Alaska VIEW STATE →

REGULATORY ACTIVITY:

• The Alaska Department of Labor and Workforce Development and the Alaska Workers’ Compensation Board propose to adopt regulation changes in Title 8 of the Alaska Administrative Code, dealing with fees for medical treatment and services, including the following: (1) 8 AAC 45.083 is proposed to be changed as follows: amend to update and clarify the medical fee schedule for treatment and services provided to injured workers. You may comment on the proposed regulation changes, including the potential costs to private persons of complying with the proposed changes, by submitting written comments to the Department of Labor and Workforce Development, Division of Workers’ Compensation at P.O. Box 115512, Juneau, AK 99811-5512. Additionally, the Department of Labor and Workforce Development, Division of Workers’ Compensation will accept comments by facsimile at (907) 465-2797 and by electronic mail at workerscompregs@alaska.gov. Comments may also be submitted through the Alaska Online Public Notice System, by accessing this notice on the system and using the comment link. The comments must be received not later than 5:00 p.m. on September 24, 2018. Oral comments may be submitted at a hearing to be held on October 4, 2018, in Room 208, 3301 Eagle St., Anchorage, Alaska 99503. Public comment will be heard from 10:15am to 11:15am and might be extended to accommodate those present before 10:15am who did not have an opportunity to comment. You may submit written questions relevant to the proposed action to the Department of Labor and Workforce Development, Division of Workers’ Compensation at P.O. Box 115512, Juneau, AK 99811-5512 or by electronic mail at workerscompregs@alaska.gov. The questions must be received at least 10 days before the end of the public comment period. The Department of Labor and Workforce Development, Division of Workers’ Compensation will aggregate its response to substantially similar questions and make the questions and responses available on the Alaska Online Public Notice System and the Division of Workers’ Compensation’s website. If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Alexis Newman at (907) 465-6059 or alexis.newman@alaska.gov no later than September 20, 2018 to ensure that any necessary accommodations can be provided. A copy of the proposed regulation changes and the material proposed for adoption by reference is available on the Alaska Online Public Notice System and by contacting Alexis Newman at (907) 465-6059 or newman@alaska.gov. After the public comment period ends, the Department of Labor and Workforce Development and the Workers’ Compensation Board will either adopt the proposed regulation changes or other provisions dealing with the same subject, without further notice, or decide to take no action. The language of the final regulation may be different from that of the proposed regulation. You should comment during the time allowed if your interests could be affected.

Statutory authority: AS 23.30.005; AS 23.30.097; AS 23.30.098; Statutes being implemented, interpreted, or made specific: AS 23.30.097; AS 23.30.098.  To view the notice, go to https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=191143.

LEGISLATIVE ACTIONS:

• House Bill 126
• The enacted legislation extends workers' compensation protection to Alaska State Defense Force Soldiers during and traveling to and from training exercises. Effective Date November 11, 2018.

Arizona Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published a summary of the insurance laws enacted during the 2018 session. Those laws include:
  • Laws 2018, Chapter 195 (HB 2181): Insurance Adjusters; Application of Laws Amends ARS § 20-321.02, to require an insurance adjuster to keep and make accessible to the Department usual and customary transaction records for at least three years.
  • Laws 2018, Chapter 133 (HB 2107): Pharmacy Benefit Managers; Pricing Creates ARS §§ 44-1751 and 44-1752, to prohibit a pharmacy or a contracted pharmacy benefits manager from:
    • Preventing a pharmacy or pharmacist from, or penalizing a pharmacy or pharmacist for, providing an insured’s individual information about the insured’s cost share or about the clinical efficacy of an available alternative drug.
    • Requiring a pharmacy or pharmacist to sell a more affordable alternative if one is available.
    • Requiring a pharmacy or pharmacist to charge or collect from an insured a copayment that is greater than the total charges submitted by the network pharmacy.

California VIEW STATE →

FEE SCHEDULE NEWS:

• The DWC has adopted the Medi-Cal rates effective August 15, 2018.  The next update is expected September 15, 2018.

REGULATORY ACTIVITY:

• On June 26, the Division of Workers’ Compensation (DWC) adopted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare Physician Fee Schedule payment system’s July 1, 2018 quarterly update.  The June 26 Order included adoption of updates to the National Correct Coding Initiative “Medically Unlikely Edits” (MUE). The MUE edits file sets forth the maximum number of units of service related to a specific procedure that are medically likely to be reported by a treating physician. It serves as a useful screening tool to identify possible billing errors for many procedure codes. However, evaluation of the July 1, 2018 MUE file reveals that many codes are listed as zero value due to Medicare coverage rules that do not apply to the scope of workers’ compensation medical care. For example, acupuncture codes and hearing aid examination codes were added to the file with a value of “zero” because they are not Medicare benefits; however, they are covered services for workers’ compensation patients when medically necessary. The fee schedule regulation provides that the correct coding edits, including the MUE, do not apply where workers’ compensation payment rules differ from Medicare rules. (Title 8, Cal. Code of Regs. § 9789.12.13, subd. (a).) In order to avoid possible confusion and inappropriate denials of bills for medically necessary care, DWC has determined that the codes listed in the MUE with a value of zero should not be included in the MUE file adopted for workers’ compensation. Therefore, the DWC has adopted a revised Physician and Non-Physician Practitioner fee schedule update Order for services rendered on or after July 1, 2018. The revised Order adopts an Excerpt of the MUE file, which deletes codes listed with a zero value.   The exclusion of the zero value codes from the MUE file does not mean that all of the deleted codes are payable. It should be noted that some of the MUE zero value codes would not be payable in workers’ compensation, in particular the codes that are identified as Status Code B (bundled) in the Relative Value Unit File and codes specifically identified in the fee schedule regulation as not payable. (Title 8, Cal. Code of Regs. § 9789.19.) Although the Status Code B bundled codes, and the workers’ compensation “not payable” codes, will not be identified by the MUE, the payer may apply other edits to identify those non-payable codes.  In addition, the Order adopts revisions to conform to current Medicare terminology, as the “Physician CCI Edits” are now entitled “Practitioner PTP Edits.”
  If a medical provider believes a medical bill has been inappropriately denied based upon the application of the MUE, he or she may submit a request for second bill review to the claims administrator.
  The order, revised regulation text and the MUE Excerpt file are effective for services rendered on or after July 1, 2018 and can be found on the DWC website.
• Posted notice in the state register regarding possible actions of the state pharmacy board.  The board proposes to clarify and make specific the standards for pharmacies and pharmacists compounding drug preparations.  The broad objective of this proposal is to ensure that compounding is performed in a manner and under conditions that ensure the compounded drug preparations dispensed to the public by a pharmacy and pharmacist are safe and effective.  The specific benefits anticipated by the proposed amendments are to protect the public from risks of unsafe and or ineffective compounding of drug preparations. Unsafe compounded drug preparations pose risks to patients, including a risk of death. In effect, compounded drug preparations can pose a risk to patients if the patient does not receive the prescribed dose of a medicine. A pharmacist’s expanded ability to extend the BUD for non−sterile compounded drug preparations makes such preparations more accessible, and therefore makes patients healthier by increasing the compliance with a doctor’s directions. It also includes benefits such as the protection of public health and safety, worker safety, the environment, and the increase in openness and transparency in business and government. To view the announcement, go to https://oal.ca.gov/august-2018-notice-registers/.

