Alabama VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 242
  The acts amends Section 25-5-50, Code of Alabama 1975. It relates to the exemption of workers' compensation coverage by removing the requirement for a corporate officer to submit a written worker’s compensation exemption certification with the Alabama Department of Labor file with the Department of Labor.  The act also adds individual limited liability company member to corporate officers that can exercise the exemption.  Effective Date August 17, 2017.

Alaska VIEW STATE →

REGULATORY ACTIVITY:

• The State of Alaska Department of Labor and Workforce Development, Workers' Compensation Division, Second Independent Medical Examiner (Sime) Selection Panel will meet July 17, 18, 24, 26 & 28, 2017. For additional information, see the Online Public Meeting Notice.

LEGISLATIVE ACTIONS:

• House Bill 132
  This legislation defines the insurance requirements for transportation network company (TNC) drivers. It clearly delineates when a driver's personal automobile policy is covering the driver's vehicle and the requirements when a driver is logged into a TNC network or proving a prearranged ride. Automobile insurers may exclude personal vehicle policies for a driver while they are logged into a transportation network company (TNC) network. This legislation exempts TNC drivers from registering their personal vehicle as a commercial vehicle. This legislation requires a TNC to maintain primary automobile insurance recognizing the driver as a TNC driver used to transport passengers for compensation, and that covers the driver while the driver is logged into a digital network of a company or while they are engaged in a prearranged ride. Insurance required under Title 28 may be placed with an insurer licensed under AS 21.09.060 or with a surplus lines insurer under AS 21.34 with a credit rating not lower than A‐.  This legislation adds an exemption to the Workers’ Compensation Act for transportation network drivers. Effective Date July 6, 2017.

California VIEW STATE →

FEE SCHEDULE NEWS:

• The Physician Fee Schedule and Practitioner Services Medically Unlikely Edits and the National Correct Coding Initiative Practitioner PTP Edits have been updated with an effective date of July 1, 2017.  The update incorporates changes to the Medicare system.  The next update is expected for October 1, 2017.
• The state adopts the DMEPOS Fee Schedule effective April 1, 2017.  The next updates are expected to become effective July 1, 2017.
• The Outpatient and ASC Fee Schedule were updated with an effective date of July 1, 2017. The state has adopted the July 2017 OPPS APC Addenda A and B and ASC Addendum AA and EE to identify the definition of a “surgical procedure”.  All other factors and data remain unchanged since the 12/15/2016 revision.
• Medi-Cal rates have been released with an effective date of June 15, 2017. The next update is scheduled for July 15, 2017.

REGULATORY ACTIVITY:

• The Division of Workers' Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.  The Physician and Non-Physician Practitioner Fee Schedule update Order adopts the following Medicare changes: Centers for Medicare and Medicaid Services (CMS) Medicare National Physician Fee Schedule Relative Value File RVU17C July 1, 2017 quarterly update, National Correct Coding Initiative Physician/Practitioner Services CCI Edits July 1, 2017 quarterly update, National Correct Coding Initiative Medically Unlikely Edits July 1, 2017 quarterly update.  The order adopting the OMFS adjustments is effective for services rendered on or after July 1, 2017 and is posted on the DWC website.
• Posted notice of proposed regulations regarding reinsurance. Notice is hereby given that the California Department of Insurance (Department) will hold a public hearing regarding the adoption of amendments to the California Code of Regulations (C.C.R.) Title 10, Chapter 5, Sub- chapter 3, Article 3, sections 2303, 2303.1, 2303.2, 4, 2303.5, 2303.8, 2303.9, 2303.11, 2303.12, 2303.13, 2303.14, 2303.15, 2303.17, 2303.19, 2303.21, 2303.22, [existing] 2303.23 [renumbered as 2303.30] and the addition of sections 2303.23, 2303.24, 2303.25, 2303.26, 2303.27, and 2303.28, hereinafter referred to as “Reinsurance Oversight Regulations”.
• The Department of Insurance posted notice rule making regarding reinsurance. The Division of Workers' Compensation published a decision regard a rule making petition.
• The Division of Workers’ Compensation (DWC) announces that the 2018 minimum and maximum temporary total disability (TTD) rates will increase on January 1, 2018. The minimum TTD rate will increase from $175.88 to $182.29 and the maximum TTD rate will increase from $1,172.57 to $1215.27 per week.  Labor Code section 4453(a) (10) requires the rate for TTD be increased by an amount equal to percentage increase in the State Average Weekly Wage (SAWW) as compared to the prior year. The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury. In the 12 months ending March 31, 2017, the SAWW increased from $1,164.51 to $1,206.92—an increase of 3.642 percent.  Under Labor Code section 4659(c), workers with a date of injury on or after January 1, 2003 who are receiving life pension (LP) or permanent total disability (PTD) benefits are also entitled to have their weekly LP or PTD rate adjusted based on the SAWW.  The first quarter 2016 SAWW figures may be verified at the U.S. Department of Labor website, as can the first quarter 2017 SAWW figures.
• The Division of Workers’ Compensation (DWC) has posted the 2016 ethics advisory committee's annual report on its website. The workers' compensation ethics advisory committee is a state committee independent from the DWC that is charged with reviewing and monitoring complaints of misconduct filed against workers' compensation administrative law judges.  The 2016 annual report may be viewed or downloaded at the DWC website.
• The Division of Workers’ Compensation (DWC) is reminding lien claimants that they are required to file a declaration for any lien filed between January 1, 2013 and December 31, 2016 for which a filing fee was paid.  Labor Code section 4903.05(c) provides: lien claimants shall have until July 1, 2017. DWC recommends that lien claimants complete their submission by 5 p.m. on Friday, June 30 to ensure a timely filing.   Senate Bill 1160, which became effective January 1, requires all lien claimants who filed a lien between January 1, 2013 and December 31, 2016, and paid a filing fee, to file the “Supplemental Lien Form and 4903.05(c) Declaration” form. Labor Code section 4903.05(c) was amended as part of the bill’s reform measures to combat fraud in the workers' compensation system. To comply with SB 1160’s requirements, DWC made available an e-form declaration and the WCAB promulgated regulations requiring the use of this form by e-filers and JET filers. Liens claimants who fail to file the “Supplemental Lien Form and 4903.05(c) Declaration” will have their liens dismissed. As with any court document, the declaration must be served on the parties in the case. Rule 10324 states: No document, including letters or other writings, shall be filed by a party or lien claimant with the Workers' Compensation Appeals Board unless service of a copy thereof is made on all parties together with the filing of a proof of service as provided for in Rule 10505. DWC is currently reviewing and evaluating filed declarations for compliance with the legislation, and will be holding hearings to determine whether the declarations are accurate and comply with the requirements of section 4903.05(c).  Lien claimants should be aware that the filing of a false declaration is grounds for dismissal of the lien. The DWC has posted frequently asked questions on use of the new form, which can be found on the DWC Website.
• The Division of Workers’ Compensation (DWC) has posted an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.  The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update Order adopts the following Medicare changes:
  • The Centers for Medicare & Medicaid Services (CMS) Medicare Hospital Outpatient Prospective Payment System (HOPPS) July 1, 2017 Addendum A ZIP file quarterly update;
  • The Centers for Medicare & Medicaid Services (CMS) Medicare Hospital Outpatient Prospective Payment System (HOPPS) July 1, 2017 Addendum B ZIP file quarterly update;
  • The Centers for Medicare & Medicaid Services (CMS) Ambulatory Surgical Center Payment System, July 2017 ASC Approved HCPCS Code and Payment Rates ZIP file, Column A of “Jul 2017 ASC AA” and Column A of “Jul 2017 ASC EE”.
• The order adopting the OMFS adjustments is effective for services rendered on or after July 1, 2017 and is posted on the DWC at http://www.dir.ca.gov/DWC/OMFS9904.htm#6.

