ADJ10282543 — California WCAB decision

What the panel ordered

Findings and Award issued on November 3, 2021, rescinded; matter returned to trial level for further proceedings consistent with this decision.

Petition for Reconsideration granted; decision after reconsideration issued rescinding the Findings and Award and returning the matter to trial level for further proceedings.

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What was disputed, and how it came out

Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.

LiensRemanded

The Appeals Board found that there was insufficient evidence to determine if WSPT Network was the owner of the lien under Labor Code section 4903.8, and remanded the matter for further proceedings to develop the record on the contractual relationship or joint venture between WSPT Network and Dr. Bien.

From the decision · page 6There is currently insufficient evidence in the record to determine the terms of the contract and/or whether there is a joint venture between WSPT Network and Dr. Bien. Without evidence, it is not possible to determine whether WSPT Network is or is not the "owner of the lien." Given that these material issues of fact were not identified or adjudicated below, we cannot interpose a

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Labor Code

Labor Code section 4903.8

Defines the requirements for ownership and payment of liens for medical services in workers' compensation cases.

From the decision · page 2Section 4903.8 identifies those entitled to an order or award of payment on a lien for services provided pursuant to section 4903, subdivision (b):2

Corporations Code

Corporations Code section 207

Permits joint ventures between general corporations and medical providers for billing and collections purposes.

From the decision · page 1State Compensation Insurance Fund (SCIF) seeks reconsideration of the Findings and Award (F&A) issued on November 3, 2021 by a workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that lien claimant WSPT Network is not barred, as a general corporation for billings and collections, from entering into a joint venture with a medical provider pursuant to Corporations Code section 207; and, that WSPT Network does not need to be registered as an acupuncturist or to obtain an assignment of the billings in order to collect since it is unrebutted that it was part of a joint venture with the provider, Dr. Soung Bieng, as authorized by Corporations Code Section 207 and further encouraged by Corporations Code Section 16770. The WCJ awarded WSPT Network payment on the lien in question.

Corporations Code

Corporations Code section 16770

Encourages formation of groups and combinations of providers for efficient contracting units in healthcare.

From the decision · page 1State Compensation Insurance Fund (SCIF) seeks reconsideration of the Findings and Award (F&A) issued on November 3, 2021 by a workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that lien claimant WSPT Network is not barred, as a general corporation for billings and collections, from entering into a joint venture with a medical provider pursuant to Corporations Code section 207; and, that WSPT Network does not need to be registered as an acupuncturist or to obtain an assignment of the billings in order to collect since it is unrebutted that it was part of a joint venture with the provider, Dr. Soung Bieng, as authorized by Corporations Code Section 207 and further encouraged by Corporations Code Section 16770. The WCJ awarded WSPT Network payment on the lien in question.

ADJ10282543 · March 25, 2022

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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The rules the panel named

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