Colorado Auto VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice regarding receiving informal comment on a proposed permanent rule concerning consumer protection for vehicle valuation and rental reimbursement. The purpose of this regulation is to establish standards for payment of claims for vehicle rental and collision damage waivers, and for valuation of total loss claims under private passenger auto insurance policies. To view the notice, go to https://www.sos.state.co.us.

Delaware VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 202

The enacted legislation ensures that the spouses of those killed in the line of duty are able to receive benefits for the remainder of their lives regardless of future marital status. When a surviving spouse remarries, the surviving spouse's benefit is reduced to 90% of the original benefit for the first 10 years after the remarrying and must be reduced to 75% of the original benefit thereafter until the death of the surviving spouse. Spouses of fallen first responders should not be forced to make decisions to carry on with their lives based on financial considerations. Effective Date June 27, 2018.

Delaware Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published in the state register a final rule by the department of insurance regarding reimbursement of chiropractic services. To view the rule, go to http://regulations.delaware.gov/register/august2018/final/22%20DE%20Reg%20164%2008-01-18.htm.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• 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.
• Posted notice of proposed amendments to 69L-5.217 Civil Penalties and Fines. The proposed rule amendment is intended to reduce the penalty structure for self-insured employers for failing to timely file forms, reports, or documents as required by section 440.38(2)(b), F.S. The proposed changes reflect changes to the penalty structure for self-insured employers. The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency. The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: This rule is being amended to reflect statutory changes and to remedy technical issues.  Any person who wishes to provide information regarding the statement of estimated regulatory costs, or to provide a proposal for a lower cost regulatory alternative, must do so in writing within 21 days of this notice.  Any person who wishes to provide information regarding a statement of estimated regulatory costs or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice. To view the notice, go to https://www.flrules.org/gateway/View_Notice.asp?id=20823007.  To view the current rule, go to https://www.flrules.org/gateway/RuleNo.asp?id=69L-5.217.

Hawaii WC VIEW STATE →

REGULATORY ACTIVITY:

• The list of certified rehabilitation providers is available on the Guidelines page under “Workers’ Compensation.” Click on Certified Rehabilitation Provider List to view the document. To view the list, go to http://labor.hawaii.gov/dcd/forms/guidelines/.

LEGISLATIVE ACTIONS:

• House Bill 1778

Improves access for firefighters to comprehensive medical benefits under the Workers' Compensation Law upon diagnosis of cancer that is presumed to arise out of and in the course of employment. Requires private health care plans to pay for or provide medical care, services, and supplies to injured employees for controverted workers' compensation claims that are accepted or determined to be compensable. Effective Date July 6, 2018.

• House Bill 2375

The enacted legislation permits advanced practice registered nurses to certify an employee's disability. Increases the penalty an employer is assessed for failing to submit timely wage and employment information. Permits filing of an appeal of a decision related to temporary disability insurance at the various offices of the Department of Labor and Industrial Relations throughout the State. Allows the department to send notices of hearing electronically or by first-class mail. Clarifies that when the notice of hearing cannot be delivered to a party in the appeal, the notice may be given by online posting on the department's webpage. Allows the parties to a hearing to appear in person, via telephone, or by other communication devices. Effective Date July 11, 2018.

• Senate Bill 2244

The enacted legislation requires health care providers in the workers' compensation system who are authorized to prescribe opioids to adopt and maintain policies for informed consent to opioid therapy in circumstances that carry elevated risk of dependency. Establishes limits for concurrent opioid and benzodiazepine prescriptions. Effective Date July 11, 2018.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

• Posted an announcement of brown bag discussion regarding Medication Assisted Treatment for Opioid Addiction in Injured Workers.  The discussion is scheduled for Thursday, September 6, 2018 between 12:30 and 2:00 pm. The discussion is being presented by The Idaho Industrial Commission and The Idaho Office of Drug Policy. 
• There is a scam phone call circulating in regard to a workers’ compensation payout. The callers claim to be with the Employees’ Compensation Appeals Board (ECAB) and are requesting payment to receive a claim payout. ECAB is an appellate board and does not pay any monetary benefits directly. For more information on how to report this scam please visit https://www.dol.gov/ecab/welcome.html.
• Issued a policy memorandum of guidance regarding prompt claims servicing.  The later was dated August 15, 2018.  To view the letter, go to https://iic.idaho.gov/.
• Issued a policy memorandum addressing mechanisms available to practitioners seeking suspension or reduction of workers' compensation benefits due to injurious practices. The later was dated August 15, 2018.  To view the letter, go to https://iic.idaho.gov/.

Illinois VIEW STATE →

REGULATORY ACTIVITY:

• The IWCC plans to implement the IAIABC's EDI Claims Release 3.1 XML Standard in the second quarter of 2019.  Draft tables and other information regarding the implementation are being developed and will be shared in the next few months.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of adoption of emergency rules regarding the operation of remote dispensing facilities.  The Indiana Board of Pharmacy temporarily amends 856 IAC 1 to add standards and requirements for the operation of remote dispensing facilities. Statutory authority: IC 25-26-13.5-18.
• The Pharmacy Board also posted notice to temporarily amend 856 IAC 2-2-2 to add synthetic drug compounds to Schedule I. Statutory authority: IC 25-26-13-4.1.

To view both posted notices, go to http://www.in.gov/legislative/iac/irtoc.htm?id=2.4&hdate=20180808&ldate=20180808.

