Today’s issue of WorkCompRecap features the release of a new report from CWCI that examined workers’ compensation Independent Medical Review (IMR) decisions rendered in 2015 in California.
The report found that even though IMR physicians continue to uphold the vast majority of Utilization Review (UR) physicians’ denials or modifications of treatment, total IMR volume still rose 19% last year. Other findings included that IMR physicians upheld the UR doctor’s modification or denial of the service 88.6% of the time, which is just a bit lower than the 91% uphold rate for 2014. The mix of services reviewed also remained similar, though prescription drug requests have now crossed the threshold to account for half of all requests vs 48% in 2014.
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