Alabama VIEW STATE →

FEE SCHEDULE NEWS:

• The state has posted new changes to the hospital and ASC fee schedules effective July 1, 2017. The hospital update includes changes effective July 1, 2017.  The next expected update is for October 1, 2017.
• The state has posted a new physician fee schedule effective January 1, 2017.  A new fee schedule is expected to be adopted with an effective date of January 1, 2018.

Arizona VIEW STATE →

REGULATORY ACTIVITY:

• Under Section 5 of Senate Bill 1332 of the Fifty-third Legislature, First Regular Session, the Industrial Commission of Arizona was directed to “review   and determine a process for streamlining the authorization process for treatment that is within the evidence-based treatment guidelines” on or before December 31, 2017.  Please be advised that the Commission will hold a public hearing to receive input or information concerning this issue on August 17, 2017, at 1:00 p.m., in the Commission's first floor auditorium located at 800 West Washington Street, Phoenix, Arizona.  This hearing will be held as part of the Commission’s scheduled meeting for that day. The record is considered open, and written and oral comments will be accepted until the close of the hearing on August 17, 2017.  Later, the Commissioners will discuss and act on the issue.  Written comments may be submitted prior to the hearing c/o Kara Dimas, Executive Secretary, Office of the Commission Director, P.O. Box 19070, Phoenix, Arizona 85005-9070.

California VIEW STATE →

FEE SCHEDULE NEWS:

• Medi-Cal rates have been released with an effective date of July 15, 2017. The next update is scheduled for August 15, 2017.

REGULATORY ACTIVITY:

• The Division of Workers’ Compensation (DWC) is now accepting applications for the Qualified Medical Evaluator (QME) examination on October 21, 2017. QMEs are independent physicians certified by the DWC Medical Unit to conduct medical evaluations of injured workers. Applications for the QME exam may be downloaded from the DWC website. Applicants may also contact the Medical Unit at 510-286-3700 to request an application via U.S. mail, email or fax. The deadline for filing the exam applications is September 7, 2017. For more information, please contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov.
• The Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) posted a progress report on the department’s Independent Medical Review (IMR) program. IMR is the medical dispute resolution process that uses medical expertise to obtain consistent, evidence-based decisions and is one of the most important components of Senate Bill 863, Governor Brown’s landmark 2012 workers’ compensation reform.
• The Department of Industrial Relations’ Division of Workers’ Compensation (DWC) has issued modified proposed regulations to adopt the Medical Treatment Utilization Schedule (MTUS) drug formulary. The proposed rulemaking implements Assembly Bill 1124 (Statutes 2015, Chapter 525), which mandates adoption of an evidence-based drug formulary. DWC has reviewed comments received during the initial comment period and has modified the proposed regulations to provide additional detail and clarity. The 15-Day public comment period will end August 2 and members of the public may submit written comments on the proposed regulations until 5 p.m. that day. Some of the changes proposed in the revised regulations include:
  • Moving the effective date to January 1, 2018
  • Changing the “Preferred/Non-Preferred” drug designations to “Exempt/Non-Exempt” to better align with how the designations affect the prospective utilization review status of the drug
  • Revised provisions relating to phased implementation of the formulary
  • Deletion of provisions regarding issues that will be addressed in the utilization review regulations, rather than in the formulary regulations
  • Clarification of applicable dispute resolution procedures
  • Updated drug listings on the MTUS Drug List and formatting changes.

The proposed formulary regulations are to be adopted at section 9792.27.1, et seq. of title 8 of the California Code of Regulations. DWC will consider all public comments, and may modify the proposed regulations for consideration during an additional 15-day public comment period.  The notice of modification of text of proposed regulation, and related rulemaking documents can be found on the DWC rulemaking web page.

Connecticut VIEW STATE →

FEE SCHEDULE NEWS:

• The medical fee schedule has been updated as of July 15, 2017. The new schedule includes updates and revisions to rules, fees and new 2017 CPT codes.  The fee schedule “will be effective for medical services rendered on or after July 15, 2017, regardless of the date of injury, that are payable to health care providers authorized or permitted to render care under the Connecticut Workers’ Compensation Act.”  The next physician fee schedule update is scheduled for July 2018.