• On Tuesday, August 21, 2018 at 2:30 Eastern, the Indiana Workers’ Compensation Board offered a Claims Release 3.1 EDI for First Report of Injury (FROI) and Subsequent Report of Injury (SROI) Webinar Information Session.
• Posted notice of adoption of an emergency rule which temporarily amends 856 IAC 3 to add requirements for licensure and operation of third party logistics providers. Statutory authority: IC 25-26-14-32. Effective 30 days after filing with the Publisher. The rule becomes effective September 14, 2018.  To view the emergency, go to http://www.in.gov/legislative/iac/20180822-IR-856180362ERA.xml.html.

Kansas VIEW STATE →

REGULATORY ACTIVITY:

• Secretary Gordon approved Troy Larson for the position of KDOL Administrative Law Judge, Workers’ Compensation Division in Lenexa. Larson's nomination was submitted by the Workers’ Compensation and Employment Security Boards Nominating Committee to fill the position previously held by Judge Steven Howard who retired in March after serving 27 years.  Larson worked as a Research Attorney for the Kansas Court of Appeals for two years before practicing law in Kansas City. In private practice, he primarily represented employers and insurers on workers’ compensation claims throughout Kansas and Missouri. Larson is a 2009 graduate of Washburn University School of Law. He and his family reside in Shawnee, Kansas.
• The Department of Insurance published in the state register a notice of changes in pharmacy networks.
• Pursuant to HB 2280, a public hearing was scheduled to 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 was 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). The meeting was canceled and will be rescheduled at a later date.
• The Work Comp Medical Fee Schedule Advisory Panel Meeting was scheduled for Friday, Aug. 24 at 401 SW Topeka Blvd. (Kansas Department of Labor building).

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

• Published the workers' compensation benefit schedule for 2019.  The announcement is dated August 17, 2018. The Education and Workforce Development Cabinet, Office of Employment and Training, has certified that the average weekly wage for Kentucky for calendar year 2017 was $868.47. Based upon that information and in accordance with KRS 342.143, the following determinations are made:
  • The increase in maximum income benefits under all provisions of the Workers' Compensation Act for the year 2017 over the year 2016 did amount to $2.00 or more; therefore, the maximum weekly indemnity benefits for calendar year 2019 shall be $868.47.
  • There was an increase of $1.00 or more in minimum income benefits; therefore, the minimum weekly indemnity benefits, where applicable under the Act, shall be $173.69 for calendar year 2019.

Louisiana VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice that workers' compensation carriers, group funds and self-insurers can pay their assessment on line.  To pay the assessment on, go to https://www.la.egov.com/lwc/owca-assessments; Enter your ID number; Enter the Carrier/Group Fund/Self Insured Employer; Enter the EXACT assessment amount as shown on your invoice; Provide credit/debit card or ACH payment information and Confirmation of secure payment will be provided on screen and by email.  To view the announcement, go to http://www.laworks.net/workerscomp/owc_mainmenu.asp.

Maine VIEW STATE →

FEE SCHEDULE NEWS:

• Maine has adopted new rules that become effective on September 1, 2018.  To view the rules, go to https://www.maine.gov/wcb/rules.html.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• The 2018 MDWCC Prescription Drug study will be available September 4 - October 3, 2018.  Information for completing the online survey is posted to the 2018 Rx Survey page. To view the survey, go to http://www.wcc.state.md.us/Gen_Info/Rx_study_2018.html.
• The 2018 Maryland Workers' Compensation Educational Association (MWCEA) Conference is scheduled for September 23 - 26, 2018. More information is available on their web page http://www.mwcea.com/conference.htm.

Massachusetts VIEW STATE →

REGULATORY ACTIVITY:

• Issued administrative bulletin 18-17 regarding 101 CMR 322.00 Durable medical equipment, oxygen, and respiratory equipment.  The bulletin is effective for services provided on or after July 19, 2018. Under the authority of 101 CMR 01(5), 322.01(6) and 322.03(16), the Executive Office of Health and Human Services (EOHHS) is issuing this bulletin to publish a rate update for certain medical supplies for Durable Medical Equipment. The following code and rate will be effective for services rendered on or after July 19, 2018.  The rate for code A7048 is $46.48 Vacuum drainage collection and tubing kit, including supplies needed for collection unit change, for use with implanted catheter, each.  To view the bulletin, go to https://www.mass.gov/lists/2018-eohhs-administrative-bulletins.
• Pursuant to the provisions of M.G.L. c. 118E and in accordance with M.G.L. c.30A, the Executive Office of Health and Human Services (EOHHS) held a public hearing on Friday, August 17, 2018 at 2:30 p.m. in the First Floor Conference room, 100 Hancock Street, Quincy, MA relative to the adoption of: 101 CMR 334.00:  Prostheses, Prosthetic Devices, and Orthotic Devices.  The proposed regulation 101 CMR 334.00 amends and updates the payment rates for Orthotic and Prosthetic services provided to publicly aided individuals by governmental units. Amendments for 101 CMR 334.00 are proposed in accordance with M.G.L. Chapter 11 SE, sections 13C and 130, which require the Executive Office of Health and Human Services (EOHHS) to establish and periodically review the rates to be paid by governmental units for non-institutional health care services, including Orthotic and Prosthetic services provided under the Mass Health program.
• Pursuant to the provisions of M.G.L. c.  118E and in accordance with M.G.L. c.  30A, the Executive Office of Health and Human Services (EOHHS) held a public hearing on Friday, August 17, 2018, at 1:00 p.m., in the First Floor Conference Room, 100 Hancock Street, Quincy, MA relative to the adoption of: 101 CMR 347.00:  Freestanding Ambulatory Surgery Centers, and the repeal of 114.3 CMR 47.00:  Freestanding Ambulatory Surgical Facilities.  These actions are being taken in order to comply with relevant provisions of M.G.L. c. 11 BE, and with c. 224 of the Acts of 2012 which transferred authority for this regulation from the Division of Health Care Finance and Policy (DHCFP) in M.G.L. c.  118G to the Executive Office of Health and Human Services (EOHHS) in M.G.L. c. 118E.  101 CMR 347.00 will replace 114.3 CMR 47.00 as the regulation governing the rates of payment to be used by state governmental units in making payments to eligible freestanding ambulatory surgery centers (FASCs) rendered to publicly aided individuals.  EOHHS is proposing to adopt 101 CMR 347.00, with amendments from 114.3 CMR 47.00.  Proposed amendments update the payment rates for FASC services included in the regulation. The proposed rates are set at 85% of the national Medicare rates for Ambulatory Surgical Centers published in January 2018 (the "January 2018 Medicare ASC File"). Certain codes listed in the January 2018 Medicare A.SC File are identified as packaged services that receive no separate payment.  Consistent with Medicare, EOHHS is listing those codes in the fee schedule with $0 rates and specifying that codes listed with $0 rates are packaged services for which no separate payment is made.
• Issued bulletin 18-18 regarding 101 CMR 614.00 Health Safety Net Payments and funding, effective October 1, 2018.  To view the bulletin, go to   https://www.mass.gov/lists/2018-eohhs-administrative-bulletins.

