Section 3823 Of Article 5. Workers’ Compensation Misrepresentations From California Labor Code >> Division 4. >> Part 1. >> Chapter 4. >> Article 5.
3823
. (a) The administrative director shall, in coordination with
the Bureau of Fraudulent Claims of the Department of Insurance, the
Medi-Cal Fraud Task Force, and the Bureau of Medi-Cal Fraud and Elder
Abuse of the Department of Justice, or their successor entities,
adopt protocols, to the extent that these protocols are applicable to
achieve the purpose of subdivision (b), similar to those adopted by
the Department of Insurance concerning medical billing and provider
fraud.
(b) Any insurer, self-insured employer, third-party administrator,
workers' compensation administrative law judge, audit unit,
attorney, or other person that believes that a fraudulent claim has
been made by any person or entity providing medical care, as
described in Section 4600, shall report the apparent fraudulent claim
in the manner prescribed by subdivision (a).
(c) No insurer, self-insured employer, third-party administrator,
workers' compensation administrative law judge, audit unit, attorney,
or other person that reports any apparent fraudulent claim under
this section shall be subject to any civil liability in a cause of
action of any kind when the insurer, self-insured employer,
third-party administrator, workers' compensation administrative law
judge, audit unit, attorney, or other person acts in good faith,
without malice, and reasonably believes that the action taken was
warranted by the known facts, obtained by reasonable efforts. Nothing
in this section is intended to, nor does in any manner, abrogate or
lessen the existing common law or statutory privileges and immunities
of any insurer, self-insured employer, third-party administrator,
workers' compensation administrative law judge, audit unit, attorney,
or other person.