Delaware VIEW STATE →

REGULATORY ACTIVITY:

• The Department of Labor posted notice in the July Register regarding proposed amendments to its administrative code 1326 regarding workplace fraud.  The Department solicits, and will consider, timely filed written comments from interested individuals and groups concerning these proposed amended regulations. The deadline for the filing of such written comments will be thirty (30) days after these proposed amended regulations are promulgated in the Delaware Register of Regulations, or by August 7, 2017. Members of the public may receive a copy of the proposed regulation at no charge by United States Mail by writing or calling Mr. Anthony DeLuca, Department of Labor, Administrator of the Office of Labor Law Enforcement, Delaware Department of Labor, 4425 North Market Street, Wilmington Delaware 19802, telephone number 302-761-8317. Members of the public may present written comments on the proposed regulation by submitting such written comments to Mr. DeLuca at the address of the Delaware Department of Labor as set forth above. Written comments must be received on or before August 7, 2017. The proposed regulations were to be considered at a public hearing scheduled for Friday, July 21, 2017 from 5:30 p.m. to 7 p.m. in the Department of Labor offices at Blue Hen Corporate Center, 655 S. Bay Road, Suite 2H, Dover, Delaware 19901. Copies of the proposed amended regulations may be obtained from the Division of Industrial Affairs (see address above).

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• A news article was recently published on the authorization procedures for compounded drugs in the 2016 Edition of the Florida Workers' Compensation Health Care Provider Reimbursement Manual (HCPRM) that went into effect on July 1, 2017.   The information contained in the article may have led to a misunderstanding of the applicability of this new provision in the HCPRM.  The HCPRM defines the dispensing of compounded drugs, regardless of the cost of the compounded drugs, as a specialty service under paragraph 440.13(3)(i), F.S.  For any further questions related to this subject or other medical service topics, please email WorkersComp.MedService@myfloridacfo.com.

LEGISLATIVE ACTIONS:

• House Bill 1114
  The enacted legislation achieves compliance with the federal Occupational Safety and Health Administration (OSHA) requirement that state-level standards and enforcement be at least as effective as OSHA standards and enforcement. It increases the monetary penalties for violations of the Hawaii Occupational Safety and Health Law or any standard or rule adopted there under. It requires the Director of Labor and Industrial Relations to: adjust the penalties each year as required by federal law; and report to the Legislature annually on the penalty adjustments. Effective Date January 1, 2018.
• Senate Bill 859
  The legislation Grants an employee the right to have a chaperone present during an independent medical examination relating to a work injury for workers' compensation purposes and, with the approval of the examining physician or surgeon, to record the medical examination. Specifies that if an employee or employee's chaperone obstructs the medical exam, the employee's right to workers' compensation shall be suspended until the obstruction ceases. Repeals on 6/30/2019. Effective Date July 12, 2017.
• Senate Bill 984
  The enacted legislation amends the definition of "physician" in Workers' Compensation Law to include advanced practice registered nurses. Effective Date July 11, 2017.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

• Updated the FY18 Strategic Plan. 

Illinois VIEW STATE →

REGULATORY ACTIVITY:

