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Medical Provider Network

As part of CAPRI’s ongoing commitment to improving its programs and offerings for our member districts, we are constantly evaluating the needs of our Districts and identifying ways to best serve the membership at large.  To that end, in 2016 the CAPRI Board of Directors voted to move forward with the creation of a Medical Provider Network (“MPN”) for our member districts.  A MPN is a select network physicians and other medical providers that are chosen to provide care because of their quality medical services and specialized understanding of the workers’ compensation system.  MPNs are proven to provide greater control of the workers’ compensation claims while also lowering medical costs, improving the injured workers’ experience in the WC system, and reducing litigation.

Since that time, the CAPRI MPN program has returned significant savings for the membership at large.  The average cost per claim has steadily decreased the past two years as CAPRI works to minimize exposure to its members.  Notably, since implementation of the program, the number of claims has decreased approximately 17% while the total paid out has decreased approximately 53% from 2016 to 2018. 

Accordingly, the CAPRI Board of Directors, recognizing the success of the program, recently voted to require all members participate in the MPN starting no later than July 1, 2019

Enclosed please find materials that further describe the program and that will assist in enrolling your District in the MPN program.  To start the enrollment process, review the Instructions Page which details how your District will complete the enrollment as follows:

·         Add the MPN number to your DWC-7 Positing Notice

·         Add the MPN Pamphlet to your new hire packet

·         Sign & Return the Compliance Form back to CAPRI

If you have any questions regarding the enrollment or anything related to the MPN, please feel free to contact me at (916) 722-5550 or (redacted).

If you believe your District requires an extension to complete enrollment, please submit a request in writing directly to my attention via email at (redacted) and include the good cause supporting your request as well as an estimate as to how long is needed to complete enrollment.

If you believe your District has good cause for not participating in the MPN program, please submit a letter of explanation to my attention no later than June 14, 2019.  The letter should be addressed to the CAPRI Board of Directors and identify any facts or circumstances justifying your request.  The CAPRI Board will consider these appeals on a case-by-case basis.  Please note, however, that the Board has indicated a strong preference to require participation in the MPN program as it has been proven to promote both the overall financial position of the pool as well as the wellness of its members’ employees.

Thank you for your participation in the CAPRI Workers’ Compensation Program.  We look forward to having your District participate in the MPN and to improving the efficiency and quality of care for your employees.  As always, should you have any questions or concerns, please do not hesitate to contact me.

 

Sincerely,

 

Matthew Duarte

Executive Director

0- Instructions for EIA MPN.pdf01- EIA CA MPN Compliance Form.pdf02 E- EIA MPN Pamphlet English.pdf02 S- EIA MPN Pamphlet Spanish.pdf03- DWC-7 - Notice to Employees Poster 2016.pdf