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Alabama VIEW STATE →

FEE SCHEDULE NEWS:

  • The state has adopted Addendum #3 to the 2018 Alabama Workers’ Compensation Prevailing Reimbursement/Maximum Fee Schedule with changes to the Hospital and Ambulatory Surgery Center Schedules effective July 1, 2018. The next update is expected in October 2018.  To view the addendum, go to https://labor.alabama.gov/wc/2018FeeSchedules.aspx.

Arizona VIEW STATE →

REGULATORY ACTIVITY:

  • Posted a resolution which adopts a new a maximum average monthly wage of $4,741.57 for injuries occurring during calendar year 2019.   To view the resolution, go to https://www.azica.gov/news-and-events.
  • Issued a document that discusses information and best practices regarding full and final settlements in light of recently revised statues Section 23-841.01.  This document is intended to provide information and suggested best practices related to full and final settlement agreements submitted under A.R.S. § 23-941.01 on or after August 3, 2018.   A copy of the document may be viewed at https://www.azica.gov/news-and-events.
  • Senate Bill 1111 directs the Industrial Commission of Arizona (the “Commission”) on or before July 1, 2019, as part of the Industrial Commission of Arizona’s annual review of the schedule of fees pursuant to A.R.S. § 23-908, to review information and data, consult with physicians and stakeholders, and hold at least one public hearing in considering whether to adopt additional reimbursement guidelines for medications dispensed in settings that are not accessible to the general public.   Please be advised that the Commission will hold a public hearing to receive input or information concerning this issue on August 23, 2018, 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 5:00 p.m. on September 13, 2018.  Action taken by the Commission on this issue will be proposed in the 2019/2020 Arizona Physicians’ and Pharmaceutical Fee Schedule Staff Proposal and Recommendations document that will be posted on the Commission website in April 2019.  Stakeholders will have an opportunity to provide comment as part of the annual fee schedule hearing process.   Written comments may be submitted prior to the August 23, 2018 public hearing c/o Jacqueline Kurth, Manager, Medical Resource Office, via fax (602) 542- 4797; email mro@azica.gov; or mail P.O. Box 19070, Phoenix, Arizona 85005-9070.
  • Posted notice of adoption of amended rules R.20-5.106; 5-1301; 5-1302; 5-1303; 5-1309; 5-1310 and 5-1311. In 2017, the Arizona Legislature (in Laws 2017, Ch. 287, § 5) directed the Commission to "review and determine a process for streamlining the authorization process for treatment that is within the evidence-based treatment guidelines." The Legislature required the Commission to complete the review process on or before December 31, 2017. Consequently, on June 29, 2017, the Commission directed its Medical Resource Office to: (1) conduct a review of the existing authorization process under the Treatment Guidelines; and (2) make a recommendation to the Commission regarding "streamlining the authorization process for treatment that is within the evidence-based treatment guidelines."  Stakeholders were provided opportunities to offer suggestions and comments regarding streamlining the authorization process, including during a public hearing conducted on August 17, 2017. At its December 14, 2017 public meeting, the Commission completed its review of the existing authorization process.  Based upon suggestions submitted by interested stakeholders, the Commission approved the following methods for streamlining the Article 13 authorization process: 1. Develop and mandate the use of a Medical Treatment Preauthorization Form with accompanying instructions; and 2. Reduce the time period within which a payer must respond to requests for preauthorization or reconsideration from ten business days to seven business days.  The effective date of the rule amendments is October 1, 2018.  To view the rule, go to  https://apps.azsos.gov/public_services/register/2018/contents.htm. Open issue 30 of the administrative register.

California VIEW STATE →

FEE SCHEDULE NEWS:

  • The DWC has amended the Physician fee schedule effective July 1, 2018. The update is relevant to the Medicare quarterly update of the MUE file dated July 1, 2018 where many codes are listed as zero due to Medicare coverage rules.  These rules are not applicable to the workers’ compensation medical care.  The new fee schedule order states: “Except where payment ground rules differ from the Medicare ground rules, claims administrators shall apply the NCCI physician coding edits” (title 8, Cal. Code Regs. §9789.12.13(a).) To lessen possible confusion and to avoid inappropriate denial of bills, the Administrative Director issues this order which replaces the full CMS July 2018 MUE update file adopted by the June 26, 2018 order, with an excerpt of the CMS July 2018 MUE update file, where all procedures assigned a value of “0” units are removed from file, for services rendered on or after July 1, 2018.”
  • The DWC has adopted the Clinical Lab fee schedule effective July 1, 2018. The next update is expected in January 2019.
  • The DWC has adopted the Medi-Cal rates effective July 15, 2018. No changes were found in the newly posted data.  The next update is expected August 15, 2018.

REGULATORY ACTIVITY:

  • The Division of Workers’ Compensation (DWC) is pleased to announce the formation of the Pharmacy and Therapeutics (P&T) Committee. The P&T Committee is established pursuant to Assembly Bill No. 1124 (2015) as an advisory body that will consult with the DWC Administrative Director on updates to the Medical Treatment Utilization Schedule Drug Formulary.   The committee’s first meeting will be held on Wednesday, September 26 from 12:30 p.m. to 3:30 p.m. in the Elihu M. Harris State Building, conference room #1 on the second floor, located at 1515 Clay Street in Oakland.  The P&T Committee will be chaired by DWC Executive Medical Director Raymond Meister, M.D. The six appointees are California-licensed medical doctors and pharmacists.   “We were fortunate to receive applications from many distinguished physicians and pharmacists for this committee and selected a very well qualified team for this important work,” said Dr. Meister. “DWC appreciates the commitment of these volunteer committee members and looks forward to a productive collaboration that will improve the therapeutic outcomes for the many injured workers that rely on the MTUS Drug Formulary.” Each member of the P&T Committee will serve a term of two years and remain in the position until the selection of a successor. The current committee members are:
    • Lori A. Reisner, Pharm.D.
    • Todd Shinohara, Pharm.D.
    • Raymond Tan, Pharm.D.
    • Basil R. Besh, M.D.
    • Rajiv P. Das, M.D.
    • Steven Feinberg, M.D.

The agenda and further information regarding the P&T Committee meeting will be posted on the DWC MTUS Drug Formulary web page at least 10 days prior to the meeting and will also be distributed to the DWC Newsline mailing list. The public may submit questions or comments about the formulary to the DWC MTUS Drug Formulary email inbox: formulary@dir.ca.gov.