• Arbitrator Dollison will not be available to preside over his Waukegan docket in July or his Rockford docket in August. His calls and hearing dates will be covered by other arbitrators. In his absence settlement contracts for review can be presented to the sitting arbitrator or can be sent to either Arbitrator Jessica Hegarty or Arbitrator Anthony Erbacci. Settlement contracts can also be sent to Bob Devereaux at the IWCC in Chicago. Motions and other correspondence related to the Rockford call on August 10th should be sent to the attention of Arbitrator Carolyn Doherty. The addresses are as follows:
  • Arbitrator Doherty
    PO Box 420
    Elmhurst, IL 60126
  • Arbitrator Erbacci
    2615 N. Drury Lane
    Arlington Heights, IL  60004
  • Arbitrator Hegarty
    PO Box 21268
    Elmhurst, IL 60126
  • Bob Devereaux
    IWCC
    100 W Randolph St Suite 8-200
    Chicago, IL 60601
• Arbitrator Dollison will be in Woodstock for the September trial cycle.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• Indiana is set to formally begin its enforcement protocol concerning the untimely filing of statutorily required forms and payment of benefits. There will be a grace period on penalties through September 30, 2017.  During this period, carriers and third-party administrators will receive letters and notice of actions found to be in violation of IC 22-3-3-7, 22-3-7-16, 22-3-4-13(a) and 22-3-7-37 so that appropriate remedies can be put in place. We also encourage your comments and concerns with this process so they may be addressed by the Board prior to October 1st, 2017.For all injury dates on or after October 1, 2017, penalties will be assessed. Pursuant to IC 22-3-4-15 escalation of penalties will apply where more than one violation occurs in a single cause concerning the same injured worker and the same injury date. In the future, violations of 631 IAC 1-1-26 shall also become the subject of notice by the Board.

Iowa VIEW STATE →

REGULATORY ACTIVITY:

• Medical mileage will be decreasing to $.535 effective July 1, 2017.

Kansas VIEW STATE →

REGULATORY ACTIVITY:

• Travel to obtain medical services on or after July 1, 2017, shall be reimbursed at the rate of 53.5 cents per mile. The mileage reimbursement rate for state officers and employees is 53.5 cents per mile effective July 1, 2017.  K.S.A. 44-515(a) provides that mileage to obtain medical services is reimbursed at the rate prescribed for state officers and employees pursuant to K.S.A. 75-3203a.‚ K.A.R. 51-9-11 provides that all round trips of over five miles to obtain medical services are reimbursable as medical mileage as provided by K.S.A. 44-515(a).
• The Kansas Department of Labor (KDOL) Workers’ Compensation Division is pleased to announce that the online registrations for the 43rd Annual Kansas Workers’ Compensation Seminar at the Overland Park Convention Center on Sept. 26 and 27 is now open. Registration can be completed online at dol.ks.gov/WorkComp/seminar.aspx and at the door until 1 p.m. Sept. 27. Presentations will feature Neutral Evaluations, Post-Traumatic Stress Disorder (PTSD) From the Circumstances Surrounding an Accident, and Work Disability Thresholds. Attendees will also learn about Burns and How to Rate Them Under the Sixth Edition, Update on Building and Implementation of the Online System for Claims Administration and Research/Regulation (OSCAR) and Orthopedic Surgery and Permanent Restrictions.  Continuing education is pre-approved for Kansas and Missouri attorneys, Certified Case Managers, Kansas APRN, RN or LPN professionals, Kansas Occupational Therapists/Certified Occupational Therapy Assistants and Kansas Licensed Physical Therapists/Kansas Certified Physical Therapist Assistants. Assistance is available to attendees who are licensed or certified in occupations requiring continuing education credits that are not pre-approved. There are 660 minutes of education available during the seminar.

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

• 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 →

REGULATORY ACTIVITY:

• The state government is shut down until a budget is approved and in place. All Workers' Compensation Board offices are closed. Board staff will not be available during the shutdown. More information about the shutdown may be available at www.maine.gov. 

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• Pursuant to L&E 9-638, the Cost of Living Adjustment (COLA) effective January 1, 2018 is 1.18%.
• The Workers’ Compensation Commission (Commission) is aware that the Division of Unemployment Insurance (Division) has revised its practice with respect to how it will handle subpoenas served on the Division, pre-stamped by the Commission, for unemployment insurance data. The Division will be sending responses directly to subpoena requesters and the Commission will be copied on those responses. The Commission has been briefed on the legal issues involved and the Division has advised the Commission that it is acting in accordance with binding federal and state law and regulations applicable to state unemployment insurance agencies and unemployment insurance data held by such agencies.

