Definition of Medical Provider Network
Medical Provider Network (MPN) is a group or entity of group health care providers that is established by an employer's workers' compensation insurance company or a self-insured employer in California and has been approved by the Division of Workers' Compensation (DWC) in California. A worker can be covered by a MPN as soon as a plan has been approved by the DWC administrative director.
There are several regulations that apply to a MPN. According to California state workers' compensation regulations:
- Each MPN has to include a mix of doctors who have expertise in general areas of medicine and doctors who specialize in work-related injuries.
- Each MPN has to follow all medical treatment guidelines that have been set up by the DWC.
- Each MPN, after an injured worker's first visit, must permit that worker to have a choice of provider or providers within the network.
- Each MPN must give an injured worker the opportunity to get second and third opinions, if the injured worker disagrees with the diagnosis or treatment prescribed by the treating doctor. If there is still disagreement after getting a second and third opinion, the injured worker may request an independent medical review (IMR).