Changing Doctors in a California MPN: Choice, Access, and Medical Records

A California medical provider network (MPN) controls which doctors are in the network, but an injured worker can choose a treating physician from that network after the first MPN evaluation. A change is easier to document when the worker identifies an available doctor with the right specialty, gives notice of the selection, and makes sure the new doctor receives the relevant records. A separate access problem may require a different response.

Choose a physician after the first MPN visit

After the first MPN visit, the employer or insurer must tell the worker about the right to choose an MPN physician and how to access the provider list. The worker may then select a physician within the MPN at any time. The regulation bases that selection, including later changes, on the doctor's specialty or recognized expertise for the injury or condition. The rule is 8 CCR § 9767.6(d)–(e).

Keep a copy of the current provider listing, the selected doctor's name and listed practice location, the date of the selection, and the notice sent to the insurer or employer. Confirm that the office is accepting MPN patients and can schedule the treatment needed.

Track the transfer of medical records

An amendment operative April 1, 2026, requires the insurer or employer to deliver all relevant claim-related medical records, including diagnostic and laboratory results, to the initial primary treating MPN physician selected by the worker within 20 days after notice of that selection. For a subsequently selected MPN physician, the insurer or employer must provide relevant records or test results that physician considers relevant when the physician requests them. The latter sentence does not state a separate 20-day period. See 8 CCR § 9767.6(f).

Preserve the selection notice, transmission confirmation, records request, and the new physician's response about what arrived. If an appointment occurs before records arrive, ask the physician's office to document in writing which records have not been received. The regulation also requires the insurer or employer to give selected MPN physicians the MPN identification number and the correct claims and authorization contact details.

Separate a doctor change from an access failure

Changing to another listed physician is different from showing that the MPN cannot furnish appropriate care. 8 CCR § 9767.5 generally requires three available primary treating physicians within 30 minutes or 15 miles, and specialists for common injuries within 60 minutes or 30 miles, of the worker's residence or workplace. DIR may approve alternative standards for a shortage area. The regulation requires a written policy for necessary out-of-network specialist treatment when MPN care cannot be obtained within the applicable access and appointment standards. A worker facing an access problem should record the requested specialty, the medical access assistant's contacts, available appointments, travel distance, and any response approving or refusing an outside specialist.

The claims administrator's ordinary petition to change a primary treating physician under 8 CCR § 9786 generally cannot be used to change the doctor of a worker treating within an MPN; § 9767.6(g) preserves the specific exception in § 9786(b)(6). That petition is not the worker's form for selecting another MPN doctor. The worker's network selection right is the starting point. The mere wish to see a non-MPN doctor does not establish an access exception. Likewise, a treatment disagreement may call for the MPN's separate second- and third-opinion process. Identify the actual problem first so the request reaches the right procedure.

What to bring to a review

• The MPN notice and provider list in effect when the doctor was selected.
• The written selection notice and appointment confirmations.
• A list of relevant reports or test results the new doctor requested and what was delivered.
• If care is unavailable, a dated log of specialist requests, travel or appointment obstacles, and medical access assistant responses.

These records help distinguish a correctable transfer delay from a network-access dispute, and allow the treating physician to assess the injury with the available medical history.