Colorado VIEW STATE →

REGULATORY ACTIVITY:

• The Division of Workers' Compensation has adopted rule 2-5 Regarding Workers' Compensation Surcharge Rate.  The rule becomes effective on July 1, 2017.
• Posted notice of rules hearing for Rules 16 and 18 Utilization Standards and Medical Fee Schedule.  The public hearing will be held on August 1, 2017 at 9:30 A.M. at 633 17th Street Denver, Colorado.  The proposed rules are expected to become effective January 1, 2018.

Connecticut VIEW STATE →

REGULATORY ACTIVITY:

• The Workers’ Compensation Commission has just received shipment of its new Bulletin No. 52, amended to January 1, 2017, which is available to the public free of charge. Bulletin No. 52 contains the entire Workers’ Compensation Act, additional related statutes, workers’ compensation administrative regulations, and illustrations of the most up-to-date Connecticut’s workers’ compensation forms. Please contact your nearest Workers’ Compensation Commission District Office for your free copy of the new Bulletin No. 52. You may also call the Commission’s Education Services at (860) 493-1500.
• Has published Memorandum No. 2017-03 which supersedes Memorandum No 2015-04.  The memorandum is regarding the Workers' Compensation Commission Guidelines for Mediation.  The guideline becomes effective July 1, 2017.

LEGISLATIVE ACTIONS:

• House Bill 7037
  This bill requires employers whose employees are subject to an income withholding order for child support to take additional steps when such employees make claims for workers' compensation benefits. By law, when an employee under an income withholding order for child support makes such a claim, his or her employer must promptly notify the dependent (i.e., spouse, former spouse, or child owed the support) or the Judicial Branch's Support Enforcement Services as directed. Under the bill, when such an employee makes a claim for workers' compensation benefits, employers must also include a copy of the income withholding order with the first report of occupational illness or injury to the workers' compensation carrier. The carrier must withhold funds pursuant to the order and pay the withheld funds to the Department of Social Services' Office of Child Support Services. By law, the office must ensure that it distributes the withheld funds to the dependent, state, or support enforcement agency of another state, as appropriate, within two business days of receipt. Effective Date January 1, 2018.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• On May 11, 2017, the Department of Financial Services, Division of Workers' Compensation (Department) entered a Consent Order approving the Settlement Agreement between the Department and Samuel J. Gerson, M.D., thereby concluding the administrative matter in Case No. 198047-16-WC.  The Settlement Agreement prospectively bars Samuel J. Gerson, M.D. from receiving payment under chapter 440, Florida Statutes.  Dr. Gerson has agreed that he shall not, except on an emergency basis, provide any medical consultations, examination, treatment or care, including prescribing medication, for any injured worker whose claim falls under the scope and jurisdiction of chapter 440, Florida Statutes.

Georgia VIEW STATE →

REGULATORY ACTIVITY:

• The state has just posted the instructions for the fee schedule that went into effect on April 1, 2017.   To view the instructions as posted go to https://sbwc.georgia.gov/medical-fee-schedule.  The instructions along with any attachments to the instructions went into effect April 1, 2017.

Hawaii WC VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the drug and biological (ASP) fee schedule retroactive to January 1, 2017.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of intent to promulgate rules - negotiated rulemaking by the Idaho Industrial Commission for the following rules: 17.02.08 miscellaneous provisions; 17.02.09 medical fees; 17.02.10 administrative rules of the industrial commission under the workers' compensation law security for compensation insurance carriers; and 17.02.11 administrative rules of the industrial commission under the workers' compensation law security for compensation self-insured employers.   A public hearing was scheduled to be held on June 20, 2017 for 02.08, 17.02.10; and 17.02.11 at 1:00 p.m. at the Idaho Industrial Commission 700 South Clearwater Lane, Boise, Idaho.  A public hearing was scheduled to be held on June 22, 2017 for 17.02.09 at 9:00 a.m. at the Idaho Industrial Commission 700 South Clearwater Lane Boise, Idaho.
• Posted Notice regarding rule making for Prompt Claims and Medical Fee Schedule.  The Prompt Claims Rule public meeting was held on June 29, 2017 at 9:00 am - Industrial Commission (700 Clearwater Ln, Boise, ID 83712).  A copy of the hand out is attached.  The Medical Fee Schedule public meeting is being held on July 10, 2017 at 1:00 pm - Industrial Commission (700 Clearwater Ln, Boise, ID 83712).

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• This year the two-dollar policy assessments will be issued August 1, 2017 with a due date of October 31, 2017. If you have any questions please contact: Mary Taivalkoski at mtaivalkoski@wcb.In.gov or David Babcock DBabcock@wcb.IN.gov.

Iowa VIEW STATE →

REGULATORY ACTIVITY:

• Effective July 1, 2017, the Division of Workers’ Compensation is increasing the fee for all copies from fifteen cents (.15¢) to twenty-five cents (.25¢). This change reflects the increased costs the Division has incurred since it last changed the fees and brings the Division of Workers’ Compensation in line with the costs charged by Iowa Workforce Development.

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

• IMPORTANT NOTICE REGARDING SERVICE OF PLEADINGS:  All post-application pleadings MUST be served on all other parties by the submitting party either conventionally (by paper) or, by agreement, by electronic means.  Submission of pleadings in LMS does not relieve the submitting party of the obligation to serve other parties pursuant to 803 KAR 25:010 Section 5 (2).

Maine VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 984
  The enacted legislation splits the current adjuster's license into two separate categories. The broad category would remain however there would be a workers’ compensation adjuster only license. For anyone who took advantage of this new license who wasn’t otherwise licensed, the Bureau of Insurance (BOI), within the Department of Professional and Financial Regulation, would receive a license fee. Effective Date January 1, 2018.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• The Commission posted a notice on their web site for practitioners:
• Note the following requirements when filing a set-with request (Request for Action on Filed Issues H-25R):
  • Issues (form H-24R) must be pending in each case for the set-with to be applied.
  • Request a set-with only when there are issues pending in all involved claims. When there are no issues, but parties want the Commissioner informed of prior awards in a claim, the party shall provide a copy of the award to the Commissioner at the hearing as part of the exhibit.
  • Send a copy of the request to the opposing counsel in all claims.
  • Claims that are set together must be for the same claimant or a different claimant involved in the same accident (same date and time).
  • When a request to set-with is filed after a claim has been scheduled for hearing, the Commission will administratively continue the claim to reschedule a new hearing date where all the cases may be heard together.
  • When a request to set-with is filed after issues are filed in one of the claims but no hearing date has been scheduled, file a set-with request (form H-25R) in each of the claims involved. Remember, there must be pending issues in each claim to have them set together.
  • If you are requesting a continuance on cases that have been set together, remember to list each claim number on the continuance request (form H-28R).

• The Commission form Insurer's Termination of Medical Benefits C-10 is revised and all should use the new form immediately.
• Posted notice that the Commission's new online employee claim filing is not available.  To view go to: http://www.wcc.state.md.us/WFMS/C1_WebForms.html

Massachusetts VIEW STATE →

REGULATORY ACTIVITY:

• Posted Bulletin17-8 regarding 101 CMR 701.00 Community Hospital Reinvestment Trust Fund Payments and Funding effective June 2, 2017.
• The division has posted a power point entitled Opioid Alternative Treatment Pathway. The document was released on June 12, 2017 and is authored by Senior Judge Omar Hernandez.
• Published a power point titled "Introducing the DIA's Document Upload Module for submitting Conference Medical and Non-Medical Packets.
• The state has published a revised bulletin 17-09 and a new bulletin 17-10.  The revised bulletin was published on June 14, 2017 and the new bulletin is effective July 1, 2017.
• The division of Workers' Compensation has issued the Advisory Council's FY 16 Annual Report.

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

• DMEPOS – CMS has released a new update effective July 1, 2017. The next update is expected on October 1, 2017.
• ASC – CMS has released a new quarterly update to the ASC fee schedule with an effective date of July 1, 2017. The next expected update is October 1, 2017.
• OPPS – CMS has released a new quarterly update to the hospital outpatient fee schedule with an effective date of July 1, 2017. The next expected update is October 1, 2017.