Michigan VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted the 2018 Michigan Hospital Cost to Charge Ratios effective August 1, 2018. The next expected hospital rates update is in August 2019.

REGULATORY ACTIVITY:

• The Department of Licensing and Regulatory Affairs, Workers’ Compensation Agency held a public hearing on Friday, August 24, 2018 starting at 10:00 a.m. at the Department of Licensing and Regulatory Affairs, Workers’ Compensation Agency, 2501 Woodlake Circle, Okemos, Michigan to receive public comment on proposed amendments to the Workers’ Compensation Health Care Services rules and fee schedule. The Health Care Services rules are revised in order to provide the Agency’s external customers with updated health care fee schedules for reimbursement to providers for treatment of injured workers and to guide providers and payers on the scope of reimbursement. The following rules of the Michigan Administrative Code are amended: R 418.10106, R 418.10107, R 418.10109, R 418.10117, R 418.10901, R 418.10902, R 418.10904, R 418.10913, R 418.101002, and R 418.101004. These rules are promulgated by authority conferred on the Workers’ Compensation Agency by sections 205 and 315 of 1969 PA 317, section 33 of 1969 PA 306, Executive Reorganization Order Nos. 1982-2, 1986-3, 1990-1, 1996-2, 2003-1, and 2011-4, MCL 205, 418.315, 24.233, 18.24, 418.1, 418.2, 445.2001, 445.2011, and 445.2030.  Rules adopted under these sections will become effective seven days after filing with the Secretary of State. Rule Set 2018-017 LR is published on the state of Michigan website at http://w3.lara.state.mi.us/orr/Rules.aspx?type=dept&id=LR and in the August 15, 2018 issue of the Michigan Register. A copy of the proposed rules may be obtained by contacting Beth VanElls at 517-284-8902 or email at vanellsb@michigan.gov.  Comments on the proposed rules may be presented in person at the public hearing. In addition, written comments will be accepted until 5:00 p.m. on August 24, 2018, at the following address or email: Department of Licensing and Regulatory Affairs Workers’ Compensation Agency-Health Care Services Division ATTN: Beth VanElls 2501 Woodlake Circle Okemos, MI  48864 Email: vanellsb@michigan.gov

Minnesota VIEW STATE →

FEE SCHEDULE NEWS:

• New Medical Fee Conversion factors have been adopted with an effective date of October 1, 2018. The next update is expected for October 2019.

REGULATORY ACTIVITY:

• Exempt rules updated the workers' compensation independent medical examination fees and workers' compensation conversion factors; Minnesota Rules parts 5219.0500 and 5221.4020.  The rules provide the annual adjustments to the maximum workers' compensation independent medical examination fees (IME) as provided in Minnesota Rules 5219.0500 and the workers' compensation conversion factors for the workers' compensation fee schedule as required by Minnesota Statutes 176.136, subd. 1a (c) and (d). The IME fees and conversion factors are adjusted by the percent change in the Producer Price Index for Offices of Physicians for 2017, which was 0.45 percent.

Montana VIEW STATE →

REGULATORY ACTIVITY:

• On August 31, 2018, at 10:00 a.m., the Department of Labor and Industry held a public hearing in conference rooms A and B of the Beck Building, 1805 Prospect Avenue, Helena, Montana. The proposed adoption of two new rules, the amendment of 15 rules and the repeal of 37 rules, all related to workers’ compensation matters were to be discussed.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• The Nebraska Workers' Compensation Court has activated its web-based data entry application for Diagnostic Related Group (DRG) reports. Hospitals and payors may report for themselves, or they may allow a third party to report for them.  To get more information regarding the DRG reports, go to https://www.wcc.ne.gov/programs-products-and-services/drg-reporting
• The Nebraska Workers’ Compensation Court website has been redesigned and relaunched using Google Sites for web pages, Google Forms for dynamic web forms, and Google Blogger for distribution of court news.  To visit the new web site, go to https://www.wcc.ne.gov/.

New Hampshire VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 541

The enacted legislation establishes a prima facie presumption that cancer disease in a firefighter is occupationally related.  Effective Date July 10, 2018.

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

• • Published the 2019 Workers' Compensation Rate. Maximum benefit is $921.00; Minimum benefit is $246.00.  To view the benefit rate announcement, go to https://www.nj.gov/labor/wc/content/stats.html#Benefit-Rates. 
  • Published in their state register notice of administrative correction.   Take notice that the Department of Labor and Workforce Development (Department) discovered an error in the text of N.J.A.C. 12:235-3.8(i). Effective October 5, 2009, the Department adopted the repeal of then-existing N.J.A.C. 12:235-3.14, Enforcement, and replaced it with proposed new N.J.A.C. 12:235-3.16, Enforcement, to enact reforms to the New Jersey Workers' Compensation law (see 41 N.J.R. 1935(a); 3807(a)). As part of this rulemaking, the Department inadvertently neglected to update the existing cross-reference of N.J.A.C. 12:235-3.14 to 3.16 at N.J.A.C. 12:235-3.8(i). 
  • Effective September 1, 2018, and in accordance with N.J.A.C. 12:235-10.5, Director and Chief Judge Wojtenko has appointed E. Richard Boylan, Esq., Joyce A. Parisi, Esq., Hon. Andrew Smith, J.W.C. (retired), Hon. George Pollard, J.W.C. (retired), Marie Rose Bloomer, Esq., Bryce S. Chase, Esq., Julius Feinson, Esq., James C. Knicos, and Mark B. Zirulnik, Esq., to serve as member of the N.J. Division of Workers’ Compensation’s Commission on Judicial Performance. Mr. Boylan shall serve as the Chairperson and Ms. Parisi shall serve as the Vice Chairperson.  Their terms of service shall expire on August 31, 2020.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

• 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.
• The Advisory Council on Workers’ Compensation and Occupational Disease Disablement is interested in different points of view about the workers’ compensation system. Anyone who wishes to speak to the Council may contact the Council’s staff assistant at 841-6052. Meetings are planned in advance and the agenda for each meeting depends on the time available. If you are a person with a disability who needs a special accommodation, please notify the staff.  While the Council’s role is advisory, the Council has authority to appoint members to the panel that approves Independent Medical Examination providers. It otherwise has no authority and cannot make recommendations on individual cases.
• The Advisory Council on Workers' Compensation and Occupational Disease and Disablement will meet for a round table discussion on September 18, 2018 at 9:30 a.m. at the WCA main office, 2410 Centre SE. The public is invited.
• 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, the WCA is conducting security audits nightly, making Electronic Case Filing (ECF), WEB-EDI, and the Inpatient applications temporarily unavailable during these security checks.  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.