Massachusetts VIEW STATE →

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated as of July 1, 2017.

REGULATORY ACTIVITY:

• Massachusetts Health and Human Services has published two new bulletins 17-12 and 17-13.  The bulletins are regarding 114.3 CMR 47.00 Free Standing Ambulatory Surgical Facilities:  CPT/HCPCS Coding Updates and 114.3 CMR 22.00 Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment Rate Updates and Insulin Pump Supplies.

Michigan VIEW STATE →

FEE SCHEDULE NEWS:

• Hospital fee schedule has been updated with new rates effective August 1, 2017.

Mississippi VIEW STATE →

REGULATORY ACTIVITY:

• The Mississippi Workers' Compensation Commission will not be processing walk-in settlement approvals on the following days: Tuesday, August 8 Wednesday, August 9 .

Missouri VIEW STATE →

REGULATORY ACTIVITY:

• The State Average Weekly Wage (SAWW) used to determine maximum workers' compensation benefits for the fiscal year beginning July 1, 2017 and ending June 30, 2018 is $879.06. This SAWW produces the maximum weekly benefit rates for injury and illness occurring on or after July 1, 2017.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• Jackie Boesen assumed the duties of Administrator of the Nebraska Workers' Compensation Court effective July 3, 2017. Until the position of General Counsel is filled, Jackie will continue to serve as the court's General Counsel. As Administrator, Jackie will serve as the chief administrative officer for the court and the primary liaison between the Presiding Judge and administrative and operational functions of the court. The Administrator is also charged with implementing and enforcing the various administrative and regulatory provisions of the Nebraska Workers' Compensation Act, and serves as liaison to the Nebraska Legislature.
• CHI Health Creighton University Medical Center Bergan Mercy has now provided the court with the necessary information to complete the DRG and Trauma Services Inpatient Hospital fee schedules.
• Judge Hoffert was elected Presiding Judge of the Nebraska Workers' Compensation Court at the biennial meeting of the court's judges on June 29, 2017. The appointment was approved by the Nebraska Supreme Court on July 21, 2017.

Nevada VIEW STATE →

REGULATORY ACTIVITY:

• Published notice of maximum compensation for fiscal year 2018.
• The Board for the Administration of the Subsequent Injury Account for Self-Insured Employers will hold a public meeting on August 23, 2017 at 10:00 a.m., at 1301 North Green Valley Parkway, WCS Conference Room, Henderson, Nevada.  The public is advised that some of the members of the Board may participate in the meeting via telephone.

New Hampshire VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 59
  The enacted legislation established that in regard to ordered drug testing in relation to blood borne disease the employer shall be responsible for payment of the testing. Paying for the testing will not prejudice the issue of causal relationship of any subsequently diagnosed disease or injury. Effective Date September 9, 2017.

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

• As per the N.J. Department of Treasury, Division of Purchase and Property, the N.J. Department of Labor and Workforce Development - Division of Workers’ Compensation shall utilize the certified court reporter’s services set forth under the current Statewide Contract (T-2767) for Certified Court Reporters/Certified Real Time Court Reporters. In accordance with that contract and its method of operation, effective July 10, 2017, J.H. Buehrer & Associates, Jersey Shore Reporting, L.L.C., and William C. O’Brien & Associates, Inc., shall provide the certified court reporters for all the courts in the N.J. Division of Workers’ Compensation for the period of July 10, 2017 through July 28, 2017.
• New Jersey has published Benefit rates for 2018.
• Pursuant to the Order to Show Cause with Temporary Restraints, entered by the Honorable Douglas H. Hurd, P.J.C.V., on July 10, 2017, the N.J. Department of Labor and Workforce Development - Division of Workers’ Compensation shall utilize the certified court reporter services as set forth in Director and Chief Judge Russell Wojtenko, Jr., memorandum of November 16, 2016.  Further instruction will be provided upon the expiration of the temporary restraining order.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

• The pharmacy board had adopted an amendment to 19.33 NMAC, Section 9.  The amended rule addresses Tele-Pharmacy and Dispensing.  It becomes effective on 06-23-2017. While this rule is not specifically targeted toward Workers' Compensation it does apply to pharmacy across the board regardless of payor.
• New Mexico Workers’ Compensation Administration (WCA) Director Darin A. Childers announced the reappointment of Shanon S. Riley to serve a new five-year term as a workers’ compensation judge, effective August 20, 2017.  By law, workers’ compensation judges are appointed for an initial one-year term, which may then be followed by subsequent five-year appointments. Judge Riley was initially appointed on August 20, 2011.