Minnesota VIEW STATE →

REGULATORY ACTIVITY:

• Published a notice of new legislation enacted in response to the Ekdahl/Hartwig cases. “To workers' compensation payers: This notice is to inform you about new legislation, effective May 31, 2017, recommended by the Workers’ Compensation Advisory Council in response to issues raised by the Minnesota Supreme Court’s 2014 decisions in Ekdahl v. Independent School District #213, et al., 851 N.W.2d 874 and Hartwig v. Traverse Care center, et al., 852 N.W.2d 251. In these cases, the Supreme Court decided that the workers’ compensation law does not allow permanent total disability (PTD) benefits to be reduced by the employee’s government retirement benefits (other than social security retirement benefits).”

Missouri VIEW STATE →

REGULATORY ACTIVITY:

• The state has posted a form regarding mesothelioma liability election of self-insured employer or group trust member pursuant to Section 287.200.43, RSMo.
• Published statewide average weekly wage and benefit maximums effective July 1, 2017.

Montana VIEW STATE →

FEE SCHEDULE NEWS:

• A new medical, ambulance and hospital fee schedule has been adopted as of July 1, 2017. The next update is scheduled for July 2018.  The new Facility Fee Schedule will increase base reimbursement rates to inpatient hospitals by 1% to outpatient hospitals by 2.7% and to ASCs by 3.6%.

REGULATORY ACTIVITY:

• The Department issued a notice regarding Permanent Total Disability Benefit Cost of Living Increases and Adoption of the State's Average Weekly Wage for Fiscal Year 2018.  Both the cost of living increase and the statewide average weekly wage become effective July 1, 2017.
• The Department has posted a notice of adoption of the Montana Facility Fee Schedule as proposed.  The state held a hearing on May 5, 2017.  Two comments were received.  The state addressed both comments.  The state is adopting the fee schedule as proposed.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• Jackie Boesen assumed the duties of Acting Administrator of the Nebraska Workers' Compensation Court Effective June 2, 2017. Jackie, who will continue to serve in her role as the court's General Counsel, replaces Tamra Walz, who has recently resigned.
• The Department of Insurance has finalized Rule Title 230 Chapter 3 Regulation for Professional Employer Organization Registration Act.  The rules became effective on June7, 2017.

Nevada VIEW STATE →

REGULATORY ACTIVITY:

• The Board for the Administration of the Subsequent Injury Account for Associations Self-Insured Public or Private Employers held a public meeting on June 14, 2017, 10:00 a.m., at 1301 North Green Valley Parkway, Conference Room B, Henderson, Nevada.  The public is advised that some of the members of the Board may participate in the meeting via telephone.

LEGISLATIVE ACTIONS:

• Assembly Bill 83
  The enacted legislation relates to insurance by providing for administrative supervision of insurers and other entities by the Commissioner of Insurance. It provides for the regulation of network plans. It  revises provisions relating to medical malpractice insurance, the general regulation of insurers, reinsurance, motor  vehicle  insurance,  industrial  insurance, health insurance in general, health benefit plans in general, funeral and burial services, individual health insurance, group and blanket health insurance, health insurance for small employers, service contracts, credit personal property insurance, nonprofit corporations for hospital, medical and dental service, health maintenance organizations, plans for dental care, prepaid limited health service organizations and managed care organizations.  The legislation revises provisions relating to the confidentiality    of certain documents and other information. It revises various references to insurance agents and    The legislation repeals various    provisions   governing summaries of coverage, loss prevention, disclosures of certain information, continuation of coverage and insurance requirements for prepaid limited health service organizations the legislation provides a penalty for violations.  Effective Date July 1, 2017.
• Senate Bill 59
  Existing law requires the State Board of Pharmacy and the Investigation Division of the Department of Public Safety to develop a computerized program to track each prescription for a controlled substance listed in schedule II, III or IV filled by a pharmacy or dispensed by a practitioner registered with the Board. The program is required to be designed to provide information regarding: (1) the inappropriate use by a patient of certain controlled substances to pharmacies, practitioners and appropriate state and local governmental agencies to prevent the improper or illegal use of such controlled substances; and (2) statistical data relating to the use of those controlled substances. (NRS 453.162) Sections 2-3 of this bill expand the scope of the program to also track each prescription for a controlled substance listed in schedule V. Existing law requires the Board to allow certain law enforcement officers to have Internet access to the database of the program only for investigating a crime related to prescription drugs. (NRS 453.165) Section 4 of this bill instead requires the Board to allow an employee of a law enforcement agency to have Internet access to the database of the program under certain circumstances only for certain purposes.   Section 1.3 of this bill requires a law enforcement officer who has probable cause to believe that a violation of chapter 453 of NRS concerning prescribed controlled substances has occurred or who receives a report of a stolen prescription for a controlled substance while acting in his or her official capacity and in the regular course of an investigation to report certain information to his or her employer. Section 1.3 requires a coroner, medical examiner or deputy thereof who determines, as the result of an investigation of the death of a person, that the person died as the result of using a prescribed controlled substance, to upload certain information to the database of the program or, if the coroner, medical examiner or deputy thereof does not have such access, report such information to a coroner, medical examiner or deputy thereof who has access to the database. Section 1.3 also requires the employer of the law enforcement officer or a coroner, medical examiner or deputy thereof to upload such reported information to the database of the program as soon as practicable after receiving the information except where the employer of a law enforcement officer determines that uploading the information will interfere with an active criminal investigation. In that case, the employer may postpone uploading the information until after the conclusion of the investigation. Section 1.3 further provides that each law enforcement officer, employer of a law enforcement officer, coroner, medical examiner or deputy of a coroner or medical examiner who makes a good faith effort to comply with section 1.3, or a regulation adopted pursuant thereto, is immune from civil and criminal liability for any act or omission relating to the transmission of information pursuant to section 1.3. Section 1.6 of this bill authorizes a coroner, medical examiner or deputy thereof who meets certain requirements to access the database of the computerized program to: (1) upload information concerning the death of a person due to using a prescribed controlled substance; or (2) investigate the death of a person. Section 4 authorizes an employee of a law enforcement agency to access the database of the program to upload the information required by section 1.3.   Existing law requires a practitioner to obtain a patient utilization report from the computerized program before initiating a prescription for a controlled substance listed in schedule II, III or IV. Section 5.5 of this bill additionally requires a practitioner to obtain such a report before initiating a prescription for an opioid that is a controlled substance listed in schedule V.  Effective Date July 1, 2017.

New Hampshire VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of rulemaking regarding rule managed care programs in workers' compensation.  The posted notice is for LAB Rule 700.  There will be a public hearing held on July 27, 2017 at 10:00 a.m. at the NH Department of Labor 95 Pleasant St, Concord New Hampshire.

LEGISLATIVE ACTIONS:

• House bill 150
  This enacted legislation makes technical changes to the law governing property and casualty insurance.  Effective Date August 1, 2017.

• House Bill 517
  The enacted legislation provides workers compensation coverage by the state to certain volunteers for the fish and game department. Effective Date July 1, 2017.
• Senate Bill 210
  The enacted legislation clarifies certain positions within the department of insurance. Effective Date August 15, 2017.

