1. Advertising 1

Question 1

What is the definition of ‘Administrative Director’ as used in the Article regarding Advertising?

Answer 1

The Administrative Director refers to the Administrative Director of the Division of Workers’ Compensation of the State of California Department of Industrial Relations including his or her designee.

Question 2

What is included in the term ‘Advertising copy’ as defined in the article?

Answer 2

Advertising copy includes any ‘public communication’ as defined in Business and Professions Code Section 651 or any communication regarding the availability for professional employment of any physician made by or on behalf of any physician to the general public or a substantial portion thereof.

Question 3

What type of advertising is deemed ‘advertising copy’ concerning medical services?

Answer 3

Advertising that concerns medical services regarding industrial injuries or illnesses that benefits any physician and is placed by any medical clinic medical service organization or other non-physician third party shall be deemed ‘advertising copy’ subject to these regulations.

Question 4

What does the term ‘Medical Board’ refer to in the context of advertising regulations?

Answer 4

The ‘Medical Board’ refers to the Medical Board of California as established in the Business and Professions Code.

Question 5

What is the definition of ‘Medical Director’ according to Code Section 2001?

Answer 5

The Medical Director is defined as the physician appointed pursuant to Labor Code Section 122 or a person designated by that physician.

Question 6

How is the term ‘Physician’ defined in Code Section 2001?

Answer 6

The term ‘Physician’ has the meaning defined in Labor Code Section 3209.3.

Question 7

What does ‘QME’ stand for and how is it defined in Code Section 2001?

Answer 7

QME stands for Qualified Medical Evaluator which is defined in Labor Code Section 139.2.

Question 8

What sections of the Labor Code are cited as authority in Code Section 2001?

Answer 8

The authority cited includes Sections 133 139.4 139.45 and 5307.3 of the Labor Code.

Question 9

Which sections of the Labor Code are referenced in Code Section 2001?

Answer 9

The referenced sections are 139.2 139.4 and 139.45 of the Labor Code.

Question 10

When is a document deemed filed according to the regulations?

Answer 10

A document filed under these regulations is deemed filed on the date it is received by the Administrative Director.

Question 11

What is prohibited in terms of advertising copy according to Code Section 153?

Answer 11

The use of false or misleading advertising copy is prohibited. No physician subject to these regulations or any person acting on their behalf may use advertising that implies guarantees warranties or predictions intended to create an impression of reliability or assurance that may mislead the public.

Question 12

What constitutes a false or unjustified expectation in physician advertising?

Answer 12

A false or unjustified expectation in physician advertising refers to the promotion that suggests favorable results concerning the outcome of the employment of the physician without a truthful basis.

Question 13

What are the restrictions on the use of names in physician advertising?

Answer 13

Any advertising copy that uses a firm name trade name fictitious business name or other professional designation must not state or imply a relationship between any physician in private practice and any governmental agency or entity except for information related to being a Qualified Medical Evaluator.

Question 14

What is the exception allowed for Qualified Medical Evaluators in advertising?

Answer 14

A physician currently or previously certified by the Administrative Director as a Qualified Medical Evaluator may state this fact in advertising copy curriculum vitae or descriptive text for the duration that it is true and correct.

Question 15

What is prohibited regarding claims of credibility for medical-legal reports?

Answer 15

Advertising copy that states or implies that a medical-legal report written by any physician or a group of physicians has any special degree of credibility by any workers’ compensation judge or judges is prohibited.

Question 16

What type of advertising behavior is cautioned against in medical-legal examinations?

Answer 16

Any advertising copy that advises or recommends the securing of any medical-legal examination must be carefully framed to avoid misleading implications or unjustified expectations.

Question 17

What is a Qualified Medical Evaluator (QME)?

Answer 17

A Qualified Medical Evaluator (QME) is an individual physician currently certified by the Administrative Director according to California Labor Code section 139.2. They are authorized to perform medical evaluations related to workers’ compensation cases.

Question 18

What regulations govern the use of the term ‘Qualified Medical Evaluator’?

Answer 18

The use of the term ‘Qualified Medical Evaluator’ or the designation ‘QME’ is regulated such that it can only be used in advertising to identify individual physicians who are certified by the Administrative Director as per Labor Code section 139.2.

Question 19

Why should advertising copy avoid the phrases ‘Agreed Medical Evaluator’ or ‘Independent Medical Examiner’?