New York VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted the EAPG (Enhanced Ambulatory Patient Groups) methodology for reimbursement of ASC and OPPS services with an effective date of October 1, 2015.  An update for the EAPG rates effective July 1, 2017 has been posted by NYDOH.
• The state has issued two bulletins Subject Numbers 046-953 and 046-952 regarding updates for 2015 and 2016 Reimbursement Rates for Acute Per Care Inpatient Hospital Rates, Exempt Hospitals, Exempt Units and Detoxification Inpatient Rates. The effective dates are retroactive to January 1, 2015 and January 1, 2016.

REGULATORY ACTIVITY:

• Issued bulletin 046-985 intended to describe the existing legal framework for labor market attachment, and introduce a revision to Form C-258 and a new Form C-258.1. The only significant recent change in the law arises from Part NNN of Chapter 59, Laws of 2017, which, at subpart A, amends Workers' Compensation Law § 15(3)(w) in several ways, including with respect to efforts to demonstrate attachment to the labor market after classification.
• Posted bulletin subject number 187-1 regarding Legal Holidays and Board Closures for 2018.
• The workers' compensation board posted notice of adoption of rule regarding Paid Family Leave.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Chairman Allen is pleased to announce the appointment of a new Deputy Commissioner, Melissa Grimes, who is joining the North Carolina Industrial Commission to serve a six-year term as a Deputy Commissioner in the Charlotte regional office. Most recently, Grimes was in private practice with Hedrick Gardner in Charlotte, where she focused her practice on workers' compensation. Originally from Eastern North Carolina, Grimes graduated magna cum laude from East Carolina University, where she received her B.A. in Communications / Public Relations. She went on to receive her Juris Doctor from the Campbell University School of Law.
• The Department of Insurance published in their register notice of amendments to rules regarding managed care, health care provider networks and third-party administrators.
• The North Carolina Workers’ Compensation Opioid Task Force met at 9:00 a.m. on Friday, July 21, 2017. The meeting took place at the Dobbs Building, located at 430 North Salisbury Street, Raleigh, NC 27603. The meeting was held in the Judge Wells Conference Room on the fifth floor.
• The North Carolina Industrial Commission’s Compliance and Fraud Investigative Division is continuing to proactively identify businesses that do not comply with the Workers’ Compensation Act at an unprecedented rate. For Fiscal Year 2016-2017, the Compliance Unit collected over $1.7 million in penalties for noncompliance, and the Fraud Investigative Unit issued 412 total charges for suspected violations of the Workers’ Compensation Act.   The North Carolina Industrial Commission’s Compliance and Fraud Investigative Division is continuing to proactively identify businesses that do not comply with the Workers’ Compensation Act at an unprecedented rate.  Over the past several years, the Commission has worked to develop this Division, which is responsible for working with businesses to ensure that adequate insurance is maintained, and to identify non-compliant businesses using an advanced data-matching application named the Non-Compliant Employer Targeting System (“NETS”).   This database analyzes data from partnering state agencies to determine if a business is reporting three or more employees, and whether they have workers’ compensation insurance coverage.  The NETS program recently received a significant upgrade to ensure that the application is utilizing the most accurate and current data available.  The Compliance Unit handles civil cases and issues civil penalties to non-insured businesses for failure to carry the requisite workers’ compensation insurance.  For Fiscal Year 2016-2017, the Commission’s Compliance Unit collected over $1.7 million in penalties from non-compliant employers, a 15% increase over the previous fiscal year total.  