California Adopts Opioid Treatment Guidelines

The Department of Industry Relations' Office of Administrative Law approved the final version of the Medical Treatment Utilization Schedule regulations that updates the Chronic Pain Medical Treatment Guidelines and adopts Opioids Treatment Guidelines.

California Department of Industrial Relations' Office of Administrative Law has approved the final version of the Medical Treatment Utilization Schedule (MTUS) regulations that updates the Chronic Pain Medical Treatment Guidelines and adopts Opioids Treatment Guidelines, DIR announced Aug 10. With many national reports of rising opioid misuse in recent years, DWC had proposed issuing guidelines and began the process with a forum for public comment in 2014. The guidelines that have been added to the MTUS provide best practices in appropriately treating injured workers and safely using these medications to manage pain.

"We welcome this update and addition to the MTUS. The information in these guidelines should aid in the provision of safer and more effective care for California's injured workers," said Division of Workers' Compensation (DWC) Executive Medical Director Dr. Raymond Meister.

The changes to the Chronic Pain Medical Treatment Guidelines are in section 9792.24.2, the Opioids Treatment Guidelines are found in section 9792.24.4, and the clarifying changes to the meaning of chronic pain are in section 9792.23(b)(1) of the California Code of Regulations. The MTUS regulations went into effect on July 28, 2016, and apply to any treatment requests made on or after July 29, 2016.

"These guidelines are an important step toward improving appropriate and safe care for workers," explained Christine Baker, director of DIR.

DWC Acting Administrative Director George Parisotto said the division "will move forward shortly to initiate the process to update all of the current MTUS chapters. This process will include new chapters for chronic pain and opioids. Regardless, the new Chronic Pain Medical Treatment Guidelines and Opioids Treatment Guidelines should be consulted and relied upon when making treatment requests and determining the medical necessity of such requests."

The final regulations are available here.

DIR also has posted prevailing wage changes that apply to public works projects that use ready-mix concrete. The changes apply to public works contracts that were advertised for bid or awarded on or after July 1, 2016, the date when amendments to Assembly Bill 219 became effective. The amendments made the following changes to Labor Code section 1720.9:

A company hauling or delivering ready-mix concrete for a public works contract shall:

  • Register as a public works contractor.
  • Submit a certified copy of the payroll records required by subdivision (a) of Section 1776 to the party that engaged the company and to the general contractor within five working days after the employee has been paid, accompanied by a written time record that shall be certified by each driver for the performance of job duties.
  • Ready-mix concrete companies' requirement to submit payroll online to DIR using its electronic certified payroll reporting system is temporarily on hold.

The amendments do not apply to public works contracts that were advertised for bid or awarded prior to July 1.

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