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

• Posted a rule regarding hospital operations and reporting.  The proposal amends rules H.J.A.C. 8:31B-3.3 and 4.6 and 8:43G-41 and creates a new rule N.J.A.C. 8:96. New Jersey posted notice of a new rule regarding hospital reporting of financial data. While this rule does not specifically regulate the workers' compensation industry it is of interest. On January 17, 2014, Governor Christie approved P.L. 2013, c. 195, "An Act concerning reporting of certain information by hospitals and supplementing Title 26 of the Revised Statutes" (Act). The Act directs the Commissioner of Health (Commissioner) to "undertake a review of New Jersey's hospital financial reporting requirements [and to] report any findings and recommendations directly to the Governor" by mid-July 2014. The Act specifically directs the Commissioner to "examine the impact of, and make recommendations on, the following areas for all [page=1294] entities receiving Health Care Subsidy Fund payments from the State: Internal Revenue Service filings, Securities and Exchange Commission filings, and audited financial statements."
• The Department of Labor and Workforce Development is adopting a final rule issued by the Federal Occupational Safety and Health Administration (OSHA) about its Hazard Communication Standard (HCS).  Specifically, OSHA explains that it is modifying its HCS to conform to the United Nations' Globally Harmonized System of Classification and Labeling of Chemicals (GHS).  Adoption of the final rule discussed above is necessary in order to comply with J.S.A. 34:6A-30, which requires that the Commissioner of Labor and Workforce Development adopt all OSHA standards by reference upon adoption of those standards by the United States Secretary of Labor.  The statutory requirement ensures that the State's Public Employees Occupational Safety and Health (PEOSH) program is at least as effective as OSHA, thereby making the State program eligible for Federal approval and funding under the 1970 Federal Occupational Safety and Health Act.      N.J.S.A. 34:6A-30 provides that the adoption of Federal standards are not subject to the formal rulemaking requirements of N.J.S.A. 52:14B-4, but shall be duly adopted upon publication in the New Jersey Register.  As a result, the Department has not held a public hearing, nor has it requested formal written comments on its adoption of the amended Federal standards.

New Mexico VIEW STATE →

FEE SCHEDULE NEWS:

• The Gross Tax Receipts schedule has been updated for the period of July 1 through December 31, 2017.

REGULATORY ACTIVITY:

• The Workers’ Compensation Administration (WCA) announces the vacancy of an Administrative Law Judge, effective July 1, 2017, due to the retirement of Judge David Skinner. The WCA Director solicits applications from interested persons to fill the position. Pursuant to NMSA 1978 52-5-2, the appointment will be made for an initial one-year term, which may be extended for subsequent five-year terms. The administration is currently accepting applications and will begin the review process June 26, 2017. The application process will be ongoing until the position is filled. For questions about the application process, please contact Executive Deputy Director Dana Chavez at Chavez@state.nm.us or (505) 841-6810.

New York VIEW STATE →

REGULATORY ACTIVITY:

• Published bulletin subject number 046-949 regarding revisions to Form C=240 Employer's Statement of Wage Earnings.
• Webinar on Timeliness of Controversies: Measuring and Monitoring Payer Performance: The New York State Workers’ Compensation Board held a webinar, Timeliness of Controversies: Measuring and Monitoring Payer Performance, on June 26, 2017, at 1 p.m. and again on June 29, 2017, at 1 p.m.
• Posted emergency rule making regarding Workers' Compensation Benefits for Transportation Network Company Drivers. The two proposed rules add to Part 319 to Title 12 NYCRR. Both proposed rules stated purposes are to clarify which drivers are covered and when they are covered by the black car fund.   The rules were published on June 21, 2017.
• Published bulletin no 046-951 regarding maximum benefits effective July 1, 2017. The maximum weekly benefit rate for workers’ compensation claimants is two-thirds of the New York State average weekly wage for the previous calendar year, as determined by the New York State Department of Labor (Workers’ Compensation Law §§ 2(16);15(6)). The Department of Labor reported to the Superintendent of the Department of Financial Services that the New York State average weekly wage for 2016 was $1,305.92. Accordingly, the maximum weekly benefit rate is $870.61 for compensable lost time for workers' compensation claims with dates of accident during the period from July 1, 2017 through June 30, 2018. To view a copy of the bulletin, go to:  http://www.wcb.ny.gov/content/main/SubjectNos/sn046_951.jsp
• Published bulletin number 046-957 regarding an increase in the aggregate trust fund administrative expense multiplier effective July 1, 2017.  The administrative expense component of Aggregate Trust Fund (ATF) deposits for deposits first directed for calculation of the amount to be deposited into the AFT on or after July 1, 2017 is increased to 6% of the present value of the award, to cover 100% of the cost of claims handling, actuarial calculations, and investment management.  Section 27(2) of the Workers’ Compensation Law requires private insurance carriers to deposit the present value of indemnity awards for death and permanent partial or total disability into the ATF. Insurers are also required to deposit “such additional sum as the board may deem necessary for a proportionate payment of expenses of administering such trust fund . . . [.]” Currently a 3% multiplier is applied to ATF indemnity award deposits to calculate the administrative expense component. The result is an additional sum that only covers approximately 50% of the State Insurance Fund’s costs. The administrative expense component of ATF deposits for deposits directed on or after July 1, 2017 is increased to 6% of the present value of the award, to cover 100% of the cost of claims handling, actuarial calculations, and investment management. The Actuarial Tables for Aggregate Trust Fund deposits contained in Special Bulletin 222C should, as of the effective date, use a 1.06 factor for the administrative expense multiplier in Examples 8, 10, and 11.  To view a copy of the bulletin go to: http://www.wcb.ny.gov/content/main/SubjectNos/sn046_957.jsp

North Carolina VIEW STATE →

FEE SCHEDULE NEWS:

• The North Carolina Industrial Commission has completed a fiscal note and proposes to amend Rule 04 NCAC 10J .0103 regarding reimbursement for services provided in an Ambulatory Surgery Center.  The proposed amendment would be effective October 1, 2017 and would reinstate the language of the temporary rule that was originally approved and effective on January 1, 2017.

REGULATORY ACTIVITY:

• The North Carolina Workers’ Compensation Opioid Task Force met at 2:00 p.m. on Tuesday, June 6, 2017. The meeting took place at the Industrial Commission, located in the Dobbs Building at 430 N. Salisbury Street, Raleigh, NC 27603. The meeting was held in the Industrial Commission Hearing Room, Room 2173, on the second floor.
• Has proposed a rule regarding continuing education for licensing requirements for multiple professionals licensed by the department of Insurance.  Comments regarding the proposed rule may be sent to: Loretta Peace-Bunch, 1201 Mail Service Center, Raleigh, NC 27699-1201; phone (919) 807- 6004; email loretta.peace-bunch@ncdoi.gov by August 14, 2017.
• Notice of Proposed Amendment to Industrial Commission Rule 04 NCAC 10J .0103:  Attached is a notice regarding proposed changes to the Commission’s Medical Fee Schedule, Rule 04 NCAC 10J .0103, including the public hearing date and the written comment period for the proposed rule amendment. The notice contains the website link for the fiscal note approved by the Office of State Budget and Management regarding the proposed rule amendment.

North Dakota VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the Physician Drug, Clinical Laboratory and Medical Provider Fee Schedule effective July 1, 2017. The next expected update is set for October 1, 2017.
• Effective July 1, 2017 WSI will implement the use of the 3M Ambulatory Payment Classification (APC) grouper. The APC grouper will enable WSI to incorporate additional Medicare APC methodologies into outpatient hospital reimbursements, including: Unconditional packaging; Conditional packaging; Composite APC packaging; and Comprehensive APC packaging.  WSI will begin processing bills utilizing the new APC grouper methodology for dates of service on or after July 1, 2017. To offset the impact of the increased APC payment packaging, WSI will provide a one-time increase of 6.28% to the Outpatient Hospital Fee Schedule conversion factor. As a result, the new conversion factor will be set to $142.10 for the remainder of 2017. WSI will update the Outpatient Hospital Fee Schedule Guideline to include the new conversion factor, as well as new status indicators and payment parameters. The guideline will be available to coincide with the release of the APC grouper. A provider should refer to the revised guideline for complete information.  If you have questions about this article, please send an email to wsipr@nd.gov (link sends e-mail).  To receive provider news, subscribe to our Email Updates list.
• WSI has published the New Guideline for Ambulatory Surgery Center Fee Schedule Guidelines effective July 1, 2017.