  • The Workers’ Compensation Appeals Board (WCAB) has approved new and updated subpoena forms for use in the district offices of the Division of Workers’ Compensation (DWC).   The fillable forms are posted on the DWC website and will also be made available at the district offices: Subpoena (DWC WCAB 30), Subpoena Duces Tecum (DWC WCAB 32).  Parties should start using the updated forms as soon as possible. To view the forms, go to https://www.dir.ca.gov/dwc/forms.html#Court. 
  • The Division of Workers’ Compensation (DWC) has received questions from the public regarding the July 1 update to the Physician Fee Schedule and its impact on acupuncture treatment. It is important for the public to know that acupuncture continues to fall within the definition of “medical treatment” as defined in Labor Code section 4600 and is available to the injured worker when it is medically necessary to cure or relieve the effects of the injury.    The July 1 update to the Physician and Non-Physician Practitioner Fee Schedule includes updates to the National Correct Coding Initiative “Medically Unlikely Edits” (MUE). The MUE edits file sets forth the number of units of service related to a specific procedure that are medically likely to be reported by a treating physician and serves as a useful screening tool to identify possible billing errors for many procedure codes.  However, in the July MUE file which was adopted by DWC, the acupuncture codes were included for the first time, and were listed with a value of zero. The Division is reviewing the July MUE file to determine what action is necessary to alleviate confusion caused by the July update. DWC expects to issue a modified July 2018 Physician Fee Schedule update shortly to address this issue. In the meantime, the public is advised that acupuncture treatment continues to be available to the injured workers when medically necessary. Maximum reimbursement for acupuncture continues to be subject to the Physician Fee Schedule without application of the MUE edit.
  • The Division of Workers’ Compensation (DWC) is now accepting applications for the Qualified Medical Evaluator (QME) examination on Saturday, October 20, 2018. 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 6. For more information please contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov.

Colorado VIEW STATE →

REGULATORY ACTIVITY:

  • The Division has published the Maximum Benefit Rates Effective July 1, 2018.  MAXIMUM COMPENSATION BENEFIT RATE:  To qualify for the maximum rate of $987.84, a wage of at least $1,481.76 per week must be earned. C.R.S.§ 8-42-105. SCHEDULED IMPAIRMENT RATE:  Payable at a weekly compensation rate of $307.26. C.R.S. § 8-42-107(6)(b) NON-SCHEDULED (OR MEDICAL) IMPAIRMENT: Payable at the TTD weekly rate, but not less than $150.00 per week and not more than $542.78 per week. C.R.S. § 8-42-107(8)(d). BODILY DISFIGUREMENT:  Maximum is $5,229.68 and up to $10,457.52 for extensive facial or body scars, burn scars or stumps resulting from the loss of limbs. C.R.S. § 8-42-108. LUMP SUMS: Maximum lump sum for an injured worker or sole dependent with a date of injury after January 1, 2014 is $91,126.84.  For cases with multiple dependents, the aggregate of all lump sums cannot exceed $182,251.37. COMBINED CAPS: Maximum combined TTD and PPD benefits for individuals with 25% or less whole person impairment is $91,126.84.  Maximum combined benefits for individuals with greater than 25% whole person impairment are $182,251.37.  FATAL CASE: Maximum of $987.84 per week, C.R.S § 8-42-114. Dependents Benefits: and the extent of their dependency is determined as of the date of injury.  The right to death benefits becomes fixed as of that date except as provided in C.R.S. § 8-41-501 (1)(c). Minimum Death Benefit:  25% of Maximum Weekly Benefit or $246.96, C.R.S. § 8-42-114. Claims with no dependents: $20,836.09 payable the Colorado Uninsured Employers Fund.

Colorado Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Posted notice of draft amendments to regulation 5-2-15 concerning consumer protection or vehicle valuation and rental reimbursement. The draft rule was open for public comment through July 19, 2018 and is now closed.

Connecticut VIEW STATE →

REGULATORY ACTIVITY:

  • Announces the publication of the 2018 Official Connecticut Practitioner Fee Schedule. Published by Optum, the 2018 Official Connecticut Practitioner Fee Schedule will reflect all changes to the 2017 schedule. This new schedule will include revisions and clarification of some rules, and the new 2018 CPT codes. This new publication will be effective for medical services rendered on or after July 15, 2018, 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. To order, please contact OPTUM360 at 1-800-464-3649, option 1, or visit optum360coding.com keyword “Connecticut”.  To view the official notice, go to https://wcc.state.ct.us/.
  • Published the August Compensation Review Board calendar. To view the calendar, go to           https://wcc.state.ct.us/crb/calendars/calendars.htm

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

  • Florida has posted a notice of withdrawal for Rule No.: 69L-31.003, 69L-31.004, 69L-31.005, 69L-31.006, 69L-31.007, 69L-31.008, 69L-31.009, 69L-31.010, 69L-31.011, 69L-31.012, 69L-31.013, 69L-31.014, 69L-31.016, 69L-31.017 Rule Titles: Petition Form, Carrier Response Form, Petition Requirements, Consolidation of Petitions, Service of Petition on Carrier and Affected Parties, Computation of Time, Carrier Response Requirements, Effect of Non-Response by Carrier, Complete Record, Joint Stipulation of the Parties, Petition Withdrawal, Overutilization Issues Raised in Reimbursement Dispute Resolution, Reimbursement Disputes Involving a Contract or Workers' Compensation Managed Care Arrangement, Carrier and Health Care Provider Non-compliance.  To view the notice, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-31.003.
  • A new rule is being introduced due to the passage of CS/CS/SB 376, which added subsections (5) and (6) to section 112.1815, Florida Statutes (F.S.). Section 112.1815(5)(f), F.S., requires the Department of Financial Services to adopt rules specifying injuries qualifying as grievous bodily harm of a nature that shocks the conscience. A rule development workshop will be held on Thursday, August 2, 2018 at 9:00 a.m. at the Hartman Building, Room 102, 2012 Capital Circle SE, Tallahassee, FL 32399.  To view the notice, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-3.009.
  • Posted notice of proposed rulemaking: The proposed rulemaking amends rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates a rule, and repeals four rules. The major changes proposed include: adding a rule for defined terms; simplifying requirements for submission of reimbursement disputes; repealing rules related to joint stipulations and non-response by a carrier; and adopting revised forms. The proposed rulemaking adds definitions, simplifies requirements for submission of reimbursement disputes, repeals rules related to joint stipulations and non-response by a carrier, and adopts revised forms.  To view the proposed rule, go to https://www.flrules.org/gateway/View_Notice.asp?id=20694482.
  • DEPARTMENT OF FINANCIAL SERVICES: Division of Workers’ Compensation; RULE NOS.: RULE TITLES: 69L-7.020 Florida Workers' Compensation Health Care Provider Reimbursement Manual; 69L-7.100; Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ascs). PURPOSE AND EFFECT: The proposed rule amendment is intended to incorporate the 2018 versions of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers and the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. The manuals contain the updated lists of Maximum Reimbursable Allowances for various medical services. SUBJECT AREA TO BE ADDRESSED: Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2018 Edition; Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ascs), 2018 Edition. RULEMAKING AUTHORITY: 13(4), (13), (13)(b); 440.591, FS.  LAW IMPLEMENTED: 440.13(7), (12), (13), (13)(b), FS. A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW: DATE AND TIME: August 24, 2018, from 9:30 AM – 12:00 PM. PLACE: Hartman Building, Room 102, 2012 Capital Circle SE, Tallahassee, FL 32301.  Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Theresa Pugh telephone: (850)413-1721, email: Theresa.Pugh@myfloridacfo.com. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice). THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Theresa Pugh, Program Administrator, address: Medical Services Section, Division of Workers’ Compensation, 200 East Gaines Street, Tallahassee, FL 32399, telephone: (850)413-1721, email: Theresa.Pugh@myfloridacfo.com. THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS AVAILABLE AT NO CHARGE FROM THE CONTACT PERSON LISTED ABOVE.  To view a copy of the notice, go to https://www.flrules.org/gateway/ruleno.asp?Id=69L-7.020.