Answer 19

Advertising copy should avoid these phrases unless they are used to refer to physicians who are currently recognized as such under the law. Misuse can imply that non-certified individuals are qualified which is misleading and potentially illegal.

Question 20

What are the implications of using a fictitious business name that includes terms like ‘QME’ or ‘IME’?

Answer 20

Using a fictitious business name that includes terms like ‘Qualified Medical Evaluator’ ‘Independent Medical Examiner’ or their abbreviations is prohibited unless the business or individuals are certified and recognized under the applicable legal standards.

Question 21

What should advertising copy never imply about a physician’s status in relation to ‘Agreed Medical Evaluator’ or ‘IME’?

Answer 21

Advertising copy must never imply or state that a physician has an ongoing title appointment or professional status as an ‘Agreed Medical Examiner’ ‘Agreed Medical Evaluator’ ‘Independent Medical Examiner’ ‘AME’ or ‘IME’ unless they are currently recognized as such by the relevant authorities.

Question 22

What legal framework governs the certification of QMEs in California?

Answer 22

California Labor Code section 139.2 governs the certification and regulation of Qualified Medical Evaluators (QMEs) in the state setting standards for qualifications and conduct.

Question 23

What penalty could be incurred by misrepresenting a physician’s status as a QME or IME?

Answer 23

Misrepresenting a physician’s status as a QME or IME can lead to legal repercussions such as fines loss of certification and potential disciplinary action from the medical board.

Question 24

What additional terms are similar to ‘Qualified Medical Evaluator’ that are also regulated?

Answer 24

Similar terms that are regulated include ‘Qualified Medical Examiner’ ‘Agreed Medical Evaluator’ ‘Agreed Medical Examiner’ ‘Independent Medical Examiner’ and their abbreviations (QME AME IME).

Question 25

What is the significance of maintaining accurate titles in medical advertising?

Answer 25

Maintaining accurate titles ensures compliance with legal standards promotes transparency in medical evaluations and protects patients from being misled about the qualifications of the medical professionals they consult.

Question 26

What is the role of the Administrative Director in terms of QMEs?

Answer 26

The Administrative Director is responsible for certifying individual physicians as Qualified Medical Evaluators (QMEs) and ensuring adherence to statutory regulations as stipulated in the Labor Code.

Question 27

What is the role of an Agreed Medical Examiner (AME) in the California Workers' Compensation system?

Answer 27

An Agreed Medical Examiner (AME) is a physician designated to conduct examinations and provide evaluations about industrial injuries or illnesses for workers' compensation cases. They are appointed by both the injured worker and the employer to offer an impartial medical opinion.

Question 28

What is the role of an Independent Medical Examiner (IME) in the California Workers' Compensation system?

Answer 28

An Independent Medical Examiner (IME) is a physician who conducts a medical evaluation and provides an opinion on an injured worker's condition. They are not chosen by either party and operate independently mostly to resolve disputes regarding the severity of an injury extent of disability or necessary medical treatment.

Question 29

What are the permissible contents of advertising for a physician acting as an AME or IME in California?

Answer 29

The permissible advertising content includes: 1. The name of each physician affiliated with or participating in the physician's practice. 2. The address telephone number and business hours of the office or offices. 3. The areas of practice for each physician. 4. An individual physician's appointment as a Qualified Medical Evaluator (QME). 5. A statement of any past periods during which the physician was certified as a QME.

Question 30

What specific details must advertising include about the physician's practice areas?

Answer 30

Advertising must accurately describe the areas of practice in which each physician engages to inform the public about their specialties and expertise.

Question 31

Can a physician not currently certified as a Qualified Medical Evaluator (QME) mention past certifications in their advertising?

Answer 31

Yes a physician who is not currently certified as a QME may state any periods in the past during which they were certified as an evaluator in their curriculum vitae or descriptive text.

Question 32

What information is required to be included regarding a physician's office in their advertising?

Answer 32

The advertising must include the address telephone number and business hours of the office or offices of the physician.

Question 33

Is it permissible for a physician to advertise a QME appointment directly?

Answer 33

Yes a physician can advertise their appointment as a Qualified Medical Evaluator (QME) in their marketing materials.

Question 34

What governing body certifies physicians as Qualified Medical Evaluators in California?

Answer 34

The Administrative Director is the governing body that certifies physicians as Qualified Medical Evaluators (QMEs) in California.

Question 35

What must be ensured in the advertising content used by physicians as AME or IME to adhere to regulations?

Answer 35

The advertising content must accurately state all required information without misleading the public ensuring compliance with the regulations governing permissible advertising content.