REGULATORY ACTIVITY:

• WSI recently revised several Utilization Review (UR) forms, which a provider should use effective immediately. Revisions include general formatting/ language changes and conversion to a fill able PDF version. Listed below are the updated forms and a summary of any additional revisions:
  • Independent Exercise Form (C59a)
  • Work Hardening/Conditioning Form (C59b)
  • Utilization Review Request Form (UR-C): Revision of Section 7, Injection Request, and Section 8, Therapy Request
  • Utilization Review Chiropractor Request Form (UR-Chiro): Revision of Section 3, Acute and Sub-Acute Care, and Section 4, Palliative Care
  • Medical Service Dispute Resolution Request Form (M2)
• As a reminder, a provider must complete these forms in their entirety, as WSI will return incomplete forms back to the provider. A provider may contact the UR department at 888-777-5871 with questions on UR form completion and prior authorization requirements.
• WSI has posted new fee schedules to become effective July 1, 2017.  The schedules published are Physician Drug, Clinical Laboratory and Medical Provider Fee Schedule.
• Effective July 1, 2017 WSI will implement the use of the 3M Ambulatory Payment Classification (APC) grouper. The APC grouper will enable WSI to incorporate additional Medicare APC methodologies into outpatient hospital reimbursements, including: Unconditional packaging; Conditional packaging; Composite APC packaging; and Comprehensive APC packaging.  WSI will begin processing bills utilizing the new APC grouper methodology for dates of service on or after July 1, 2017. To offset the impact of the increased APC payment packaging, WSI will provide a one-time increase of 6.28% to the Outpatient Hospital Fee Schedule conversion factor. As a result, the new conversion factor will be set to $142.10 for the remainder of 2017. WSI will update the Outpatient Hospital Fee Schedule Guideline to include the new conversion factor, as well as new status indicators and payment parameters. The guideline will be available to coincide with the release of the APC grouper. A provider should refer to the revised guideline for complete information.  If you have questions about this article, please send an email to wsipr@nd.gov (link sends e-mail).  To receive provider news, subscribe to our Email Updates list.
• WSI has published the New Guideline for Ambulatory Surgery Center Fee Schedule Guidelines effective July 1, 2017.

Ohio VIEW STATE →

REGULATORY ACTIVITY:

• A rule in the category Workers' Compensation - Bureau of Workers' Compensation is being considered for review: -Rule Title: Provisional treatment reimbursement approval - pilot program. -Rule Number: 4123-6-01.2 -Proposed Action: Amended.
• Posted notice of five-year review of rule 4123-19 regarding self-insured risk providers.
• Has posted waiting for Common Sense Initiative Recommendations the Ohio Rule Number 4123-6-21.3 Outpatient medication formulary Appendix (formulary list of medications covered by the Ohio Bureau of Workers Compensations.  The proposals will become effective October 1.
• Published Chapter 4123-19-01 Definition: state risks, self-insuring risks Five Year Rule Review notice for review and comment.  The state is recommending no changes.

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

• The Commission has proposed an emergency rule for Title 810 Chapter 25.

LEGISLATIVE ACTIONS:

• House Bill 2423
  HB 2423, as introduced, updates existing statutes referring to the Workers’ Compensation Court. The measure clarifies that these statutes may refer to the Workers Compensation Court of Existing Claims, or to the Workers’ Compensation Commission. The measure also updates statutory language. Effective Date July 1, 2017.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• Published bulletin 376.  This bulletin notifies self-insured employers of the new base rates to be used for premium assessment during the July 1, 2017 through June 30, 2018 fiscal year. In addition, this bulletin provides reporting instructions and rating plan options. This bulletin replaces amended Bulletin 374 dated Nov. 1, 2016.
• Posted notice regarding insurance annual reporting.
• Published in the June 1, 2017 Bulletin Adoption of Annual and Supplemental Statement Blanks and Instructions for Reporting Year 2016.
• Has published a report that is the estimate of the total number of Oregon employees covered by Workers' Compensation (WC) insurance in 2016. The table includes final data for 2012-2015. The information in the table is organized by industry division, and by industry code/name.
• Oregon has revised bulletin 1 effective July 1, 2017.  This bulletin publishes the annual adjustment to attorney fees awarded under ORS 656.262(11) (a) and ORS 656.308(2) (d).  See OAR 438-015-0038; OAR 438-015-0055(5); OAR 438-015-0110(3).  This bulletin replaces Bulletin No. 1 dated June 1, 2016.
• Proposed revision to the Certificate of Compliance filing form reflecting Division of Financial Regulation.
• Amend: OAR 836-010-0011- The proposed rule updates the Certificate of Compliance sample form required as a part of each rate and form filing. The form sample is currently an exhibit within OAR 836-010-0011, this rulemaking will remove the exhibit from the rule and place it on the Division of Financial Regulation website. In addition, the proposed rule updates the form to correct the reference to the Oregon Insurance Division to the Division of Financial Regulation to reflect the official name change that occurred in January of 2016. Currently, a rulemaking is necessary to replace references to the Oregon Insurance Division with the Division of Financial Regulation because this form is an exhibit within the rule. This rulemaking will allow for future updates to the form to be carried out without having a formal rulemaking process.  Public comment: The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.  Filed: June 12, 2017 Public hearing: July 27, 2017, 1:30 p.m.  Last day for public comment: August 4, 2017, 5:00 p.m.
• The Workers’ Compensation Board held a meeting at 10:30 a.m. on Thursday, June 29, 2017, in Hearing Room A, at 2601 25th St. SE, Suite 150, Salem, OR.  On the agenda is: Mandatory quarterly Board meeting pursuant to OAR 438-021-0010(1) (d).   The meeting location was accessible to persons with disabilities.
• The Oregon Workers' Compensation Division has posted proposed rules to its website:
  OAR 436-010, Medical Services
  • OAR 436-030, Claim Closure and Reconsideration
  • OAR 436-035, Disability Rating Standards
• The division will be holding a public hearing on the proposed rule on July 25, 2017, 9 a.m. in the Labor & Industries Building on 350 Winter Street NE, Room F (basement), Salem, Oregon 97301.

Pennsylvania WC VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the PAWC Part A and Part B Fee Schedule services with an effective date of July 1, 2017.  The next expected update is for October 1, 2017.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the inpatient, ASC and emergency room hospital fee schedule effective July 1, 2017. The next expected update is scheduled for July 1, 2018.
• The state is expected to update their physician fee schedule in mid July 2017.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

• On May 9th, 2017, Governor Henry McMaster signed House Bill H.3441 which amends Title 42 by adding § 42-9-450.  This new statute allows payment of compensation to be made by check or electronic payment systems, but requires the payments to be made “in accordance with the policies, procedures, or regulations as provided by the commission”. S.C. Code Ann. § 42-9-450.  The Commission has proposed changes to Regulation 67-1602 which will provide the framework for how parties can go about using electronic payment systems. However, the proposed changes to the regulations did not become law this year, and will be before the General Assembly in January 2018.  At the June 19^th 2017 Commission Business Meeting, the Commissioners issued an Administrative Order adopting policies and procedures regarding the payment of compensation pursuant to § 42-9-450 of the S.C. Code of Laws.

South Dakota VIEW STATE →

FEE SCHEDULE NEWS:

• A new updated fee schedule is expected to be adopted July 2017.

REGULATORY ACTIVITY:

• The South Dakota Department of Labor and Regulation's Workers' Compensation website (http://dlr.sd.gov/workerscomp) has been updated to include:  An updated version of the Rules Text for the proposed administrative rules that were presented at the May 15, 2017 public hearing.

