Today’s issue of WorkCompRecap features the release of a new update from CWCI that found that after hitting a record low in 2021, the number of independent medical reviews (IMRs) used to resolve California workers’ compensation medical disputes continued to decline in the first half of 2022.
CWCI’s latest review shows that 62,859 IMR decision letters were issued in the first half of this year, down 7.6% from the first half of 2021. The latest full-year count shows 133,494 letters issued in 2021, down 2.4% from 2020 and down 27.7% from the all-time high of 184,735 letters in 2018. CWCI noted that since peaking in 2018, IMR letter counts have declined across all medical service categories, but most of the overall decline was due to the sharp decline in prescription drug disputes after the state incorporated Chronic Pain and Opioid Guidelines into the MTUS in late 2017 and implemented the MTUS Prescription Drug Formulary in January 2018. As a result, prescription drug requests dropped from 47.3% of all IMRs in 2017 to 33.9% in the latest half-year data. The latest data also indicate that a small concentration of physicians continue to drive much of the IMR activity, with the top 1% (just 81 doctors) driving almost 40% of requests.