California Assembly Bill 1048 has been amended to require payers to include contract-specific information in the Explanation of Review (EOR) sent to providers.

The bill would also establish a new right for providers to request a copy of the contract. If not received within 30 business days, bills must be reprocessed and paid at the full fee schedule rate.

Originally introduced to give providers a way to challenge contractual discounts through the California Division of Workers’ Compensation (DWC) Independent Bill Review (IBR) process, even when third-party access to proprietary contract details was involved, has been amended, AB 1048 now removes the IBR process.

The bill remains in the Senate. If passed, Assembly concurrence is required before it can proceed to the governor.

While this bill addresses concerns about disclosing proprietary contracts to third parties, it creates new operational challenges, requiring system updates to include contract-specific details in the EOR. Payers will be required to create a process to furnish contracts within the proposed 30-business day window, or face bills being reprocessed at the full fee schedule rate, potentially increasing costs.