Tennessee VIEW STATE →

REGULATORY ACTIVITY:

• The Bureau of Workers' Compensation published a document summarizing legislative changes to the state's workers' compensation statutes.
• Rule-making Hearing on Proposed Electronic Medical Billing, "E-Billing": The Bureau will be conducting a public rulemaking hearing on August 8 at 10:00 am CDT. The hearing will be held in the Tennessee Room of the Department of Labor and Workforce Development offices located at 220 French Landing Drive in Nashville. Proposed rules would govern the processes by which carriers pay medical providers for treatment provided in workers' compensation claims.
• Filed notice of a hearing regarding the Workers' Compensation Appeals Board.  Hearing will be to consider amendments to the Appeals Board rule 0800-02-22.  The hearing will be held on August 16, 2017 at the Tennessee Room 220 French Landing Drive, 1-A Nashville, TN at 2:00p.m.

Texas VIEW STATE →

REGULATORY ACTIVITY:

• The Division of Workers’ Compensation recently reviewed form letters it sends to injured employees and decided to modify the correspondence using nationally recognized principles to increase usability. In other words, they made them easier to read. A group of experts from across the agency looked at ways to meet legal requirements for the letters while also making them more readable and useful to injured employees. Eight letters and notices have been redone so far and will be used starting this month. “Workers’ compensation is complex, and we want to do everything we can to help injured employees get the care and benefits they’re entitled to,” said Commissioner Ryan Brannan. “A clearly written letter can help the employee better understand the process.” The project started by looking at an inventory of hundreds of letters sent to injured employees, said the division’s Melody May. The letters that are used most frequently were the first to be reviewed and improved. “We stripped the letters down and started to rebuild them with input from the subject matter experts,” May said. The wording, format, and organization of the new letters were guided by plain language writing techniques to make them easier to understand. TDI’s Fawn Escalante, who helped with the project, said the revised letters use shorter words and sentences, have clear headings, and avoid jargon. One of the notices revamped by the group is the Request for Required Medical Examination letter. The previous letter was written at a college reading level. After the revision, the letter now is at a seventh-grade level. New headings make it easy for someone skimming the letter to see what action they need to take (get an exam), the name of the doctor, and how to change the appointment time if necessary. “We know people often skim letters, and we wanted to make it easy for the reader to get the information they need quickly,” Escalante said. May said the work group had three requirements for its finished letters: The content had to be current, the format had to be compatible with records processing, and the wording had to meet legal requirements. The work group met the third condition by including legal terms on the letters in parentheses next to the more common wording.
• The division also revised notices that workers’ compensation carriers send to injured employees and is reviewing comments received on those changes. It expects improved versions of those letters to be approved this summer.
• Posted informal notice regarding to amendments to 28 TAC Section 134.500.
• The Texas Department of Insurance, Division of Workers' Compensation has determined, pursuant to the authority and direction given under the Texas Workers' Compensation Act (Texas Labor Code, §401.023), that any interest or discount provided for in the Act shall be at the rate of 4.71 percent. This rate is computed by using the treasury constant maturity rate for one-year treasury bills (1.21 percent) issued by the United States Government, as published by the Federal Reserve Board on June 16, 2017 (the 15`^h day preceding the first day of the calendar quarter for which the rate is to be effective), plus 3.5 percent as required by Texas Labor Code, §401.023. The rate shall be effective July 1, 2017, through September 30, 2017. The rate in effect for the previous period of April 1, 2017, through June 30, 2017, was 4.50 percent. For more information regarding calculation of the Discount Rate and Interest Rate, contact Dylan McCoy, Texas Department of Insurance, Financial Services, at 512-676-6195. Issued in Austin, Texas, on 26th day of June 2017.

LEGISLATIVE ACTIONS:

• House Bill 451
  The enacted legislation amends Chapter 451, Labor Code, to authorize a first responder who alleges a violation of employment discrimination by a state or local governmental entity that employs the first responder based on the responder's pursuit of a workers' compensation claim to sue the governmental entity for relief. H.B. 451 waives and abolishes sovereign or governmental immunity from suit to the extent of liability created by statutory provisions prohibiting such discrimination. The bill establishes that its provisions do not affect the immunity of a person who has official or individual immunity from a claim for damages. The bill amends Chapter 504, Labor Code, to limit the liability of a political subdivision under statutory provisions prohibiting employment discrimination based on an employee's pursuit of a workers' compensation claim to money damages capped at $100,000 for each person aggrieved by a violation of those provisions and at $300,000 for each single occurrence of such a violation. The bill establishes that a single occurrence is considered to be a single employment policy or employment action that results in discrimination against or discharge of one or more employees concurrently. Effective Date September 1, 2017.

• House Bill 919
  Interested parties assert that there is no mechanism for the state to provide workers’ compensation insurance benefits for non-state-employee members of Incident Management Teams or Texas Intrastate Fire Mutual Aid System teams while on state-activated deployments or training. These parties contend that no state coverage exists for these personnel in the event participants are injured or killed during state-activated deployments and that the state could maximize the effectiveness of its emergency response if it appropriately covered these first responders. The enacted legislation addresses this issue by providing appropriate coverage for non-state-employee task force members while deployed on state authorized training activities. It amends current law relating to workers' compensation insurance coverage for certain intrastate fire mutual aid system team members and regional incident management team members. Effective Date September 1, 2017.

• House Bill 1983
  Interested parties note that under current law, post-traumatic stress disorder (PTSD) is not recognized as a compensable injury under the Texas' workers' compensation system like many physical wounds. To receive care for this disorder, a first responder must show a physical condition such as sleep deprivation that could be remedied with treatment for PTSD or receive a diagnosis of a mental impairment or mental illness that has a treatment similar to PTSD. Under the current system mental illness or mental impairment diagnosis could result in a claim that a first responder was unfit for duty when a small amount of counseling was all they required. Furthermore, delays in receiving diagnoses or treatment leave first responders at higher risk for self-harm and self-destructive behavior resulting from this disorder. The enacted legislation seeks to remedy these issues with the current system by amending Subchapter B, Chapter 504, Labor Code, to make PTSD, as diagnosed according to the American Psychiatric Association, a compensable injury under workers' compensation.  It gives a firefighter or police officer the option to apply for benefits under workers' compensation for PTSD without declaring a mental impairment, providing they meet the diagnostic criteria and the condition was caused by an event occurring within the scope of their employment as a firefighter or police officer. The legislation amends current law relating to the eligibility of a first responder for workers' compensation benefits for post-traumatic stress disorder.  Effective Date September 1, 2017.

• House Bill 1989
  Current law allows a certified self-insurer to withdraw from self-insurance with the approval of the commissioner of workers' compensation (commissioner) if it shows to the satisfaction of the commissioner that it has established an adequate program to pay all incurred losses, including unreported losses, that arise out of accidents or occupational diseases first distinctly manifested during the period of operation as a certified self-insurer. To add clarity to current law and to reduce compliance burdens on self-insurers choosing to withdraw. The legislation will provide that, for purposes of withdrawal, an "adequate program" includes one in which the self-insurer has insured or reinsured all of its incurred workers' compensation obligations with an authorized insurer under an agreement that is filled with and approved in writing by the commissioner.  The enacted legislation amends current law relating to the requirements for withdrawal by a certified self-insurer from workers' compensation self-insurance.  Effective Date September 1, 2017.

• House Bill 1990
  The Texas Certified Self-Insurer Guaranty Association (TCSIGA) was established by the workers' compensation reforms of 1989 and is composed of large employers in Texas who have elected to self-insure. Different from non-subscribers, these employers serve as their own carriers and contribute to the Texas certified self-insurer guaranty trust fund, which is fully funded by the member companies. Currently the trust fund is capped at $2,000,000. Members believe that this amount is too low and that capping with a dollar amount rather than a rate makes the fund insufficiently sensitive to fluctuating risks. The enacted legislation addresses these issues by replacing the dollar cap with a risk-sensitive cap of three percent of the combined value of the security deposits of all certified self-insured employers. It also directs the TCSIGA board of directors to submit a recommended balance of the trust fund to the commissioner of workers' compensation for approval and conditions the requirement for the board to adopt a year-by-year schedule of assessments fund on the commissioner's approval.  The enacted legislation amends current law relating to the administration of the Texas certified self-insurer guaranty trust fund.  Effective Date September 1, 2017.

