Governor Newsom has vetoed SB 636 (Cortese).
The bill would have required that beginning 7/1/2026, for private employers, only a physician licensed pursuant to California state law could modify or deny requests for authorization of medical treatment under California’s workers’ compensation system.
Newsom’s September 20, 2024 veto message is as follows:
“To the Members of the California State Senate:
I am returning Senate Bill 636 without my signature.
This bill would require, for private employers, that utilization review (UR) under the workers’ compensation system be performed by medical professionals licensed under California law.
While I appreciate the author’s intent to increase accountability in the UR process, I am concerned about the lack of data to warrant the changes proposed by this bill. Existing workers’ compensation law already provides a regulatory structure that holds utilization review organizations and their utilization reviewers accountable for their decisions. Additionally, the bill would result in differential treatment for employees of private employers versus public employers while also narrowing the pool of utilization reviewers, causing potential delays in medical treatment and increased administrative costs to private employers.
For these reasons, I cannot sign this bill.”
A similar bill was vetoed by Governor Jerry Brown in 2011 (AB 584).
Supporters of the bills included various unions (AFSCME, the Teamsters, Machinists, & California Labor Federation) as well as the medical Board of California and various specialty medical associations.
Opponents included many of the entities who comprise the employer and insurer coalition that has been zealously fighting in changes in the 2004 and 2012 workers’ comp reforms.
The California Senate legislative analysis aptly outlined the rationale behind SB 636:
“Under current law, insurance companies may employ medical professionals licensed in any state to perform UR. As a result, medical professionals not licensed in California are exempt from regulation and discipline by the Medical Board of California and the California Division of Workers’ Compensation. When these medical professionals wrongfully modify or deny WC claims, there is no regulatory structure to hold them accountable for malpractice.
“Senate Bill 636 requires a medical professional to be licensed in California to perform UR for California WC claims. This bill increases accountability for doctors conducting UR and guarantees that California workers are provided a fair claim review process informed by our state’s licensing standards. SB 636 would not prevent physicians based in other states or countries from completing UR so long as they are licensed by the Medical Board of California.”
Newsom’s veto demonstrates that he is unlikely to support anything other than minor tweaks to the California workers’system unless the employer and insurer coalition buys into the deal.
But as of the date of this post, the Governor still has a week to act on SB 1299 (Cortese), a heat presumption bill that is a high priority for labor advocates. We shall see.
Stay tuned.
Julius Young
https://www.boxerlaw.com/attorney/julius-o-young/
510.835.8870