The Division of Workers’ Compensation has posted an example of a streamlined End of Medical Provider Network (MPN) Coverage Notice to the DWC website.
This streamlined notice is only used when an employer-based or insurer-based MPN ends its coverage and consolidates medical care into an MPN established by an entity that provides physician network services and the medical treatment of injured workers is not affected. Medical treatment will not be affected if the underlying network of providers is used by all of the MPNs involved.
Since an injured worker’s medical treatment will remain with the same physician and continue with the MPN that is taking over medical care, a Transfer of Care Notice pursuant to California Code of Regulations, title 8, section 9767.9 is not required. However, a complete employee notification must be provided pursuant to California Code of Regulations, title 8, section 9767.12(a), along with the streamlined End of Medical Provider Network (MPN) Coverage Notice. This sample gives three options to choose from to provide the complete employee notification.