Determination of Fees for QME Eligibility. 8 CCR § 16

(a) For purposes of establishing the annual fee for any qualified medical evaluator pursuant to Article 2, physicians (as defined under Section 3209.3 of the Labor Code) shall be classified into one of three categories: (1) QMEs who meet all applicable requirements under Article 2 and 5 and who have conducted 0-10 comprehensive medical-legal evaluations in the twelve months prior to the assessment of the fee. Comprehensive medical-legal evaluations are evaluations as defined under Section (1)(i) of this Chapter performed by a physician. (2) QMEs who meet all applicable requirements under Article 2 and 5 and who have conducted 11-24 comprehensive medical-legal evaluations in the twelve months prior to assessment of the fee. Comprehensive medical-legal evaluations are evaluations as defined under Section (1)(i) of this Chapter performed by a physician. (3) QMEs who meet all applicable requirements under Article 2 and 5 and who have conducted 25 or more comprehensive medical-legal evaluations in the twelve months prior to assessment of the fee. Comprehensive medical-legal evaluations are evaluations as defined under Section (1)(i) of this Chapter performed by a physician. (b) The evaluations shall be conducted in compliance with all applicable statutes and regulations. (c) Verification of the number of examinations shall be made by the Administrative Director using The Qualified or Agreed Medical Evaluator Findings Summary Form in section 111 (See, 8 Cal. Code Regs. § 111), as well as any other relevant records or sources of information. Misrepresentation of the number of evaluations performed for purposes of establishing a physician's QME fee shall constitute grounds for disciplinary proceedings under section 60 of this chapter. NOTE: Form referred to above is available at no charge by downloading from the web at www.dir.ca.gov/dwc/forms.html or by requesting at 1-800-794-6900.