In fiscal year 2015-2016, the Commission collected nearly $1.5 million in civil penalties.  This was approximately 50% higher than fiscal year 2014- 2015, when the Commission collected $992,965 in civil penalties.  The clear proceeds of civil penalties are remitted to the Civil Penalty and Forfeiture Fund, and distributed to public schools across the state.  The Fraud Investigative Unit operates as a law enforcement agency, and is responsible for conducting criminal investigations into cases of suspected workers’ compensation fraud and violations related to workers’ compensation claims.  Because of their investigations, the Commission issued 412 total charges for suspected violations of the Workers’ Compensation Act in Fiscal Year 2016-2017, up 275% from 150 total criminal charges in the previous Fiscal Year, with just one charge against an employee.  Notably, an alleged scheme to scam two insurance companies for more than $150,000 in workers’ compensation claims based on policies issued to fake businesses was recently exposed and stopped in its tracks by Fraud Investigators of the Industrial Commission.  One man was arrested and charged with four felony counts in conjunction with the scheme.
• Posted notice of rulemaking to amend the provisions of Rule 04 NCAC 10J .0103 for several reasons.  The proposed amendment to Paragraph (a) is a clarification regarding the qualifications for reimbursement under Paragraphs (c), (d), and (f).  Next, there are two primary reasons for the proposed amendments to the provisions related to fees for ambulatory surgical centers, Paragraphs (g) and (h).  First, this rule has been the subject of litigation that is ongoing at the time of filing.  The provisions of the rule as adopted on April 1, 2015, that relate to fees for ambulatory surgical centers, specifically Paragraphs (g) and (h) and the reference to (h) in Paragraph (i) were held to be invalid by Wake County Superior Court Judge Paul Ridgeway in an August 9, 2016 Decision.  The decision was predicated on the court’s belief that those provisions of the rule were not adopted in compliance with the Administrative Procedure Act because no fiscal note was prepared.  The Industrial Commission has appealed that ruling, and the matter is pending before the North Carolina Court of Appeals.  The August 9, 2016 Decision was stayed by Judge Ridgeway by Order dated September 2, 2016.  While the Industrial Commission maintains its position that it was not required to complete a fiscal note to adopt and/or amend the challenged provisions, the Industrial Commission has now completed a fiscal note and seeks to amend the ambulatory surgical centers fee provisions of Rule 04 NCAC 10J .0103.  Pending the outcome of the litigation, the amendments are sought to restore certainty and balance to the fee schedule for stakeholders, including payers and medical providers, as to future medical expenses.  Moreover, the Industrial Commission is statutorily obligated to periodically review the schedule of maximum fees charged for medical treatment in workers’ compensation cases and make revisions if necessary.  The proposed amendments to Rule 04 NCAC 10J .0103 incorporate feedback from various stakeholders that the addition of a provision setting maximum fees for ambulatory surgical centers, for additional procedures covered by the Medicare Outpatient Prospective Payment System, would be beneficial to payers, providers, and injured workers. Supporting documentation is attached.
• The North Carolina Workers’ Compensation Opioid Task Force met at 1:30 p.m. on Monday, July 31, 2017. The meeting took place at the Albemarle Building, located at 325 North Salisbury Street, Raleigh, NC 27603.

North Dakota VIEW STATE →

REGULATORY ACTIVITY:

• North Dakota adopted amendments to Chapter 92-01-02 Rules of Procedure North Dakota Workers' Compensation Act that became effective July 1, 2017.