Again, these closure periods are temporary. We hope to complete security audits and reopen full access within a few weeks. We apologize for any inconvenience and appreciate your cooperation as we conduct these necessary security audits.”

New York VIEW STATE →

FEE SCHEDULE NEWS:

• The State has adopted new changes to the DME fee schedule effective September 1, 2018.

REGULATORY ACTIVITY:

• Published Bulletin Subject No 187-1 regarding the 2019 Legal Holidays and Board Closures for 2019.  To view the notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn187_1_2019.jsp.
• Effective August 1, 2018, the New York State Workers’ Compensation Board is rescinding the designation of ICE Exams, Inc. as an entity registered to derive income from independent medical examinations in workers’ compensation cases. This rescission is made pursuant to Section 13-n of the Workers’ Compensation Law and 12 NYCRR §300.2(e)(6)(iv). Pursuant to 12 NYCRR § 300.2(e)(6)(ii)(a)(3), ICE Exams, Inc.’s name shall be removed from the list of registered entities effective August 1, 2018. This rescission is permanent. The entity’s address is: 1 Oakland Street; Mansfield, MA 02048. On the effective date of this rescission, the entity named above is permanently prohibited from deriving income from independent medical examinations in workers’ compensation cases. Examinations conducted prior to August 1, 2018 are valid. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.
• Effective August 1, 2018, the New York State Workers’ Compensation Board is rescinding the designation of Aimes Enterprises, Inc. as an entity registered to derive income from independent medical examinations in workers’ compensation cases. This rescission is made pursuant to Section 13-n of the Workers’ Compensation Law and 12 NYCRR §300.2(e)(6)(iv). Pursuant to 12 NYCRR § 300.2(e)(6)(ii)(a)(3), Aimes Enterprises, Inc.’s name shall be removed from the list of registered entities effective August 1, 2018. This rescission is permanent. The entity’s address is: 73-26 Yellowstone Blvd., Suite 26C Forest Hills, New York 11375. On the effective date of this rescission, the entity named above is permanently prohibited from deriving income from independent medical examinations in workers’ compensation cases. Examinations conducted prior to August 1, 2018 are valid. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.

LEGISLATIVE ACTIONS:

• Senate Bill 08929

The enacted legislation extends workers' compensation coverage to certain TNC drivers including a TNC driver that is logged onto a TNC digital network and is not engaged in a TNC prearranged trip but is engaged in an activity reasonably related to driving as a TNC drive.  Effective Date July 10, 2018.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• The Industrial Commission intends to amend the rules cited as 11 NCAC 23A .0101-.0103, .0108, .0302, .0411, .0503, .0602, .0603, .0608, .0609A-.0611, and repeal the rule cited as 11 NCAC 23A .0618.  Pursuant to G.S. 150B-21.17, the Codifier has determined it impractical to publish the text of rules proposed for repeal unless the agency requests otherwise.  The text of the rule(s) is available on the OAH website at http://reports.oah.state.nc.us/ncac.asp. Link to agency website pursuant to G.S. 150B-19.1(c):  http://www.ic.nc.gov/proposed11NCAC23AGroup1Rules.html; Proposed Effective Date:  December 1, 2018. Oral comments on the proposed rule amendments and repeal may be made at the Public Hearing before the Industrial Commission: Date:  September 26, 2018 Time:  2:00 p.m. Location:  Room 245, 2nd Floor, Department of Insurance, Albemarle Building, 325 North Salisbury Street, Raleigh, NC 27603. Written comments on the proposed rule amendments and repeal may be submitted to:  Ashley B. Snyder, 1233 Mail Service Center, Raleigh, NC 27699-1233; phone (919) 807-2524; email snyder@ic.nc.gov. Comment period ends:  October 15, 2018. Reason for Proposed Action:  On its own initiative, the Industrial Commission ("Commission") conducted an internal review of its rules and sought informal stakeholder feedback.  The proposed amendments reflect changes the Commission felt were necessary to clarify the rules, provide for increased efficiency, or update the rules to reflect current practices. The Industrial Commission proposes to repeal Rule 11 NCAC 23A .0618 because it is unnecessary.  Pursuant to G.S. 97-78.1 the Code of Judicial Conduct applies to Commissioners and Deputy Commissioners.  Since the Code of Judicial Conduct governs disqualifications and recusals, the rule is repetitive. Procedure for Subjecting a Proposed Rule to Legislative Review: If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.   
• Effective August 16, 2018, Governor Roy Cooper appointed A. Robinson "Robby" Hassell as a Commissioner of the North Carolina Industrial Commission on an urgent basis, pending confirmation by the General Assembly. Before his appointment as Commissioner, Hassell served as an Emergency Superior Court Judge. Robby Hassell received his B.A. in Political Science and Economics from the University of North Carolina at Chapel Hill and his law degree from the University of North Carolina School of Law. Governor Cooper appointed Hassell to the seat of former Commissioner Tammy R. Nance.

LEGISLATIVE ACTIONS:

• House Bill 995

The enacted legislation amends the workers’ compensation act to exempt the city of Winston-Salem from the definition of a third party administrator.  Effective Date June 29, 2018.