Georgia VIEW STATE →

REGULATORY ACTIVITY:

  • Effective January 1, 2019, the filing of Form WC-1 will be required in all claims, including all “medical only” claims.  Penalties will be assessed if parties fail to timely file a WC-1 after January 1, 2019, pursuant to the provisions of O.C.G.A. §§ 34-9-12(a), 34-9-18 and Board Rules.
  • We are pleased to report that effective August 1, 2018, ICMS is available for the filing of the WC-1 in all claims. We expect EDI to be available for the filing of the WC-1 in medical only claims on December 1, 2018.

Hawaii WC VIEW STATE →

REGULATORY ACTIVITY:

Idaho Auto VIEW STATE →

REGULATORY ACTIVITY:

Illinois VIEW STATE →

REGULATORY ACTIVITY:

Indiana VIEW STATE →

REGULATORY ACTIVITY:

  • The Board has posted the EDI Claims Release 3.1 Requirement Tables, Version 1.0. The Requirement Tables are immediately available for download on the EDI Requirements Page of INWCB EDI Claims Website: https://INWCBEDI.info/requirements . The Event Table, Element Requirement Table and Edit Matrix each contain a change log worksheet that will identify any changes made to that specific table after these initial requirements are published.
  • Important EDI Claims R3.1 Information: Trading Partner Profile Registration for EDI Claims; Release 3.1 is Now Available!! Indiana’s EDI Trading Partner Registration can be found online at https://inwcbedi.info/register. Detailed registration instructions on how to complete the online form is available for download here.  Trading Partners are expected to complete the Indiana EDI Claims Release 3.1.  Registration no later than November 7, 2018. If you have any questions, please contact the INWCB EDI Support Team by email at INWCBEDI@iso.com.

Iowa VIEW STATE →

REGULATORY ACTIVITY:

  • Posted notice in the state register that the Workers’ Compensation Commission amends Chapter 8 regarding the filing of payroll tax tables.  The amended rule becomes effective on August 8, 2018.  To view the rule, go to https://www.legis.iowa.gov/law/administrativeRules.

Kansas VIEW STATE →

REGULATORY ACTIVITY:

  • The Kansas Division of Workers' Compensation will adopt the IAIABC Claims Release 3.1 Standard on November 29, 2018. The Kansas IAIABC R3.1 release date coincides with go-live of Kansas’ Online System for Claims Administration Research/Regulation (OSCAR).  Kansas EDI data will be integrated into OSCAR and some of the new requirements in claims 3.1 are needed to support OSCAR functionality and processes.  To view additional information, go to https://www.dol.ks.gov/WorkComp/edinews.aspx.
  • Travel to obtain medical services on or after July 1, 2018, shall be reimbursed at the rate of 54.5 cents per mile. The mileage reimbursement rate for state officers and employees is 54.5 cents per mile effective July 1, 2018. 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).
  • Weekly Benefits have changed effective July 1, 2018 to June 30, 2019. Maximum Weekly Benefits are $645 and Minimum Weekly Survivors Benefit are $430.
  • Pursuant to HB 2280, a public hearing will be conducted at 3:00 p.m. Friday, August 10, 2018, in Hearing Room 3 of the Department of Labor Building, 401 SW Topeka Blvd., Topeka, Kansas. The purpose of the hearing will be to consult and solicit information from individuals and entities that may be affected by the proposed changes to the Workers' Compensation 2019 Schedule of Medical Fees (hereafter Medical Fee Schedule). All interested parties may submit written comments prior to the hearing to the Division of Workers' Compensation, 401 SW Topeka Blvd., Suite 2, Topeka, KS 66603 or by email to Jose.Castillo@ks.gov. All interested parties will be given a reasonable opportunity to present their views orally regarding the proposed changes to the Medical Fee Schedule. In order to provide all parties an opportunity to present their views, it may be necessary to request that each participant limit any oral presentation to five minutes.  An individual with a disability may request an accommodation in order to participate in the public hearing and may request a copy of the proposed changes to the Medical Fee Schedule and economic impact statements in an accessible format.  Request for accommodation to participate in the hearing should be made at least five working days in advance of the hearing by contacting Jose Castillo at 785-296-4000, ext. 2159 or TYY 1-800-766- 3777. The northwest entrance to the Department of Labor Building is accessible. Handicapped parking is located at the northwest side of the Department of Labor Building.  Copies of the proposed changes to the Medical Fee Schedule and the Economic Impact Statement can be obtained by contacting Jose Castillo at 785-296-4000 2159 or Jose.Castillo@ks.gov.

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

  • Published the minutes from the July 9th Regulatory Advisory Meeting. Judge Gott reviewed the three missions of the committee, to establish regulations for extension of benefits beyond the statutory 780 weeks, to adopt regulations for implementation of a pharmaceutical formulary, and to adopt regulations for implementing treatment guidelines, both of the latter of which are to be developed by the Medical Advisory Committee.  He noted that the committee will accept public comments from those present at the meeting.  Anyone listening via telephonic conference was invited to attend the next meeting in person as well as to submit any questions or concerns via email to any member of the committee.
  • The Department of Workers’ Claims is considering revising 803 KAR 25:092, the Pharmacy Fee Schedule, regarding reimbursement methodology and will hold a stakeholders’ meeting to receive input on this issue.  The meeting was held on July 31, 2018.  
  • Beginning September 5, 2018, the Department of Workers’ Claims will accept optional electronic submission of Settlement Agreements in LMS.  Electronic submission of Settlement Agreements will become mandatory January 1, 2019.  The DWC will present an instructional Webinar with a live demonstration of the submission process on Friday, August 10, 2018, at 10:00 a.m.  The link and audio connection to access the webinar are as follows:

Maine VIEW STATE →

REGULATORY ACTIVITY:

  • Posted notice in the state register that rules that were proposed in April of 2018 have been adopted and will become effective September 1, 2018. AGENCY: 90-351 - Workers’ Compensation Board; CHAPTER NUMBERS AND TITLES:
    1, Payment of Benefits; Ch. 2, Section 213 Compensation for Partial Incapacity; Ch. 3, Form Filing
    Ch. 4, Independent Medical Examiner; Ch. 5, Medical Fees; Reimbursement Levels; Reporting ; Requirements; Ch. 6, Rehabilitation; Ch. 7, Utilization Review, Treatment Guidelines, Permanent Impairment; Ch. 8, Procedures for Payment; Ch. 9, Procedures for Coordination of Benefits
    Ch. 12, Formal Hearings; Ch. 13, Rules of Appellate Division; Ch. 14, Review by Full Board
    Ch. 15, Penalties; Ch. 16, Confidentiality of Files; Ch. 18, Examinations by Impartial Physician(s) Pursuant to 39-A MRSA Section 611; ADOPTED RULE NUMBER: 2018-122 thru 136
    CONCISE SUMMARY: The changes define terms, prescribe forms and clarify procedures regarding the processing and payment of workers’ compensation claims. EFFECTIVE DATE: September 1, 2018.
    AGENCY CONTACT PERSON / RULEMAKING LIAISON: John C. Rohde, General Counsel, Workers’ Compensation Board, 27 State House Station, Augusta, ME 04333. Telephone: (207) 287-7086. Email: John.Rohde@Maine.gov .

Maryland VIEW STATE →

FEE SCHEDULE NEWS:

  • The Commission posted a revision of the 2018 ASC Reimbursement Rates dated 7/2/18. The revised document only makes changes to the column names. All rates remain unchanged for 2018.  To view the revised document, go to   http://www.wcc.state.md.us/MFG/Medical_Fee_Schedule.html.

REGULATORY ACTIVITY:

  • James R. Forrester was appointed a member of the Maryland Workers’ Compensation Commission in 2018 by Governor Lawrence J. Hogan, Jr. He is a graduate of Randolph-Macon College and the University of Baltimore’s Merrick School of Business and School of Law. He earned a Master of Business Administration in 1995 and a Juris Doctor in 1998, with honors. In 1999, he joined the Law Offices of Ileen M. Ticer as an Associate Claims Attorney. Thereafter, he joined Semmes Bowen & Semmes, P.C. in the firm's Workers’ Compensation and Employers’ Liability Department, having been elected a Principal in 2009. Throughout his years in legal practice, Commissioner Forrester has concentrated in the area of workers’ compensation, appearing before all levels of the judiciary in the State of Maryland. He is also licensed and practiced in the District of Columbia and served as President and Member of the Executive Board of the Baltimore Claims Association as well as the Co-Chair of the Workers’ Compensation Section of the Maryland Defense Counsel. He also serves in a leadership role with several civic organizations.
  • Pursuant to L&E 9-638, the Cost of Living Adjustment (COLA) effective January 1, 2019 is 1.29%.  The updated MDWCC COLA document can be accessed at http://www.wcc.state.md.us/Adjud_Claims/Comp_Rates.html.

Maryland-Auto VIEW STATE →

REGULATORY ACTIVITY:

Massachusetts VIEW STATE →

FEE SCHEDULE NEWS:

  • The Division has adopted a new hospital fee schedule effective July 1, 2018. The next update is expected July 2019.

REGULATORY ACTIVITY:

  • Administrative Bulletin 18-16 114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals. The Executive Office of Health and Human Services (EOHHS), pursuant to 114.1 CMR 41.05(1) and (3) and in accordance with Section 123 of Chapter 224 of the Acts of 2012, is publishing the Payment on Account Factors (PAF) for acute and non-acute hospital services rendered to industrial accident patients. The PAF was computed using data from each hospital’s most recent complete fiscal year. The application of the PAF to all billed charges payable pursuant to 114.1 CMR 41.00 results in the payment of the average percentage of charges paid by the private sector to each hospital for its services. This payment calculation shall be deemed to meet the test of reasonable cost of medical services prescribed by M.G.L. c. 152, the Workers’ Compensation Act. No lesser amount shall be paid unless agreed to by the provider, insurer, and employer.  Provided below are the PAFs for acute and non-acute hospital services rendered on or after July 1, 2018. To view the bulletin, go to https://www.mass.gov/lists/2018-eohhs-administrative-bulletins.

Michigan Auto VIEW STATE →

REGULATORY ACTIVITY:

  • R 501.3 was promulgated to set standards for public adjusters (formerly known as adjusters for the assured). Subsequent amendments to the Insurance Code incorporate nearly all of the rules provisions. Accordingly, the rule is duplicative of requirements contained in statute; and, in two instances, obsolete. The rule should be rescinded.

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, 2018 and ending June 30, 2019 is $902.51. This SAWW produces the maximum weekly benefit rates for injury and illness occurring on or after July 1, 2018, as follows:
    • Temporary Total Disability $947.64
    • Permanent Total Disability $947.64
    • Permanent Partial Disability $496.38 Death $947.64
  • The actual weekly wage rate necessary to attain the maximum benefit rate is $1,421.45 for Death, Temporary Total Disability and Permanent Total Disability and $744.57 for Permanent Partial Disability.
  • Also, as of July 1, 2018, the mileage allowance for travel expenses is 54.2 cents per mile.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

  • On April 19, 2018, Governor Ricketts approved LB953, which revises Neb. Rev. Stat. Section 48-139 of the Nebraska Workers' Compensation Act. Effective July 19, 2018, LB953 will impact the court's review of certain lump sum settlement applications with respect to unpaid medical expenses and consideration of Medicare's interests. To view the notice, go to https://www.wcc.ne.gov/news/nwcc_news.aspx.
  • Jill Gradwohl Schroeder to assume the duties of NWCC Administrator effective July 23, 2018. Over the course of her career, Jill has participated in several law-related and community organizations, including the Nebraska State Bar Association Workers' Compensation Section (Executive Board 1993-1999); the National Alliance of Medicare Set Aside Professionals (Board of Directors 2005-2010); Leadership Lincoln (Board of Directors 2005-2009); Lincoln Bar Association (currently Chair of the Memorials Committee); and Cedars Youth Services (Board of Directors 2015 to present).

Nevada VIEW STATE →

REGULATORY ACTIVITY:

  • The state Average Weekly Wage for computing maximum disability compensation for Fiscal Year 2019 has been certified by the Nevada Department of Employment, Training and Rehabilitation, Employment Security Division, to be $901.70 per week.  Nevada Revised Statutes (NRS) 616A.065 requires the average monthly wage to be capped at 150 percent of the state Average Weekly Wage, multiplied by 4.33.

