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The Division of Workers’ Compensation (DWC) has posted proposed changes to the existing Medical Treatment Utilization Schedule (MTUS) regulations to the online forum where members of the public may review and comment on the proposals.

“These changes to DWC’s evidence-based medical treatment guidelines provide a critically needed framework describing best practices for providing medical care for work-related illnesses and injuries,” said DWC Executive Medical Director Dr. Rupali Das. The proposed updates to the MTUS were developed in cooperation with the multidisciplinary Medical Evidence Evaluation Advisory Committee (MEEAC).

The proposed amendments to the MTUS regulations modify regulatory definitions, which includes a definition for Evidenced Based Medicine, and adds new definitions for terms used in the strength of evidence methodologies. The regulations clarify the role of the MTUS in accordance with Labor Code section 4600 and set forth the process to determine if medical care is reasonable and necessary when the MTUS is inapplicable.

In situations where the MTUS is inapplicable, the regulations state that medical care shall be in accordance with the recommendations supported by the best available medical evidence. To determine the best available medical evidence, the regulations set forth strength of evidence methodologies to evaluate both the quality of medical treatment guidelines as well as the quality of evidence in studies published in the medical and scientific literature.

The regulations also amend the composition of the MEEAC to include two additional members, one from the pharmacology field and one from the nursing field. “The addition of these areas of expertise will enhance this distinguished committee,” said Das.

The proposed changes to the MTUS regulations start with section 9792.20 of title 8 of the California Code of Regulations. The forum is located on the DWC website.