North Dakota VIEW STATE →

REGULATORY ACTIVITY:

• Effective September 1, 2018, WSI will require prior authorization for non-emergent air transportation services, see North Dakota Administrative Code 92-01-02-34.5(e). To request prior authorization, a provider must complete the Non-Emergent Air Ambulance Facility-to-Facility Request form and submit to WSI along with supporting medical documentation. WSI will notify the requesting provider of the authorization status within 24-hours, or by the end of the next business day. To facilitate safe and cost-effective air transportation for injured workers, WSI has established Memorandums of Understanding (MOUs) with several air transportation companies. Companies with current MOUs include Bismarck Air Medical, Trinity Health System, and TravelAire. It is WSI's expectation a provider will utilize these companies for non-emergent air transportation services. If you have questions about this article, please send an email to wsipr@nd.gov.
• Effective October 1, 2018, WSI will implement a change to the window period allowed in the existing chiropractic pilot program. The pilot program currently requires a chiropractor to obtain authorization for all chiropractic treatment extending beyond the initial 6 visits.  Based on pilot program analysis and provider feedback, WSI will alter the program to extend the window period from 6 visits to 10 visits.
• WSI defines the window period as a period of initial chiropractic treatment on a claim not requiring prior authorization.  For initial treatment with a date of service on or after October 1, 2018, each claim will have one window period, which will include:
  • 10 visits or 60 days of care, whichever comes first, including initial evaluation
  • Treatment of all body parts accepted on a claim
  • Up to two modalities per visit

For treatment occurring outside the window period, a chiropractor will need to complete the Utilization Review Chiropractic (UR-Chiro) form.  For window periods beginning prior to October 1, all treatment provided after the sixth visit will require prior authorization. For window periods beginning on or after October 1, all treatment provided after the tenth visit will require prior authorization. WSI will continue to require prior authorization for all palliative care. If you have questions about this article, please send an email to wsipr@nd.gov.  To view this announcement, go to http://www.workforcesafety.com/news/news-item/change-to-chiropractic-window-period.  A copy of the form is attached.

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

• Important Instructions: Click the Affidavit of Exempt Status button on the Oklahoma web site https://ok.gov/wcc/  to access the electronic affidavit form.  The form is listed under OTHER SERVICES on the Case OK website  https://caseok.wcc.ok.gov/public. Please note the Workers' Compensation Commission will not accept checks for the Affidavit of Exempt Status Fee.
• Published an alert pertaining to electronic data interchange.  Per Commission Rule 810:1-1-8, the Commission’s reporting scheme will shift to electronic data interchange (EDI) beginning September 1, 2018.  All reporting requirements will be defined by the aforementioned rule, the Commission’s EDI Implementation Guide, and the Commission’s IAIABC requirements tables, published at https:\\okwccedi.info.  As of September 1, the following paper forms will no longer be accepted:  CC-Form-2; CC-Form-4; CC-Form-2A; CC-Form-2A Extension. Impact of EDI on the Joint Petition Process: Parties looking to do unrepresented settlements will likely no longer be able to complete same-day filings in many instances, as the Commission’s vendor, ISO, will process a particular day’s filings no earlier than the next business day.  For this reason, it will be most convenient for parties looking to file joint petitions to ensure that a First Report of Injury (FROI) has already been filed at least one business day in advance of the intended settlement date, or to have the claimant complete a CC-Form-3, in order to perfect the settlement process. Trading Partner Registration: Many trading partners (i.e., those responsible for reporting) have chosen vendors to help them fulfill their reporting requirements, while others have registered independently as trading partners.  Any entity intending to file directly must register as a trading partner at https:\\okwccedi.info.  If contracting with a vendor, an employer or carrier still needs to register as a trading partner, but the vendor may be willing to assist in this process.  Any insurer/self-insurer using a TPA will not have to register, as the TPA should have registered on its behalf.  The separate trading partner agreement required by Oklahoma statute should be signed and returned to ISO by every trading partner, otherwise the trading partner agreement will be inactivated, and the trading partner will be unable to send transactions.  Any questions can be directed to me or to our EDI team at ISO.   ISO: okwccedi@iso.com

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• 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.  The bulletin and form became effective July 26, 2018.
• Published revised bulletin 124 effective July 30, 2018.  The bulletin provides forms, examples, checklists, and a chart for insurers and vocational assistance providers to use under Oregon Administrative Rules (OAR) 436-120. The bulletin also provides the cost-of-living matrix and fee schedule for vocational assistance expenditures. This bulletin is revised because of changes to the rules, effective Aug. 1, 2018. This bulletin replaces Bulletin 124 dated March 15, 2018, and the addendum dated May 22, 2018.  To view the bulletin and forms, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• The July issue of Board News and Case Notes is now available.  To view the July Issue, go to https://www.oregon.gov/wcb/Pages/news-notes.aspx.
• The Workers’ Compensation Division of the Department of Consumer and Business Services received notification of 35 compensable fatalities in 2017. The 2017 compensable fatality characteristics brochure is now available with information on the event of injury, source of injury, occupation, industry, tenure and other claimant characteristics.  To view the report, go to https://www.oregon.gov/dcbs/reports/protection/Pages/index.aspx.
• Issued Bulletin 345 regarding Employer-reimbursed medical service costs. This bulletin instructs insurers and self-insured employers how to apply employer-reimbursed medical service costs for individual claims and provides updated maximum reimbursement amounts. This bulletin replaces Bulletin No. 345 dated Aug. 24, 2017.   The effective date for the bulletin is January 1, 2019.  To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.

Pennsylvania WC VIEW STATE →

REGULATORY ACTIVITY:

• On Monday, July 16, 2018, the Wolf Administration introduced opioid prescribing guidelines for workers’ compensation to help healthcare providers determine when opioids are appropriate for treatment of someone injured on the job.  For additional information, go to https://www.dli.pa.gov/Businesses/Compensation/WC/Pages/default.aspx.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• The state has published the 2018 Medical Fee Schedule with an effective date of October 1, 2018. A new update is expected in October 2019.

REGULATORY ACTIVITY:

• Please be advised that a meeting of the Rhode Island Workers’ Compensation Court Medical Advisory Board has been scheduled for Tuesday, September 18, 2018, 6:00 p.m., Workers’ Compensation Court Room 4M, One Dorrance Plaza, Providence, Rhode Island.  Entrance to the building at this hour is through the rear personnel doors.  Attendees may be asked to sign in. To view the notice, go to https://www.courts.ri.gov/Courts/workerscompensationcourt/MedicalAdvisoryBoard/Pages/default.aspx.

South Dakota VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 1029

The enacted legislation increased certain fees for self-insured employers. Effective June 1, 2018.

• Senate Bill 141

The enacted legislation established a new section that sets forth that a pharmacy benefits manager may neither prohibit nor penalize a pharmacist or pharmacy for providing cost-sharing information on the amount a covered individual ma pay for a particular prescription drug. The legislation also establishes that the following acts or practices by a pharmacy benefits manager are declared to be false, misleading, deceptive or unfair: prohibiting a pharmacist or pharmacy for providing cost-sharing information on the amount that a covered individual may pay for a particular prescription drug by a pharmacist or pharmacy, or penalizing a pharmacist or pharmacy for providing cost-sharing information that a covered individual may pay for a particular prescription drug by a pharmacist or pharmacy.   Effective Date May 27, 2018.

Tennessee VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 1652; Senate Bill 1544

The enacted legislation extends the medical advisory committee for six years to June 30, 2024.  Effective Date February 22, 2018.