• House Bill 2053
  Workers' compensation fraud occurs when a person knowingly or intentionally conspires to commit, misrepresents, or makes a false statement to either deny or obtain workers' compensation benefits, or profits from the deceit. In an effort to focus more attention on identifying, investigating and prosecuting premium and provider workers' compensation fraud, the Texas Department of Insurance, Division of Workers' Compensation (TDI; DWC) leadership established a dedicated DWC fraud unit in 2016. This allows experienced DWC staff to better monitor and investigate fraud specific to the workers' compensation system. Along with this centralization of workers' compensation fraud investigations, current statutes authorizing the investigation of fraud were re-evaluated and it was determined that it is necessary to clarify existing authority to ensure that criminal workers' compensation fraud investigations are conducted in an effective and transparent manner. The legislation seeks to clarify DWC's existing authority to conduct workers' compensation fraud investigations. The legislation amends current law relating to the enforcement of workers' compensation compliance and practice requirements.  Effective Date June 9, 2017.

• House Bill 2056
  The Division of Workers' Compensation (DWC) contracts with designated doctors to provide independent medical opinions at the request of an injured employee or insurance carrier. Those doctors in turn contract with scheduling companies to which they delegate various administrative responsibilities. DWC has expressed concern that it is not always clear what responsibilities have been delegated to a scheduling company, making it difficult to ensure that only authorized agents have access to confidential claims information. To address this issue, the legislation requires a designated doctor, upon request by DWC, to provide the division with a copy of any contract between the doctor and an authorized agent providing services related to the doctor's duties, including scheduling, billing, and organizing medical records. As a result, the legislation would ensure that DWC is able to compel production of documents currently shielded from open records law, thus enhancing DWC's ability to determine that doctors are not sharing confidential claims information with scheduling companies.  The enacted legislation amends current law relating to access by the division of workers' compensation to certain designated doctor contracts under the workers' compensation system. Effective Date September 1, 2017.

• House Bill 2060
  The Office of Injured Employee Counsel (OIEC), an office within the Texas Department of Insurance's Division of Workers' Compensation, staffs its field offices with "ombudsmen," personnel whose role in the agency is to assist claimants in filing claims. Section 404.152(b), Labor Code, provides that, to be eligible for designation as an OIEC ombudsman, a person must, among other requirements, "have at least one year of demonstrated experience in the field of workers' compensation." The OIEC finds this requirement to be an onerous impediment to staffing its 21 field offices throughout the state. Filling an ombudsman vacancy, the agency reports, takes 15 months at minimum, and, with an already limited applicant pool, it becomes increasingly difficult to find a person who is located near where the vacancy exists and who also possesses the requisite year of experience. The enacted legislation addresses this issue and enhances the ability of OIEC to staff its ombudsman offices by eliminating the one-year experience requirement.  The legislation amends current law relating to the eligibility requirements for employment as an ombudsman of the Office of Injured Employee Counsel under the Texas Workers' Compensation Act. Effective Date June 9, 2017.

• House Bill 2061
  Workers' compensation claim disputes are first addressed through the Texas Department of Insurance, Division of Workers' Compensation (DWC) dispute resolution process, which consists of a benefit review conference, a contested case hearing, and a review, by the appeals panel. If a party disagrees with the agency's decision, it may seek judicial review in district court. Section 410.253, Labor Code, requires a party to provide "written notice of the suit or notice of appeal" to DWC and authorizes DWC to intervene in any judicial review proceeding (Section 410.254, Labor Code). However, the form and substance of the required written notice is not defined. This leads to DWC often having no opportunity, or only a limited opportunity, to discern why the petitioner disagrees with DWC's appeals panel decision.  Once a petition for judicial review has been filed in district court there are several possible outcomes, including settlement, a default judgment, a summary judgment, an agreed judgment, or judgment after trial on the merits. Current statute (Section 410.258, Labor Code), requires that any proposed judgment or settlement made by the parties be filed with DWC thirty days prior to the date the court is scheduled to enter the judgment or approve the settlement. This allows DWC to review proposed judgments to ensure that they comply with the law. However, some proposed settlements or judgments filed with DWC contain generic language that describes what is being resolved at a high level, but the terms and conditions of the agreement or settlement appear to be intentionally ambiguous or remain undisclosed. As a result, it is often extremely difficult for DWC to review proposed judgments and settlements for compliance with the law and to monitor the quality of appeals panel decisions by tracking the outcome of those appeals. The enacted legislation amends Section 410.253, Labor Code, to clarify that a party seeking judicial review of a DWC appeals panel decision shall provide DWC with a copy of the party's petition that has been filed with district court. This clarification will ensure that DWC does not receive a generic notice of appeal. The legislation also amends Section 410.258, Labor Code, to clarify that a party's duty to file any proposed judgment or settlement with DWC includes all proposed judgments and settlements to be entered after summary proceedings, hearings or trial, and any other judgments on the merits, and that any proposed judgments filed with DWC set forth the precise terms of the settlement or agreement. The enacted legislation amends current law relating to service and filing requirements for a party seeking judicial review in certain workers' compensation cases.  Effective Date September 1, 2017.

• House Bill 2082
  Interested parties contend that first responders seeking treatment for on-the-job injuries should not be left to navigate the complex process of resolving workers' compensation insurance claims on their own. The enacted legislation seeks to assist injured first responders in obtaining benefits, care, and dispute resolution under the workers' compensation system by providing for the designation and training of an employee of the office of injured employee counsel as a first responder liaison to provide such assistance. The legislation amends current law relating to the designation of a liaison to assist first responders with workers' compensation claims.  Effective Date September 1, 2017.

• House Bill 2111
  Under current law, when a dispute arises regarding a workers' compensation claim, the dispute may be resolved through a quasi-judicial process involving a hearing. The Division of Workers' Compensation (DWC) personnel who preside at these hearings are referred to in current law as "hearing officers." DWC's leadership believes that this title does not accurately reflect those employees' role. Hearing officers must be licensed attorneys, and, for purposes of the state employee classification titles established by the State Auditor's Office, they already are classified as administrative law judges. What's more, personnel discharging similar duties in other states' workers' compensation systems and in other agencies in Texas typically are referred to as administrative law judges. For clarity and consistency, Texas DWC hearing officers should be so called as well. The enacted legislation amends the Division of Worker's Compensation statute to change references in that statute from "hearing officer" to "administrative law judge."  The enacted legislation amends current law relating to changing statutory references to hearing officer and hearings officer to administrative law judge under the workers' compensation system.  Effective Date September 9, 2017.

• House Bill 2112
  The purpose of the enacted legislation is to promote efficiency by eliminating completed or obsolete reporting requirements from the statute that governs the Division of Workers' Compensation (DWC) and to authorize the division to send and receive various notices electronically. Current statute requires DWC to produce a number of one-time legislative reports or perform reporting functions that are no longer necessary. Some of these reports have been completed; other reporting functions are obsolete and create inefficiencies for system stakeholders. Current statute also requires that many notices sent to and provided by DWC be physically mailed or personally delivered, which creates system inefficiencies and does not allow DWC the flexibility to determine the best method for delivering or receiving notices.  The enacted legislation strikes the obsolete reporting requirements and would allow electronic transmission of statutorily required communications.  Effective Date June 9, 2017.

• House Bill 2119
  Interested parties contend that, although the workers' compensation system allows for the treatment of injured workers by a physician assistant, such an assistant is not currently authorized to complete and sign work status reports regarding an injured employee's ability to return to work. The enacted legislation increases efficiency within the workers' compensation system by authorizing a licensed physician assistant to complete and sign such reports. The legislation amends current law relating to completion of work status reports by a physician assistant under the workers' compensation system. Effective Date June 9, 2017.

