Medical Provider Networks (MPNs) in Workers’ Compensation

When it comes to workplace injuries and workers’ compensation claims, one term that often comes up is “Medical Provider Network” or MPN. But what exactly is an MPN, and how does it impact injured workers seeking medical treatment? In this blog post, we’ll delve into the details of Medical Provider Networks and their role in the workers’ compensation system.

 What is a Medical Provider Network (MPN)?

 A Medical Provider Network, commonly referred to as an MPN, is a network of healthcare providers and doctors approved by an employer’s workers’ compensation insurance carrier. These networks are established to provide medical treatment and care to employees who have sustained work-related injuries or illnesses AND control the costs of treatment, often jeopardizing the health of the injured worker. Although the primary objective of an MPN SHOULD be to ensure that injured workers receive prompt and appropriate medical attention and facilitate their recovery and return to work. Unfortunately, all too often saving money seems to be the ultimate goal of MPN’s.

 Key Features of MPNs:

1. Controlled list of Providers: MPNs consist of a group of healthcare professionals and medical facilities, including physicians, specialists, hospitals, and clinics that are handpicked by the insurance company. Injured workers are required to seek medical treatment from healthcare providers within the MPN unless a legal exception applies.
2. Quality Assurance? MPNs should be subject to rigorous evaluation and approval processes by the state’s workers’ compensation regulatory agency, but unfortunately, insurance companies are permitted to include anyone they want in an MPN, and the State authorities cannot question it.
3. Treatment Coordination? Within an MPN, there should be focus on coordinating and managing the care of injured employees, but many injured workers experience delay, denial and chaotic treatment that prevents them from healing and getting back to work.  

 Challenges and Seeking Legal Assistance:

 While MPNs offer some assistance for minor injuries, in complex injuries injured workers usually face challenges in obtaining the treatment they need to get back to work. In such cases, it’s crucial to seek legal assistance from an experienced workers’ compensation attorney in Orange County, like Thomas F. Martin, PLC.

Attorneys like Mr. Martin have extensive knowledge of workers’ compensation laws and can advocate for injured workers’ rights. Whether it involves ensuring access to the right medical specialists or addressing treatment disputes at the courthouse, having legal representation can make a significant difference in the outcome of a workers’ compensation claim. Medical Provider Network (MPN) in serious cases often fall short in providing the crucial medical care injured workers need. While MPNs save money for insurance companies, they often jeopardize the injured workers’ health and recovery with delays and denials of treatment. If you have questions or concerns about your workers’ compensation treatment within an MPN, don’t hesitate to reach out to Thomas F. Martin, PLC, a trusted workers’ compensation attorney in Orange County with over 30 years of experience.