• House Bill 1653; Senate Bill 1545

The enacted legislation extends the medical payment committee for six years to June 30, 2024.  Effective Date February 22, 2018.

Texas VIEW STATE →

REGULATORY ACTIVITY:

• The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) asks for input on the development of a Neuromuscular Testing Referrals Plan-Based Audit.  The audit will assess if a health care provider’s decision to order neuromuscular testing was appropriate, medically necessary, and supported by recordkeeping. The audit sets the scope, methodology, selection standards, and program area duties as laid out in the Medical Quality Review Process. A copy of the proposed audit is available on the TDI website at tdi.texas.gov/wc/hcprovider/medadvisor.html.  The Medical Advisor approved a Neuromuscular Testing Referrals Plan-Based Audit plan as part of the CY 2018 Medical Quality Review Annual Audit Plan, which is available on the TDI website at http://www.tdi.texas.gov/wc/hcprovider/documents/auditplan18.pdf.
• On July 26, 2018, Commissioner of Workers’ Compensation Cassie Brown adopted the repeal of 28 TAC §108.1, Charges for Copies of Public Information. The adoption was filed with the Office of the Secretary of State on August 13, 2018. The adoption was published in the August 24, 2018, issue of the Texas Register and may be viewed on the Secretary of State website at sos.state.tx.us/texreg/index.shtml. A courtesy copy of the adoption is available on the Texas Department of Insurance website at www.tdi.texas.gov/wc/rules/2018rules.html.  The repeal of 28 TAC §108.1 is necessary because other statutes and rules currently govern charges for public information.   To view notice as published in the Texas Register, go to http://www.sos.state.tx.us/texreg/archive/August242018/Adopted%20Rules/28.INSURANCE.html#95

Utah No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Issued Bulletin 2018-04 regarding premium increases prohibited for certain claims or inquiries.  Published August 14, 2018.  To view the bulletin, go to https://insurance.utah.gov/consumer/legal-resources/bulletins.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

• Published a notice of review and statement of continuation regarding rule R602-4 Procedures for termination of temporary total disability compensation pursuant to reemployment under section 34A-2-410.5. Subsection 34A-1-104(1) and Section 34A-1-304 authorize the Labor Commission (Commission) to adopt rules and conduct adjudicative proceedings relating to the administration of the Utah Workers' Compensation Act (Act).  Section 34A-2-41.5 of the Act provides a means for an employer or its insurance carrier to request the Commission's permission to reduce or terminate an injured worker's temporary total disability compensation.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish rules that govern the adjudication of such a request.  Also posted same for R602-5 regarding Procedures for Resolving Disputes Regarding "Cooperation" and "Diligent Pursuit" Under Subsection 34A-2- 413(6)(e)(iii) and Subsection 34A-2- 413(9) Consistent with Utah Administrative Code Subsection R612-200-7(D)(4). Subsection 34A-1-104(1) and Section    34A-1-304    authorize    the    Labor    Commission (Commission) to adopt rules and conduct adjudicative proceedings   relating   to   the administration of   the   Utah Workers' Compensation Act (Act).  Subsection 34A-2-413(6) (c)(iii) of the Act requires an administrative law judge to issue a decision on a claim for permanent total disability benefits based on an employer's failure to pursue a reemployment plan.  Subsection 34A-2-413(9) of the act requires an administrative law judge to dismiss a claim for permanent total disability benefits based on an employee's failure to cooperate with an approved reemployment plan.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish procedural requirements for hearings   related to an employer’s failure to pursue a reemployment plan or an employee's failure to cooperate with a reemployment plan.  Also posted for same was R602-6 regarding Subsection 34A-1-104(1) and Section    34A-1-304    authorize    the    Labor    Commission (Commission) to   adopt   rules   and   conduct   adjudicative proceedings   relating   to   the administration of   the   Utah Workers' Compensation Act.   Section 34A-2-420 of the Act requires   the   Commission   to   review   all   settlement   or commutation agreements for workers' compensation claims or occupational disease benefits.  It also grants the Commission the discretion to approve such agreements.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish the procedural requirements for Commission approval of these agreements. To view the posting, go to https://rules.utah.gov/publications/utah-state-bull/.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

• The proposed Vermont Workers’ Compensation and Occupational Disease Rules 1-27 have been filed with the Secretary of State’s office.  The rules as proposed can be found at the following link:  http://labor.vermont.gov/legal-information/proposed-rules/

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice in the state register of intended regulatory action.  Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Pharmacy intends to consider amending 18VAC110-20, Regulations Governing the Practice of Pharmacy. The purpose of the proposed action is to regulate brown bagging of drugs requiring reconstitution or compounding prior to administration and to set specific requirements for specialty pharmacies participating in white bagging. The intent of the regulatory action is to ensure drugs are appropriately dispensed and administered. The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.  Statutory Authority: §§ 54.1-2400 and 54.1-3307 of the Code of Virginia. Public Comment Deadline: September 5, 2018. Agency Contact: Caroline Juran, RPh, Executive Director, Board of Pharmacy, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4456, FAX (804) 527-4472, or email caroline.juran@dhp.virginia.gov.  To view the notice, go to http://register.dls.virginia.gov/details.aspx?id=6991.
• Posted final regulation for the practice of pharmacy. The amendments (i) add eight compounds into Schedule I of the Drug Control Act as recommended by the Virginia Department of Forensic Science pursuant to § 54.1-3443 of the Code of Virginia, which will remain in effect for 18 months or until the compounds are placed in Schedule I by legislative action of the General Assembly; and (ii) add one drug to Schedule I, add one drug to Schedule II, and remove one drug from Schedule II to conform Virginia's Drug Control Act with federal law.  To view the final notice and regulation, go to http://register.dls.virginia.gov/details.aspx?id=7006.   The regulation becomes effective September 5. 2018.
• The regulatory advisory panel appointed by the Virginia Workers’ Compensation Commission has been charged with reviewing several issues related to workers’ compensation. One issue being reviewed and studied centers on attorney’s fees paid to claimant attorneys when they assist in obtaining payment for health care services in a case where the employer or insurance carrier has denied liability. These attorney’s fees are commonly referred to as “714” fees as that references the statute number that authorizes their payment under the workers’ compensation act. There are no current means to track the amount of 714 fees that are paid by providers. Often a claimant’s attorney will contact a provider and negotiate the amount of the fees. Some fee amounts are rumored to be as low as 15% of the provider’s bill recovered to as high as 40%. While the Workers’ Compensation Commission has authority to adjudicate disputes over 714 fees, rarely are they called upon to do so. The regulatory advisory panel asked the VHHA and MSV to survey providers to gather data on 714 fees, their frequency and amounts. DISCLAIMER: This survey was developed by the Medical Fee Schedule Regulatory Advisory Panel Members. The Virginia Workers’ Compensation Commission is placing this survey on its website as a courtesy to the Panel so that the public is aware of it.