Maximum Average Monthly Wage

  • $901. 70 X 150% X 4.33 = $5,856.54
  • Maximum disability compensation in Nevada is 66-2/3 percent of the Average Monthly Wage (NRS 616A.065 and 616C.475).   If the earned wage on the date of injury was less than $5,856.54 per month. compensation is 66-2/3 percent of the actual earned wage.
    • $5,856.54   X 66 2/3% =   $3,904.36
    • ($5,856.54 X 8 +   12 = $3,904.36)
  • To view the memo regarding benefit levels, go to http://dir.nv.gov/WCS/Important/.

Nevada Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Posted adoption of administrative code Chapter 684A sections 2-26.  A regulation  relating to insurance; prescribing the pre-licensing education requirements for applicants for a license as an adjuster or an associate adjuster; prescribing certain continuing education requirements for renewal of a license as an adjuster held by an individual; prescribing the requirements for the approval of courses of instruction for pre-licensing education and continuing education and for the approval of instructors of such courses of instruction; and providing other matters properly relating thereto.  To view a copy of the adopted rule, go to https://www.leg.state.nv.us/register/indexes/2018_NAC_REGISTER_KEYWORD.htm.

New-Hampshire-Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued Bulletin 18-040-AB affecting all property casualty insurers doing business in the state. All pre-1999 Property & Casualty Bulletins are hereby withdrawn. As such, they should not be relied upon by any entity in making decisions as to the legality of any action under New Hampshire Insurance laws. If you have any questions regarding this Bulletin, please contact Emily Doherty, Property & Casualty Attorney, at emily.doherty@ins.nh.gov or 603.271.4843.  To view the bulletin, go to https://www.nh.gov/insurance/media/bulletins/2018/index.htm.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

  • The WCA Will Temporarily Limit Access to its Electronic Filing Systems:  As you may be aware, the WCA’s public website was recently hacked. We want to assure the public that no data was retrieved or compromised at that time. However, in order to ensure that we can continue to provide users with a secure connection, we will complete security audits nightly, making Electronic Case Filing (ECF), WEB-EDI, and the Inpatient applications temporarily unavailable during these security checks.
  • Beginning on Friday, July 27, 2018, the ECF, EDI and Inpatient applications will ONLY be available during the following hours:

                      Monday – Friday:            6 a.m. to 6 p.m.

                      Saturday/Sunday:            8 a.m. to 5 p.m.

  • New Mexico Workers' Compensation Administration Director Darin A. Childers announced the reappointment of Anthony "Tony" Couture to serve a five-year term as a workers' compensation judge, effective August 28, 2018. By law, workers' compensation judges are appointed for an initial one-year term, which may then be followed by subsequent five-year appointments. Judge Couture began his initial term on August 28, 2017. The reappointment expires in August 2023.

New York VIEW STATE →

FEE SCHEDULE NEWS:

  • The State has adopted new Inpatient Fee Schedule rates for hospitals with effective dates of January 1, 2017, April 1, 2017 and January 1, 2018.
  • A new EAPG data set was released with an effective date of July 1, 2018. The next update is expected in October 2018.

REGULATORY ACTIVITY:

  • As announced on April 17, 2018, in Subject Number 046-1058 Proposals to Improve Medical Care for Injured Workers, the New York State Workers' Compensation Board (Board) will replace the current Board treatment forms: Doctor's Initial Report (Form C-4), Doctor's Progress Report (Form C-4.2), Occupational/Physical Therapist's Report (Form OT/PT-4), Psychologist's Report (Form PS-4), and Ancillary Medical Report (Form C-AMR) with the CMS-1500 to help reduce paperwork and lower provider administrative burdens. This initiative will leverage providers' current medical billing software and medical records while promoting a more efficient workers' compensation system. It is expected that the initiative will roll out in three phases, as follows:
    • Phase 1: Commencing January 1, 2019 providers may voluntarily transmit CMS-1500 medical bills (and required medical narratives, and/or attachments as applicable) through an approved XML Submission Partner ("clearinghouse") to workers' compensation insurers/payers. Guidance on required medical narratives and attachments is available on the Board's website. As previously conveyed in Subject Number 046-785, if a CMS-1500 is submitted without the detailed narrative report or office note, it is not a valid bill submission. A listing of approved clearinghouses for the CMS-1500 will be posted on the XML Forms Submission section of the Board's website after each entity successfully completes testing and executes an XML Submission Partner agreement with the Board. Workers' compensation insurers/payers will accept CMS-1500 medical billing files from clearinghouses and electronically return acknowledgments of receipt of CMS-1500 files. Such acknowledgements (including receipt date) will be forwarded from the clearinghouses back to providers and the Board. The Board will receive CMS-1500 files, narrative attachments and acknowledgements of receipt from clearinghouses in a designated XML format. The CMS-1500 forms and narrative attachments will be combined and displayed in the applicable claimants WCB case folders.
    • Phase 2: On or about July 1, 2019 workers' compensation insurers/payers will electronically transmit Explanations of Benefits (EOB) to their clearinghouses upon adjudication of the associated electronic CMS-1500 medical bills. Such EOB data will be forwarded from the clearinghouses back to providers and the Board. The Board will receive EOB data from clearinghouses in a designated XML format. The Board plans to eliminate the requirement for the insurer/payer to file Form C-8.1B or C-8.4 form (to object to full or partial payment of a medical bill) when an EOB for the medical bill was transmitted through the clearinghouse and the Provider may file Health Provider's Request for Decision on Unpaid Medical Billing (Form HP-1) (based on receipt of EOB).
    • Phase 3: On or about January 1, 2020 providers will be required to submit electronic CMS-1500 medical bills (and required medical narratives, as applicable) through their clearinghouses to workers' compensation insurers/payers and to receive EOBs back through their clearinghouse. Providers will be required to electronically transmit any disputes for unpaid medical bills to their clearinghouse using the Board-prescribed form. The clearinghouses will electronically transmit medical disputes to the Board in a designated XML format. The Board will eliminate Forms C-4, EC-4, C-4.2, EC-4.2, C-4.1, PS-4, C-4AMR, EC-4AMR, OT/PT-4, EOT/PT4 and EC-4NARR forms. Web submission and XML submission of these forms will no longer be available. The Board will establish a hardship exception process for providers who are unable to meet the mandatory electronic reporting requirements.
  • Visit the CMS-1500 Initiative section of the website to access technical specifications for the CMS-1500 medical billing and associated acknowledgement data and to find periodic updates. Please direct questions to CMS1500@wcb.ny.gov.  A copy of the notice can have viewed at http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1079.jsp.
  • Pursuant to New York Public Health Law § 2807-c (6-1), the workers' compensation fee schedule for inpatient hospital care tracks New York Medicaid rates, with limited statutory modifications. The New York State Department of Health (DOH) is required by statute to announce the workers' compensation inpatient rates. The DOH recently provided the Workers' Compensation Board (Board) with updated reimbursement rates for acute per case inpatient rates, exempt hospitals, exempt units and detoxification inpatient rates for the period of April 1, 2017 through December 31, 2017, and new reimbursement rates for January 1, 2018 through December 31, 2018. Rates of payments for these services are based upon rates determined for state governmental agencies (Medicaid) in accordance with Article 2807-c (6)(1). These rates, which also apply to treatment provided under the Comprehensive Motor Vehicle Reparations Act, Volunteer Firefighters' Benefit Law, and Volunteer Ambulance Workers' Benefit Law, are posted on the Board's website. Please see 2017 Medical Care Fee Schedules and 2018 Medical Care Fee Schedules.
  • New York Bulletin Subject Number 046-1085 Form C-4AUTH Denials-Form C-8.1 Part A No Longer Required Date: July 25, 2018; The Attending Doctor's Request for Authorization and Carrier's Response (Form C-4AUTH) has been revised to remove the instruction that a Notice of Treatment Issue(s)/Disputed Bill Issue(s) (Form C-8.1 Part A) must be filed in cases where the insurer denies the request for authorization. Per a Memorandum of Decision (MOD) in the Matter of J&A Concrete Corporation, 2017 NY Work Comp G1078502 (filed 9/5/2017), Form C-8.1A is no longer required to be submitted with a Form C-4AUTH Denial. The matter held: The Board Panel finds that the carrier's denial of the request for the bone growth stimulator was a sufficient response and the failure to file a timely C-8.1A form was not ultimately dispositive under these circumstances. The C-4AUTH form was filed March 17, 2016 and the denial, along with its supporting medical opinion, was timely filed on March 29, 2016. The carrier's denial of authorization for special services must be effectuated by the timely filing of a Board-prescribed form, coupled with the timely filing of a supporting medical opinion. As the timely filing of a C-4AUTH denial, coupled with a supporting medical opinion, sets forth the carrier's objection to the special services and provides the basis for that objection, the filing of a C-8.1A form, which mirrors the C4-AUTH, is redundant and unnecessary. Therefore, the C4-AUTH denial was timely and properly filed herein. This revision is effective immediately. Please contact Claims@wcb.ny.gov if you have any questions.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

