Health care providers treating, evaluating (QME), or reviewing (UR or IMR) in the California workers’ compensation system may access the MTUS (ACOEM) Guidelines and MTUS Drug List at no cost by registering for an account.’ Source: CA DWC Filed Under: Industry News, Legislative & Regulatory News, Top Stories, Workers' Compensation
What are the MTUs guidelines?
The MTUS guidelines are based on the principles of evidence-based medicine and treatment guidelines developed by the American College of Occupational and Environmental Medicine (ACOEM). Providers were previously required to obtain a commercial license to access the guidelines.
How do I get access to the MDGuidelines CA MTUs-ACOEM edition?
The State of California Division of Workers' Compensation (DWC) provides free access to ACOEM’s Practice Guidelines for medical providers who handle California workers’ compensation cases. Providers must register with Reed Group in order to gain access to the MDGuidelines® CA MTUS-ACOEM Edition.
What does MTUs stand for?
The regulations establish an evidence-based drug formulary, consistent with California’s Medical Treatment Utilization Schedule (MTUS), to augment the provision of high-quality medical care, maximize health, and promote return to work in a timely fashion, while reducing administrative burden and cost.
How do I contact the DWC MTUs office?
The MTUS regulations include the MTUS formulary, which is evidence-based and built on the foundation of the MTUS treatment guidelines recommendations. Questions may be submitted to the DWC MTUS email box at [email protected].
What are the MTUS guidelines?
The MTUS regulations also contain rules to determine what is reasonable and necessary care in the two limited situations that may warrant treatment based on recommendations found outside of the MTUS treatment guidelines. Recommendations found in the MTUS guidelines are presumed correct and will automatically be applied to guide patient care, unless the injured worker’s injury or condition is not addressed by an MTUS medical treatment guideline or if the treating physician disagrees with its recommendations and wishes to rebut the presumption of correctness.
What is MTUS regulation?
MTUS Regulations – Conditions Not Covered by the Treatment Guidelines; Rebutting the Guidelines. The MTUS regulations also contain rules to determine what is reasonable and necessary care in the two limited situations that may warrant treatment based on recommendations found outside of the MTUS treatment guidelines.
What is MTUS in medical?
The MTUS is based on the principles of evidence-based medicine. The MTUS regulations establish a systematic methodology to determine the quality and strength of evidence used to support treatment recommendations for a medical condition or injury.
What is MTUS based on?
The MTUS is based on the principles of evidence-based medicine. That means treatment decisions are guided by recommendations supported by the best-available evidence.
What is MTUS in California?
The Medical Treatment Utilization Schedule (MTUS) is a set of regulations found in title 8, California Code of Regulations section 9792.20 through 9792.27.23 that contain medical treatment guidelines and rules for determining what is reasonable and necessary medical care.
What is reasonable and necessary to cure or relieve an injured worker from the effects of injury?
In most cases, medical treatment that is reasonable and necessary to cure or relieve an injured worker from the effects of injury means treatment that is based upon the ACOEM treatment guidelines adopted in the MTUS.
What is MTUS in California?
The medical treatment utilization schedule (MTUS) provides medical treatment guidelines for utilization review and an analytical framework for the evaluation and treatment of injured workers. It helps medical providers understand which evidenced-based treatments have been effective in providing improved medical outcomes to those workers. The MTUS is promulgated by the DWC administrative director under Labor Code sections 5307.27 and 4604.5, and can be found in sections 9792.20 et seq. of Title 8, California Code of Regulations.
Is the MTUS correct?
The MTUS is presumed to be correct on the issue of extent and scope of medical treatment and diagnostic services it addresses. However, that presumption can be set aside by a preponderance of scientific medical evidence using strength of evidence criteria to show that a variance from the schedule is reasonably required to cure or relieve the injured worker from the effects of his or her injury. For all conditions or injuries not addressed by the MTUS, authorized treatment and diagnostic services must be in accordance with other scientific, evidence-based medical treatment guidelines that are nationally recognized by the medical community as set forth in § 9792.25 of Title 8, California Code of Regulations.
About the Course
Physicians treating in the California workers' compensation system are required to follow the evidence-based recommendations in the DWC medical treatment utilization schedule ( MTUS (link is external) ).
Accreditation
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the California Medical Association (CMA) through the joint providership of The Center for Occupational and Environmental Health (COEH) and State of California Department of Industrial Relations Division of Workers' Compensation.
Disclosure
No individuals involved in the planning or presentation of this activity have any relevant financial relationships with commercial interests to disclose.
Learning Objectives
Overview
- The medical treatment utilization schedule (MTUS) provides medical treatment guidelines for utilization review and an analytical framework for the evaluation and treatment of injured workers. It helps medical providers understand which evidenced-based treatments have been effective in providing improved medical outcomes to those workers. The MTUS i...
History
- Jan. 1, 2004– The Legislature charged the DWC administrative director (AD) with adopting an MTUS that would be presumed correct on the issue of extent and scope of medical treatment, and made the American College of Occupational and Environmental Medicine Practice Guidelines, 2nd Edition, (ACOEM) the standard until the adoption of an MTUS by the AD. June 15, 2007– The dat…
General Approaches
- The DWC administrative director adopts and incorporates specific guidelines into the MTUS set forth from the ACOEM Practice Guidelines for the chapters on prevention, general approach to initial assessment and documentation, initial approaches to treatment, cornerstones of disability prevention and management. The general approaches section of the MTUS are set forth in § 97…
Clinical Topics
- The clinical topics apply to the initial management and subsequent treatment of presenting complaints specific to the body part as set forth in § 9792.23.1et seq. of Title 8, California Code of Regulations. 1. Neck and upper back complaints 2. Shoulder complaints 3. Elbow disorders 4. Forearm, wrist, and hand complaints 5. Low back complaints 6. Knee complaints 7. Ankle and fo…
Special Topics
- The special topics of the MTUS addresses issues in common across the clinical topics and are set forth in § 9792.24.1et seq. of Title 8, California Code of Regulations. 1. Acupuncture medical treatment guidelines 2. Postsurgical treatment guidelines 3. Chronic pain medical treatment guidelines The chronic pain guidelines are set forth in § 9792.24.2of Title 8, California Code of R…
Presumption of Correctness
- The MTUS is presumed to be correct on the issue of extent and scope of medical treatment and diagnostic services it addresses. However, that presumption can be set aside by a preponderance of scientific medical evidence using strength of evidence criteria to show that a variance from the schedule is reasonably required to cure or relieve the injured worker from the effects of his or he…