Question 36

What is required if a physician states they are Board Certified?

Answer 36

If a physician states they are Board Certified they must include the name of the certifying board in their statement.

Question 37

What does Business and Professions Code Section 651 relate to regarding physicians?

Answer 37

Business and Professions Code Section 651 authorizes Board Certified physicians or those who limit their practice to specific fields.

Question 38

What must be disclosed about languages spoken in a medical practice?

Answer 38

The physician must disclose any languages spoken fluently by themselves or their staff.

Question 39

What is required regarding diagnostic or therapeutic facilities in a physician's practice?

Answer 39

A physician must provide a description of any diagnostic or therapeutic facilities available in their practice.

Question 40

What does 'surgery or hospitalization on a lien basis' refer to?

Answer 40

It refers to the availability of surgical procedures or hospital services that can be billed after the treatment typically when a patient is involved in a lawsuit.

Question 41

What information should be provided regarding appointment scheduling?

Answer 41

The usual time frame for scheduling appointments or producing medical reports must be stated.

Question 42

How must all billings be processed according to regulatory guidelines?

Answer 42

All billings must be made in compliance with the Official Medical Fee Schedule promulgated by the Administrative Director.

Question 43

What biographic information about the physician must be included in advertisements?

Answer 43

Biographic information must encompass the physician's educational background internships residencies hospital affiliations professional affiliations and professional publications.

Question 44

What are the consequences of a physician disseminating false advertising?

Answer 44

If a physician disseminates false advertising they may face professional disciplinary action as it violates the standards of medical advertising set forth by legal regulations.

Question 45

What is the importance of compliance with advertising regulations in medicine?

Answer 45

Compliance with advertising regulations is crucial to ensure ethical standards protect patient welfare and maintain public trust in the medical profession.

Question 46

What must be done before using any material related to industrial injury or illness that is not specified in subsection a?

Answer 46

A written application must be submitted to the Administrative Director for approval.

Question 47

Under what condition will the Administrative Director approve requests for advertising material related to workers' compensation?

Answer 47

Requests will be approved if they do not contain material that is false or likely to mislead the public regarding workers' compensation.

Question 48

What must happen before advertising copy submitted to the Council can be used?

Answer 48

The advertising copy must receive written approval from the Administrative Director.

Question 49

Who can file a complaint regarding a physician's advertising practices?

Answer 49

Any person may file a complaint with the Medical Director.

Question 50

What law's provisions can be allegedly violated in a complaint against a physician's advertising?

Answer 50

Business and Professions Code Section 651.

Question 51

What form must complaints filed with the Medical Director take?

Answer 51

Complaints must be in writing.

Question 52

What specific information must be included in a complaint filed with the Medical Director?

Answer 52

1. The full name and address of the party filing the complaint. 2. The full name and address of the physician against whom the complaint is filed.

Question 53

What is the role of the Medical Director in relation to complaints about physicians?

Answer 53

The Medical Director reviews complaints that allege physicians are using advertising copy in violation of specified provisions.

Question 54

What type of material is subject to approval by the Administrative Director in the context of workers' compensation?

Answer 54

Any material related to industrial injury or illness that is not specified in subsection a.

Question 55

What criteria can lead to the rejection of advertising material by the Administrative Director?

Answer 55

Material that is false or likely to mislead the public with respect to workers' compensation.

Question 56

What is the initial requirement from the complainant when filing a complaint regarding physician advertising?

Answer 56

The complainant must provide as much information as possible to assist the Administrative Director in identifying the physician who used the advertisement even if they are unable to identify the physician.

Question 57

What is required if the complainant has a copy of the advertising?

Answer 57

If available the complainant should provide a copy of the advertising against which the complaint is made or at least a detailed description of the medium in which the advertising appeared.

Question 58

What should the description of the advertising medium include according to the guidelines?

Answer 58

The description must contain sufficient details regarding the manner and form in which the advertising copy was published to allow the Administrative Director to obtain a copy of the advertising.

Question 59

What specific grounds must be detailed in the complaint about the advertising copy?

Answer 59

The complaint must include a detailed statement of the grounds on which the advertising copy is alleged to violate Business and Professions Code Section 651 or the regulations related to advertising.

Question 60

Where should all complaints filed regarding physician advertising be submitted?

Answer 60

All complaints should be filed with the Medical Director at the Division of Workers' Compensation P.O. Box 71010 Attention Medical Unit Oakland CA 94612.