Which entity is responsible for approving a Medical Provider Network plan submitted by the ER or insurer?

• A. Administrative Director
• B. Medical Director
• C. CA Insurance Commissioner
• D. Mgr of SIP

Answer: (C)

The key point is that approving a Medical Provider Network plan in California workers’ comp is handled by the Administrative Director of the Division of Workers’ Compensation. The ER or insurer submits the MPN plan to this office, which reviews it for compliance with statutory requirements on provider access, treatment standards, and cost controls. Only after this official approval can the MPN operate as the network through which medical care is coordinated for injured workers. The California Insurance Commissioner regulates insurers in general, but the specific approval of MPN plans falls under the Administrative Director, not the Insurance Commissioner. The other roles mentioned do not have authority to approve MPN plans.