Ohio VIEW STATE →

REGULATORY ACTIVITY:

• The Ohio Bureau of Workers’ Compensation will hold a public hearing on Monday, August 14, 2017, at 1:00 p.m., in Room 1, Level 2, 30 West Spring Street, Columbus, Ohio 43215, to consider the following rule to: Amend, for the purpose shown below:  4123-6-21.3 Outpatient medication formulary.  The Bureau proposes to revise the formulary appendix to this rule by amending coverage to the opioid drug class and drug products listed in the formulary.  These recommended changes are the result of recommendations from the Bureau's Pharmacy & Therapeutics Committee (P&T) Committee as well as a general cleanup of the formulary appendix.
• The Ohio Bureau of Workers’ Compensation will hold a public hearing on Friday, August 4, 2017, at 2:00 p.m., in Room 1, Level 2, 30 West Spring Street, Columbus, Ohio 43215, to consider the following rule to:  Amend, for the purpose shown below: 4123-6-01.2 Provisional treatment reimbursement approval – pilot program.   Based on the success of the pilot program to date, the Bureau proposes that rule OAC 4123-6-01.2 be amended to extend the pilot program an additional two years, through June 30, 2019.
• The Ohio Bureau of Workers’ Compensation will hold a public hearing on Monday, August 14, 2017, at 1:00 p.m., in Room 1, Level 2, 30 West Spring Street, Columbus, Ohio 43215, to consider the following rule to:   Enact, for the purpose shown below:  4123-3-38 Surplus fund charge of qualified motor vehicle accident claims.  The proposed new rule provides that, in lieu of the traditional subrogation, the Bureau will charge the entire cost of the claim to the surplus fund if the employer can establish that the claim is based on a motor vehicle accident involving a third party, the third party is issued a citation for violation of any law or ordinance regulating the operation of a motor vehicle arising from the accident, and the third party has insurance that covers the claim.
• Ohio has posted notice of two rules that are going to be reviewed.  The two rules are 4123-6-02.3 Provider access to the HPP - provider application and certification and rule 4123-6-32 Payment for lumbar fusion surgery.   Comments may be submitted on this rule electronically the day 7/24/2017 12:00:00 AM. If you would like to comment on Rule Number: Provider application and certification criteria, please click HERE. The comment period will be open until 8/14/2017 12:00:00 AM

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

• Published in the state register notice of intent to adopt emergency rules regarding insurance and self-insurance.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• Posted in the July register notice of hearing by the Department of Consumer and Business Services, Workers' Compensation Division, Chapter 436 Rule Caption: Amendments to reflect the Oregon Supreme Court's decision in Brown v. SAIF Corporation.
• Enrolled House Bill 2335 has been passed by both houses of the Oregon Legislature and signed by Governor Brown. Effective Jan. 1, 2018, when the director (of the Department of Consumer and Business Services) appoints a medical arbiter panel, the director may appoint either a two member or three-member panel. Currently, panels must have three members. The basis for the decision on the size of the panel must be criteria that the director sets by rule. The affected rule is OAR 436-030-0165. The Workers' Compensation Division has scheduled a rulemaking advisory committee meeting. The agenda for the meeting and draft rule (in one file) are posted to the division 's website: http://wcd.oregon.gov/laws/Documents/rule-meetings/2017/2017-07-25-SAC-030/SAC-agenda-2017-07-25-HB2335.pdf. Time and location and teleconference information:
  • July 25, 2017, 10:30 a.m. to Noon (or until finished), Pacific Daylight Time Room F (basement), Labor and Industries Building, 350 Winter Street NE, Salem, Oregon
  • Teleconference: 1-213-787-0529 | Access code: 9221262#
• The division plans to limit this rulemaking to what is necessary to carry out the requirements of HB 2335.
• Posted an industry notice regarding new rejection process for missing required information on insurer prepared Forms 801 and 1502.
• The Workers’ Compensation Division will resume auditing self-insured employers’ premium assessment filings in the fall of 2017 for the time July 1, 2016, through June 30, 2017.  All self-insured employers (including self-insured employer groups) will be subject to the audit. This audit was last performed in 2010. The purpose of the audit is to determine the accuracy and appropriateness of the records, reports, and payroll classifications submitted to the Department of Consumer and Business Services. The requirements and guidelines for filing premium assessments are prescribed by OAR 436-085 and the applicable bulletin. Additional audit details will be communicated before conducting the audit.  The results of the audit may be used to determine and collect additional assessment amounts due, or credit previous over-payments. Self-insured employers’ experience rating modifications may also be recalculated using audited payroll information. In addition, self-insured employers may be assessed civil penalties for reasons including, but not limited to, the submission of inaccurate or inappropriate assessment filings. If you have questions about this notice, contact Self-Insurance, Registration, and Reimbursements Manager Barbra Hall at 503-947-7751 or barbra.hall@oregon.gov.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted a new physician fee schedule with an effective date of September 1, 2017.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Posted the agenda for the Commission's business meeting scheduled for July 17, 2017. The following is a summary of the items discussed and actions taken at the SC Workers’ Compensation Commission’s Business Meeting on July 17, 2017.
  • The Commission approved applications to self-insure 16 prospective members of one (1) fund, and one application to self-insure for workers’ compensation.
  • Gary Cannon, Executive Director, briefed the Commission on Optum’s draft of the proposed fees for the 2017 Medical Services Provider Manual. The Commission accepted the proposed MSPM as information and will consider final approval at the business meeting on August 21.  The Effective date of the new fee schedule is September 1, 2017. For additional information, visit the Commission’s website, wcc.sc.gov.
  • The Commission approved an amendment, effective August 1, 2017, to the Administrative Policy for the Use of Court Reporter Services to pay a court reporter that travels more than 200 miles roundtrip in one day be paid a minimum of $155 appearance fee for the day.
  • The Department Directors and Executive Director reviewed their monthly reports submitted to the Commission prior to the meeting.

