-control measures available to defendants.

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