  • On October 19, 2017, the Rules Review Commission approved the rule amendment to Rule 04 NCAC 10J .0103. However, the rule received ten or more letters of objection. Therefore, this rule was subjected to legislative review with a delayed effective date of the earliest of the 31st legislative day of the General Assembly's session beginning May 2018 or the date of adjournment. The General Assembly adjourned June 29, 2018. Following the period for legislative review, the Industrial Commission's amended rule has been upheld as approved by the Rules Review Commission and is effective immediately. Please note the rule was re-codified as 11 NCAC 23J .0103 due to the Commission's transfer to the Department of Insurance. For dates of service between April 1, 2015 and June 28, 2018, the effective rule can be found at  http://www.ic.nc.gov/news.html#hot.  For dates of service on or after June 29, 2018, the effective rule can be found http://www.ic.nc.gov/news.html#hot.
  • Commissioner Myra L. Griffin's appointment to the Industrial Commission was confirmed by the North Carolina General Assembly on June 29, 2018. Governor Roy Cooper appointed Commissioner Griffin to fill the unexpired term of former Commissioner Linda Cheatham.

North-Carolina-Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued bulletin 18-B-08 regarding consent to rate laws.  The bulletin was issued June 29, 2018 and published on their web site on July 6, 2018.  The notice is in regard to laws that become effective January 1, 2019.  To view the bulletin, go to http://www.ncdoi.com/PC/Bulletins.aspx. 

North Dakota VIEW STATE →

REGULATORY ACTIVITY:

  • July 2018:  WSI recently partnered with Cordant Health Solutions to assist in the coordination of medication monitoring for injured workers on chronic opioid therapy. Monitoring of drug testing is a component of WSI’s Chronic Opioid Therapy medical policy. The services provided by Cordant Health Solutions replace those previously managed by Ameritox Ltd. The following is an overview of the process for medication monitoring pertaining to chronic opioid therapy: Cordant Health Solutions analyzes WSI’s pharmacy data to identify injured workers who have been on opioid therapy for 90 consecutive days for treatment of pain. Cordant Health Solutions contacts the WSI claims adjuster to request authorization to coordinate drug testing for an injured worker meeting the criteria listed above. The WSI claims adjuster reviews the identified injured worker’s file to assess the need for drug testing. Factors taken into consideration of this decision include whether WSI has record of previous drug testing, and if so, the date, type and scope of the testing. If the WSI claims adjuster approves drug testing, Cordant Health Solutions contacts the last prescriber of record to collect information on current medications and inquire about the next upcoming visit. Cordant Health Solutions sends a laboratory kit with collection instructions to the prescriber. A provider may bill WSI for collection using CPT® code 99000. Cordant Health Solutions sends results of the drug testing to both the prescriber and WSI. Cordant Health Solutions performs definitive testing to quantify the presence of prescribed, non-prescribed and illicit drugs in all samples. A provider may utilize laboratory services other than Cordant Health Solutions to conduct drug testing. However, it is WSI’s expectation the testing is comparable in type and scope, i.e. a provider must conduct definitive testing for prescribed, non-prescribed, and illicit drugs. The announcement may be viewed at http://www.workforcesafety.com/news/news-item/introduction-of-cordant-health-solutions-for-chronic-opioid-monitoring.

Ohio VIEW STATE →

REGULATORY ACTIVITY:

  • Published notice of rules awaiting Common Sense Initiative recommendations for Rule 4123-6-21.3 Outpatient medication formulary and 4123 Chapter 17 BWC Professional Employer organization Rules.  To view the notice and documentation, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.  For rule 4123-6-21.3 the agency is adopting a formulary which will become effective January 1, 2019.  For rule Chapter 17 4123-17-15 the commission is adopting amendments to the current rule.