Tennessee VIEW STATE →

REGULATORY ACTIVITY:

• Published its Annual Report to the Legislature.
• The Bureau will conduct three public rulemaking hearings on August 29, beginning at 1:00 pm CDT. The hearings 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 General, Claims Handling Standards, and Adjuster Certification rules will be addressed at the hearing along with recommended revisions required to comply with recent revisions to T. C. A. 50-6-419 and to implement a voluntary Adjuster Certification. These hearings are open to the public.

Utah WC VIEW STATE →

FEE SCHEDULE NEWS:

• Ambulance rates have been updated as of July 10, 2017. The next expected update is scheduled for July 2018.

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• The Virginia Workers' Compensation Commission and the International Workers' Compensation Foundation are jointly sponsoring an Educational Conference which is unique in Virginia. The goal of this conference is to educate all those who participate in the Virginia workers' compensation system regarding current rules, procedures, policies and forms, and to provide an opportunity for dialogue among these participants. Breakout sessions will be utilized to discuss certain topics in specific detail for a more specialized view while other topics will be presented from a more general perspective. The 2017 VWC Educational Conference will be held October 24-25 at the Richmond Convention Center.

Washington VIEW STATE →

REGULATORY ACTIVITY:

• The state has issued a coverage decision regarding sacral nerve stimulation for treatment of fecal incontinence.  The coverage decision is covered with conditions.  This decision will take effective on September 1, 2017.
• Posted notice of rulemaking regarding vocational rehabilitation.  The purpose of this rulemaking is to implement Senate House Bill 1496 (Chapter 137, Laws of 2015). The proposed rule change provides further clarification about Option 2 vocational training benefits. After a worker’s vocational retraining plan is approved by the department, the worker can elect Option 2, which allows the worker access to training funds for a self-directed training plan. The worker can use up to ten percent of the Option 2 training funds for vocational counseling and job placement services if the worker’s vocational retraining plan was approved on or after July 31, 2015. The proposed rules will:
  • Revise wording to make the rules easier to understand;
  • Explain the worker’s option election limits;
  • Define Option 2 vocational counseling and job placement services;
  • Specify who can provide Option 2 vocational counseling and job placement services;
  • Describe how Option 2 vocational counseling and job placement services are delivered;
  • List the vocational provider’s Option 2 reporting requirements; and
  • Outline how Option 2 vocational bills are charged and paid.

The proposed rules were developed in consultation with the Vocational Subcommittee.