Virginia Auto VIEW STATE →

REGULATORY ACTIVITY:

• Issued administrative order 12065.  Effective October 1, 2018 - AIPSO Filing VA 18-01 files ISO’s 2013 Division One Commercial Business Auto Forms, Virginia Exclusions Auto Dealers Endorsement, AP 72 51 and corresponding rating rules. The Filing also amends the Virginia Changes- Cancellation and Nonrenewal Endorsement, AP 30 17, to reference Auto Dealers. To view the order, go to https://www.scc.virginia.gov/boi/adminords/2018.aspx.

Washington VIEW STATE →

REGULATORY ACTIVITY:

• Pursuant to RCW 39.12.015, 39.12.020 and WAC 296-127-011, on August 1, 2018, the industrial statistician will determine and publish on the internet the statewide prevailing rates of wage. These rates become effective thirty days from publication on August 31, 2018. For more information on prevailing wage or a copy of the rates please visit our web site at www.lni.wa.gov/TradesLicensing/PrevailingWage/ or call 360-902-5335.
• Posted notice of a new rule regarding Presumptive PTSD Coverage (Chapter 296-14 WAC, WAC 296-14-300, 296-14-310).  The purpose of this rulemaking is to consider amending WACs 296-14-300 and 296-14-310 and creating a new rule in chapter 296-14 WAC due to recently passed legislation. This legislation passed during the 2018 session (Chapter 264, Laws of 2018, Substitute Senate Bill 6214), resulted in updates to RCWs 51.08.142 and 51.32.185 and the addition of a new chapter to 51.08 RCW. The amended law provides a prima facie presumption for certain fire fighters, law enforcement officers, and emergency medical technicians covered under workers’ compensation.  To view the rule, go to: http://www.lni.wa.gov/LawRule/WhatsNew/Proposed/default.asp.
• Published a new coverage decision regarding Therapeutic genicular nerve blocks for chronic knee pain.  Coverage decision: Not Covered (Effective date: October 1, 2018). Genicular nerve block for treating chronic knee pain is not a covered benefit. The knee joint is innervated by the articular branches of several nerves including the femoral, common peroneal, saphenous, tibial and obturator nerves. These articular branches around the knee joint are known as genicular nerves. Genicular nerve block for treating chronic knee pain is controversial. The effectiveness of the procedure on relieving chronic knee pain is not established. The safety of repetitive anesthetic/steroid injections to the genicular nerves is unproven.  To view the decision, go to http://www.lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/TherapeuticGenicularblock.asp?utm_medium=email&utm_source=govdelivery.

West Virginia VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 4628

The enacted legislation amends and reenacts Section 23-2C-3 of the Code of West Virginia, 1931. The amendment relates to authorizing the redirection of amounts collected from certain surcharges and assessments on workers’ compensation insurance policies for periods prior to January 1, 2019.  It terminates the surcharges and assessments after December 31, 2018 and terminates the provisions of the section beginning on and after January 1, 2019.  Effective Date June 7, 2018.

• Senate Bill 46

The enacted legislation amends the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §33-51-9, relating to pharmacy benefit managers; providing that a pharmacy, pharmacist, or pharmacy technician may inform consumers of lower cost alternatives and cost share to assist health care consumers in making informed decisions; prohibiting pharmacy  benefit  managers  from  penalizing  a  pharmacy,  pharmacist,  or  pharmacy technician for discussing certain information with consumers; prohibiting pharmacy benefit managers  from  collecting  cost  shares  exceeding  the  total  submitted  charges  by  a pharmacy, pharmacist, or pharmacy technician; setting forth limitations on pharmacy benefit  managers  when  charging  certain  adjudicated  claim  fees  to  a  pharmacy, pharmacist, or pharmacy technician; and excluding an employee benefit plan under the Employee Retirement Income Security Act of 1974 or Medicare Part D from this code section. Effective Date June 8, 2018.

Wisconsin VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of order of adoption revised rule 65 regarding Vocational Rehabilitation.  The adopted rule becomes effective August 1, 2018. To view a copy of the adopted rule, go to http://docs.legis.wisconsin.gov/code/register/2018/751B/register/final/cr_18_013_rule_text/cr_18_013_rule_text.
• Posted notice of a hearing regarding changes to Wis. Admin. Code Ch. HA 4 concerning the rules of procedure for adjudication of worker’s compensation and related claims.  To view a copy of the notice and rule text, go to http://docs.legis.wisconsin.gov/code/register/2018/752A1/register/rule_notices/cr_18_059_hearing_information.

LEGISLATIVE ACTIONS:

• Senate Bill 781

The enacted legislation eliminates the right of action in tort by an injured employee against certain third parties by reason of the injury if the injured employee has the right to make a claim for compensation against his or her employer under the workers’ compensation law. Under current law, workers’ compensation is the exclusive remedy for an employee who is injured while performing services growing out of and incidental to his or her employment, except that, subject to certain exceptions, an injured employee may claim workers’ compensation from his or her employer and bring an action in tort against a third party for damages by reason of the injury.  Current law also provides that certain specified types of employee are prohibited from making claims against certain third parties, such as a “temporary help agency” or “employee leasing company,” if the injured employee makes a claim for compensation under the workers’ compensation law. The enacted legislation prohibits an injured employee from maintaining an action in tort against certain third parties, specified under current law, regardless of whether the employee makes a claim for compensation under the workers’ compensation law against his or her employer.  For example, an injured employee of a temporary help agency engaged in work for the employer to which the employee is placed or leased may not maintain a tort action against the employer to which the employee is placed or leased if the employee has the right to make a claim for compensation under the workers’ compensation law. Effective Date March 2, 2018.

Wyoming VIEW STATE →

REGULATORY ACTIVITY:

• Workers' Compensation Medical Providers Wyoming Workers' Compensation will be using a new medical billing review vendor, Medata, beginning September 12. The change will primarily affect the billing process for health care providers. To learn more about Medata, go to  https://www.medata.com/. Health care providers with questions regarding medical billing may contact Medata via email at providerinquiry@medata.com, or via phone at (877) 479-3817.