• Senate Bill 877
  Under Chapter 417, Labor Code, an injured employee/beneficiary may pursue a third-party action, seek damages and may also pursue workers’ compensation benefits under the Texas Workers’ Compensation Act. These third-party actions may be initiated in situations where persons or company’s other than the employer for the injured employee caused the work-related injury or fatality (for example, pursuing the manufacturer of a machine that was not properly designed and caused an injury or pursuing a third-party who caused an automobile accident that involved the injured employee).  In these situations, if the injured employee/beneficiary recovers any damages under the third-party action, then Chapter 417, Labor Code, clarifies that the workers’ compensation insurance carrier may recover any payments made by the carrier as a result of the workers’ compensation claim (such as medical and/or indemnity benefits) from the net recovery amount received by the injured employee/beneficiary. Additionally, Chapter 417, Labor Code, provides for the payment of attorney fees to a claimant attorney in certain situations where the claimant attorney is also representing the interest of the workers’ compensation insurance carrier in a third-party action. The 79th Legislature, Regular Session, 2005, added Section 504.053, Labor Code, to allow political subdivisions the option of either establishing/contracting with a certified workers’ compensation health care network under Chapter 1305, Insurance Code, or directly contracting with health care providers for health care services. New Section 504.053(e), Labor Code, also included the following language, "Nothing in this chapter waives sovereign immunity or creates a new cause of action." Prior to the addition of Section 504.053(e), Labor Code, political subdivisions that subrogate and recover workers’ compensation benefit payments made to the injured employee/beneficiary could not assert sovereign immunity to shield themselves from attorney fees. However, in recent years, some governmental entities may have begun to claim sovereign immunity from the payment of injured employee/beneficiary attorney fees, including attorney fees as a result of third-party actions on a workers’ compensation claim. This could create inequity between injured employees/beneficiaries who have a workers’ compensation claim administered by a political subdivision, compared to a certified self-insured employer or commercial workers’ compensation insurance carrier.  Effective Date September 1, 2017.

• Senate Bill 1494
  Under current law, work-hardening and work-conditioning treatments require pre-authorization and concurrent review unless provided by an organization credentialed by the commissioner of workers’ compensation (commissioner) by rule. The Texas Department of Insurance believes the credentialing requirement has not been sufficient to deter overutilization of these costly treatments, often with no better outcomes than would be expected from non-credentialed providers. The enacted legislation addresses the ineffective overutilization of work-hardening and work-conditioning therapies by amending Section 413.014(c), Labor Code, to give the commissioner discretion to require preauthorization and concurrent review of such therapies even when performed by credentialed providers.  Effective Date September 1, 2017.

• Senate Bill 1895
  Currently, under Section 415.021, Labor Code, in cases of an administrative penalty, the commissioner of workers' compensation considers the seriousness of the violation, the history and extent of previous administrative violations, the demonstrated good faith of the violator, the penalty necessary to deter future violations, and the economic benefit resulting from the prohibited act. The enacted legislation gives the commissioner of workers compensation additional relevant facts when reviewing technical compliance issues in order to rationalize penalties for purely technical violations where there is no adverse impact to injured workers. Effective Date September 1, 2019.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

• Published in the state register notice of proposed changes to Rule 993-300 Certification Requirements for Interpreters for the Hearing Impaired.   Also posted were notices for five-year notice of review and statement of continuation for Rule 590-238 Captive insurance Companies; Labor Commission Administration Rule 600-2 Operations; Adjudication Rule 602-1 General Provisions; Adjudication Rule 602-2 Adjudication of Workers' Compensation and Occupational Disease Claims.
• Published in their bulletin notice of five-year review notice on two rules for workers' compensation.  The public notice of review was published for R982-601 Provider Code of Conduct and R994-404 Payment Following Workers' Compensation.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

• The new Form 28(FY18) and the Form 28A (FY18), which should be used to update claimant’s rates as of July 1, 2017, are now available.  Both forms can be downloaded at:  http://labor.vermont.gov/forms/#comp.  The new maximum for those injuries arising after June 30, 1986 is $1,281.00.  The new maximum for injuries prior to that date is $854.00.  The minimum in all cases is $427.00.  Historical wage rates are available http://labor.vermont.gov/wordpress/wp-content/uploads/historicalrates.pdf.  Please be aware of the requirement to forward a copy of the Form 28 to the injured worker or dependent: 8.2010 The Employer or insurance carrier shall file a Notice of Change in Compensation Rate (Form 28) with the Commissioner by July 1st annually as to any injured worker or dependent who is receiving indemnity benefits as of that date and who is entitled to an adjustment of compensation in accordance with this Rule.  Concurrent with the filing, the employer or insurance carrier shall mail a copy of the Notice of Change in Compensation rate to the injured worker or if appropriate, to his or her dependent(s).

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• The Virginia Beach Regional office, located at 281 Independence Blvd., Virginia Beach, VA 23462 relocated on June 5th - June 8th, and reopened for business on Friday, June 9th. The new office is located on the 3rd Floor (Suite 310) and replaces the 6th Floor suite. The new office address is 281 Independence Blvd., Suite 310, Virginia Beach, VA 23462. The office can be contacted using the same fax and phone numbers as previously used:  Phone: 757-648-7100; Fax: 757-552-1114.
• Virginia has posted medical fee schedule dispute resolution process on their web site for comments. A copy of the process is attached.  To post a comment on the process go to: https://www.surveymonkey.com/r/VA-MFS-Comment
• The Commission has published a new online from 17A Notice Terminating Prior Rejection of Coverage. To view the form, go to: https://webfile.workcomp.virginia.gov/portal/vwc-portal/Form17A.

Washington VIEW STATE →

FEE SCHEDULE NEWS:

• The Department of Labor & Industries has adopted a new medical and ASC fee schedule with an effective date of July 1, 2017.  The update increases the conversion factor for most services from $61.25 to $63.25.  The conversion factor for anesthesia procedures is also increased to $3.44 per minute from $3.41 per minute.  Further, the state has increased the cap on the daily maximum amount that a provider can be paid for physical or occupational therapy to $126.94 per day from $125.68 per day and introduced a limitation for authorized massage therapy of 75% of the daily physical therapy cap.

REGULATORY ACTIVITY:

• L&I has significantly expanded and updated the Foot and Ankle guideline.  Public comments were being accepted on the draft guideline through June 29, 2017. The draft guideline will be presented, along with all public comments, at the July 27th Industrial Insurance Medical Advisory Committee
• Extracorporeal Shock Wave Therapy (ESWT) - L&I has adopted the Health Technology Clinical Committee’s coverage determination to not cover ESWT for musculoskeletal conditions. This coverage decision takes effect on August 1, 2017.
• Updated Carpal Tunnel Syndrome Guideline-  L&I has expanded the work-related portion of the Carpal Tunnel Syndrome (CTS) guideline related to computer use (mousing and keyboarding).  The surgical criteria remain the same.  The updated guideline is also available within the Medical Treatment Guideline section and is effective July 1, 2017.

West Virginia VIEW STATE →

REGULATORY ACTIVITY:

• Has published benefit rates effective July 1, 2017.

Wisconsin VIEW STATE →

REGULATORY ACTIVITY:

• Posted an emergency rule related to Operation of the prescription drug monitoring program.

Wyoming VIEW STATE →

REGULATORY ACTIVITY:

• The Wyoming Department of Workforce Services (DWS) will be issuing premium credits to eligible Wyoming employers enrolled in the workers' compensation program starting this August.
• The one-time premium credit is the result of a bill passed by the Wyoming Legislature and signed into law by Governor Mead. The 8.33 percent credit can be used by employers toward their workers' compensation premium starting August 1, 2017, and applied toward premium payments until January 31, 2018. If not used during that timeframe, the opportunity to apply the credit toward premium will expire on January 31, 2018.
• To be eligible for the credit, employers must have made premium payments in calendar year 2016, and are required to be in good standing with the Workers' Compensation Division on all required workers' compensation payments as of June 15, 2017.