California's UR overhaul quietly changed the economics of workers' comp on April 1, 2026, and most programs are still catching up.
The new rules add a 30-day treatment window where a physician can provide medically necessary care without prior authorization, provided the body part is accepted, the treatment aligns with MTUS, and the doctor's first report and RFA go in simultaneously. Speed at the front of a claim, discipline on documentation.
Timeliness penalties also sharpened. Missed or delayed decisions now carry $250 per day up to $5,000, and expedited-review misses run $250 per untimely hour up to $18,000. UR that misses a clock is no longer a paperwork problem, it is a line item.
Atlas UR runs to those clocks by design, with nurse-driven review that keeps requesting physicians talking to reviewing physicians and cuts avoidable IMR volume. A well-run UR program is not the enemy of care, it is the alignment layer.
If your UR vendor cannot show you their timeliness rate this quarter, is it protecting you or exposing you?
Source: Sullivan on Comp, DWC Overhauls Utilization Review Regulations
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