California's amended Utilization Review regulations were approved by the Office of Administrative Law on December 30, 2025 and are now shaping every RFA workflow in the state.
The rule-making path was contentious. Multiple comment periods, an OAL rejection along the way, and a dropped proposal to merge the RFA with the PR-2 progress report. What survived tightens timing, raises documentation standards, and gives reviewers cleaner ground to defer or deny when the file is thin.
Atlas built its utilization review approach to match the standard before it became the rule. Every request is paired with current clinical findings, MTUS-supported rationale, and a complete treatment history. The work that used to happen after a denial is now happening before the submission ever leaves the desk.
WorkCompCentral provided the most detailed walk-through of the new rules.
For California employers and TPAs, is your UR vendor running on the December 2025 standard, or last year's playbook?
Source: WorkCompCentral
UR built for December 2025, not last year's playbook.
Every Atlas UR request pairs current clinical findings with MTUS-supported rationale and a complete treatment history. The work that used to happen after a denial now happens before submission.
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