Workers Comp Unwrapped Episode 501: The April 2026 UR Overhaul: How the New Rules Change Every RFA You File in California

Send us Fan MailSeason 5 opens with the biggest regulatory shift utilization review has seen in years. In this episode, Aneeq and Angela break down the DWC's April 1, 2026 overhaul of the UR and IMR regulations — new URAC accreditation and disclosure requirements, the codified 30-day UR exemption under Labor Code 4610(b), a sharply shortened IMR filing window for formulary drug disputes, and a penalty structure with real teeth.Drawing from her 15 years of industry experience, Angela walks through what actually changed, what didn't, and where providers are most likely to file an RFA the old way and get burned by it.The conversation explores:Why this is being called the biggest UR overhaul in years, and where that's fair and where it's overstatedThe 30-day exemption under Labor Code 4610(b) — what it covers, and the MPN catch that limits itThe new URAC accreditation and disclosure requirements, and what "identify the liable entity" now means in a denial letterThe IMR filing deadline change — 10 days for formulary-drug-only disputes, 30 days for everything elseWhy UR denials now hold for 12 months and what "material change in facts" actually needs to look likeThe elimination of the performance rating system and the new penalty structureWhat has to change in how RFAs are built and documented starting nowA season-opening checklist for getting compliant before the next audit cycleAneeq leads Angela through a structured walkthrough built for providers who need to know exactly what's different in how they file — not just that something changed.Key takeaway: This isn't a minor form update. The DWC rewrote the rules on exemption, accreditation, deadlines, and penalties in the same package — and providers who treat this like routine compliance housekeeping are going to get caught by the details, particularly the MPN condition on the 30-day exemption and the new 10-day IMR clock.Support the show#podcast #newepisode #episode #healthcare #hospitals #medical #workerscomp #attorney #doctors #california #usa #billing #workerscompbilling #trump #medicalprovider #LienFiling #SBR #Revenuecycle #DOR #Eamscasesearh #DIR #Credentialing #Collections #Insurancepayments #LienFunding #WCclaimsFor more infoCall 📱 888-296-1109Book Appointment Now | https://medicallienmgt.com/contact/