Ohio-Auto VIEW STATE →

REGULATORY ACTIVITY:

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

  • An alert was issued to inform that the Workers' Compensation Commission adopted emergency rules and forms pertaining to the Oklahoma Legislature's enactment of SB1249 (2018) creating the Affidavit of Exempt Status (in lieu of a Certificate of Noncoverage) and Cancellation of an Affidavit of Exempt Status. The proposed emergency rules and forms were posted on the Commission's website on June 12, 2018 and public comments were accepted through July 13, 2018.   After hearing public comments at a meeting on July 13, 2018, the Commission adopted the emergency rules and CC-Form 36C Cancellation of Affidavit of Exempt Status as proposed; adopted the CC-Form 36A Affidavit of Exempt Status as modified at the meeting; and repealed the CC-Form 36 Application for Certificate of Noncoverage. The adopted emergency rules will become effective upon approval by the Governor. The adopted CC-Form 36A and CC-Form 36C will become effective on August 2, 2018. The adopted emergency rules and forms are available to view on the Commission's website at https://ok.gov/wcc/Legal/Governing_Documents_/index.html.
  • Published in the state Register the withdrawal for rules Title 810 Chapter 25 Subchapter 1 and Subchapter 5.  To view the notice of withdrawal, go to http://www.oar.state.ok.us/oar/codedoc02.nsf/frmMainOpenFrameSet&Frame=  Main&Src=_75tnm2shfcdnm8pb4dthj0chedppmcbq8dtmmak31   ctijujrgcln50ob7ckj42tbkdt374obdcli00

Oregon VIEW STATE →

REGULATORY ACTIVITY:

  • The Workers’ Compensation Division has posted a minor correction to Bulletin 111, "Computation of temporary disability, permanent disability, and death benefits based on Oregon's state average weekly wage": https://wcd.oregon.gov/Bulletins/bul_111-corrected.pdf
  • Oregon has announced the publication of  rules: OAR, and OAR 436-120-Vocational Assistance to Injured Workers, rules 0003 and 0147  in final form. To view the rules, go to https://wcd.oregon.gov/laws/Pages/new-rules.aspx.
  • The maximum statutory rate for claims with dates of injuries between 7/1/2017 and 6/30/2019 has been corrected to $1,339.38 from the published amount of $1,339.37. No other changes have been made to the bulletin.
  • Published Bulletin 260 regarding Employer-at-Injury Program Reimbursement Request Form.  This bulletin provides a revised Form 2360, “Employer-at-Injury Program Reimbursement Request Form.” This bulletin replaces Bulletin 260 dated Dec. 9, 2016. Changes to the form include: Adding a correction check box to indicate the request is a resubmission of a corrected returned request; and Adding a section to request information about concurrent injuries under Oregon Administrative Rules (OAR) 436-105-0530. To view the bulletin and revised form, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.

Pennsylvania WC VIEW STATE →

REGULATORY ACTIVITY:

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

  • With the approval of the FY18-19 Budget, the General Assembly authorized an increase in the Commission’s filing fee from $25.00 to $50.00 for each requested hearing, settlement or motion. Funds generated by the increase will help support the development and implementation the IT Legacy Modernization Project. This Project is a strategic plan to transform the agency’s business system and processes and upgrading the existing 29-year-old claims management system (Progress). Benefits to the stakeholders include improved security of data, ability to provide financial transactions of fees and fines electronically and creating an avenue for filing pleadings electronically and document accessibility by parties to claims.  The effective date of the increase is August 1, 2018. Each request for a hearing, settlement or motion filed on or after August 1 will require a $50.00 filing fee.
  • The following is a summary of the items discussed and actions taken at the SC Workers’ Compensation Commission’s Business Meeting on July 16, 2018.  Commission Approved 23 Applications to Self-Insure The Commission approved applications to self-insure twenty-three (23) prospective members of four (4) funds.  Received Agency Departmental Reports The Department Directors and Executive Director reviewed their monthly reports submitted to the Commission prior to the meeting.   Filing Fee Increase, Effective August 1, 2018 Effective August 1, 2018, the filing fee will increase from $25.00 to $50.00 for each requested hearing, settlement, or motion.  A complete copy of the summary can be viewed at http://www.wcc.sc.gov/Pages/default.aspx.

South Dakota VIEW STATE →

REGULATORY ACTIVITY:

Tennessee VIEW STATE →

REGULATORY ACTIVITY:

  • The Bureau will conduct a rulemaking hearing on a new set of proposed rules concerning access to the public records maintained by the agency. The hearing will be held at 10:00 a.m. CDT in the Tennessee Room of the Department of Labor and Workforce Development's offices, located at 220 French Landing Drive, Nashville, Tennessee. The public is invited to attend and to offer comments.  To view the notice, go to https://www.tn.gov/workforce/injuries-at-work/bureau-announcements.html.
  • New Claims Handling Standards will go into effect August 2, 2018. Revisions to the Claims Handling Standards include requirements for adjusting entities to designate a liaison to the Bureau to serve as a primary point of contact, clarification on the steps to file claims if the SSN is missing or unknown, deletion of the requirement to have a claims office in the state, and new requirements for making contact with the injured employee. To view a copy of the regulation to go into effect August 2, 2018, go to https://www.tn.gov/workforce/injuries-at-work/bureau-announcements.html.

Texas VIEW STATE →

REGULATORY ACTIVITY:

  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) reminds attorneys of the requirements to claim a fee for representing a party in the Texas workers’ compensation system.  Requirements: To claim a fee, an attorney representing any party must submit to the division a complete and accurate application for attorney fees in the form and manner prescribed by the division.  28 TAC §152.3(a).  The attorney must provide an itemized list of each legal service performed and expense incurred representing the claimant or insurance carrier that identifies the attorney or legal assistant who provided the service, the date the service was provided, and the hours or amount requested.  28 TAC §152.3(b)(7).  Each attorney must bill for hours using that attorney’s state bar card number.  28 TAC §152.4(e). In certifying an application for attorneys’ fees, the attorney certifies that every statement, numerical figure, and calculation is within the attorney’s personal knowledge, is true and correct, and represents the services, charges, and expenses provided by the attorney or a legal assistant under the attorney’s supervision.  28 TAC §152.3(b)(8).  Enforcement: DWC emphasizes that attorneys are subject to review for compliance with commissioner rules, the Texas Workers’ Compensation Act, and other laws under Labor Code Chapter 414. An order approving, partially approving, or denying an application for attorney fees does not limit the commissioner's authority to enforce a sanction, administrative penalty, or other remedy authorized by the Act. DWC may take appropriate enforcement action for failing to file an application for attorney fees in the form and manner prescribed by the division.  To view a copy of this notice, go to http://www.tdi.texas.gov/alert/whatsnew/index.html.
  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) will hold a public hearing on Thursday, August 2, 2018, in the Tippy Foster Room at the DWC Central Office, 7551 Metro Center Drive, Suite 100 in Austin, Texas.  Streaming audio of the public hearing will be available at http://tdimss.tdi.texas.gov/tdi/tdi.asx.  The meeting will begin at 10 a.m. and DWC will receive comments on the following rules:
    • Amended 28 TAC §180.8.  Notices of Violations; Notices of Hearing; Default Judgments.
    • Amended 28 TAC §180.26.  Criteria for Imposing, Recommending and Determining Sanctions; Other Remedies.  The rule proposal was published in the May 18, 2018, issue of the Texas Register.  DWC has extended the comment period, which closes on August 2, 2018, at 5 p.m. CST.  DWC offers reasonable accommodations for persons attending meetings, hearings, or educational events, as required by the Americans with Disabilities Act.  If you require special accommodations, contact Maria Jimenez at (512) 8044703.

Utah No-Fault VIEW STATE →

REGULATORY ACTIVITY:

  • Published Bulletin 2018-03 regarding application and renewal fee exemption for certain military individuals and spouses. This Bulletin is to notify an individual producer, surplus lines producer, limited line producer, consultant, managing general agent, reinsurance intermediary, independent adjuster or public adjuster of changes to the Insurance Department's fees pursuant to 2018 General Session Senate Bill 227, Licensing Standards for Military Spouses.  Senate Bill 227 amended Utah Code Annotated §§ 31A-23a-104 and 31A-26-202 to provide a license fee exemption for military individuals and spouses applying for a Utah nonresident initial license, or a license renewal, on or after May 8, 2018.  An individual, or the spouse of an individual who is serving in the armed forces of the United States, is exempt from the licensing fee while: (1) the individual is stationed within this state; (2) the individual or spouse who is applying holds a valid insurance license issued by another state or jurisdiction recognized by the department; and (3) the license held in the other state is current and in good standing in that state or jurisdiction.  To view the bulletin, go to https://insurance.utah.gov/consumer/legal-resources/bulletins.

Utah WC VIEW STATE →

FEE SCHEDULE NEWS:

  • New ambulance rates have been updated with an effective date of July 1, 2018. The next expected update is October 2018.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

Virginia VIEW STATE →

REGULATORY ACTIVITY:

  • Published a final regulation regarding the prescribing of opioids and buprenorphine.  The rule is not a specific workers' compensation rule but would apply to prescribing under any health care situation. The regulatory action adopts requirements for the prescribing of opioids and products containing buprenorphine as required by Chapters 291 and 682 of the 2017 Acts of Assembly. The regulations establish the practitioners to whom the regulations apply and the exceptions to or non-applicability of the regulations. Provisions for the management of acute pain include requirements for the evaluation of the patient, limitations on quantity and dosage, and medical record keeping. Provisions for the management of chronic pain include requirements for evaluation and treatment, including a treatment plan, informed consent and agreement, consultation with other providers, and medical record keeping. Provisions for the prescribing of buprenorphine include requirements for patient assessment and treatment planning, limitations on prescribing the buprenorphine mono-product (without naloxone), dosages, co-prescribing of other drugs, consultation, and medical records for opioid addiction treatment. Changes since the proposed regulation was published include (i) adding treatment for pain associated with sickle cell as an exception to the regulations, (ii) adding information regarding the nature of tramadol each time that drug is listed, and (iii) changing the requirement for drug testing following the first year of chronic pain management to be consistent with that of the Centers for Disease Control and Prevention. To view a copy of the rule as adopted, go to http://register.dls.virginia.gov/details.aspx?id=6950.
  • Notice of Intended Regulatory Action was given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Nursing intends to consider amending 18VAC90-30, Regulations Governing the Licensure of Nurse Practitioners and 18VAC90-40, Regulations for Prescriptive Authority for Nurse Practitioners. The purpose of the proposed action is to eliminate the requirement for a separate license for a nurse practitioner to have prescriptive authority. 18VAC90-40, Regulations for Prescriptive Authority for Nurse Practitioners, likely will be repealed, and the necessary provisions will be incorporated into a new part in 18VAC90-30, Regulations Governing the Licensure of Nurse Practitioners. The goal is to reduce the financial and logistical burden on nurse practitioners, who currently must maintain a separate license to prescribe. The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register. Statutory Authority:§ 54.1-2400 and 54.1-2957.01 of the Code of Virginia. Public Comment Deadline: August 22, 2018.

 

Agency Contact: Jay P. Douglas, R.N., Executive Director, Board of Nursing, 9960 Maryland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4520, FAX (804) 527-4455, or email jay.douglas@dhp.virginia.gov.

Virginia Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued administrative order 12062 regarding AIPSO Filing VA 18-04 makes revisions to Section 23 of the Plan Manual to introduce a new procedure for returning EASi Applications.  For amendment to the Virginia Automobile Insurance Plan Manual of rules, classifications, territories, rates additional charges, and forms to provide for writing insurance upon applicants assigned by the Virginia Automobile Insurance Plan.  To view a copy of the order, go to https://www.scc.virginia.gov/boi/adminords/2018.aspx.

Washington VIEW STATE →

REGULATORY ACTIVITY:

  • Subject of Possible Rule Making: Chapter 296-14 WAC, Industrial insurance, pension discount rates (PDR) for the state fund and self-insurance.
  • Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 04.020, 51.44.070(1), 51.44.080, chapter 282, Laws of 2018 (SB 6393).
  • Reasons Why Rules on this Subject may be needed and What They Might Accomplish: PDR is the interest rate used to account for the time value of money when evaluating the present value of future pension payments. The purpose of this rule making is to lower the PDR using different assumptions for annual investment returns for the reserve funds for self-insured and state fund pension claims, and to align with recent department requested legislation passed in the 2018 session allowing for the department to use different methods of calculating state fund and self-insured liabilities when determining the annuity values of a pension based on the rates of mortality, disability, remarriage, and interest.
  • This rule making will consider reducing the pension discount rate to 4.5 percent for the state fund and to 6.0 percent for self-insurance.
  • Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.
  • Process for Developing New Rule: Parties interested in these rules may contact the individual listed below. The public may also participate by commenting after amendments are proposed by providing written comments and/or testimony during the public hearing and comment process. Public hearings will be held after the proposal is filed.
  • Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Suzy Campbell, Legal Services, P.O. Box 44250, Olympia, WA 98504-4250, phone 360-902-5003, fax 360-902-4960, TTY 360-902-4252, email campbell@lni.wa.gov.
  • Secure Access Washington (SAW) is getting an upgrade Aug. 3; Many L&I customers use Secure Access Washington (SAW) to log into resources and services at L&I and other state agencies. This message is for L&I customers who access our web resources through SAW, so you know about a coming change to the site. If you’re a SAW user, you’ll notice a new look and feel on August 3. The site will work the same as always - it will just look different (see images below). You can continue to use the same username and password and will have the same access you had before the upgrade. The improved site will automatically adjust to your screen size, so it works better on phones and tablets, and a streamlined signup process makes it more user-friendly for new users.  If you have questions or experience problems with the new site, contact https://support.secureaccess.wa.gov/sawuser/help/contact-support.

West Virginia VIEW STATE →

REGULATORY ACTIVITY:

  • Reminder West Virginia has published benefit rates for fiscal year 2019 effective from July 1, 2018 through June 30, 2019.



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