Alaska VIEW STATE →

REGULATORY ACTIVITY:

• The Alaska Workers' Compensation Board and Medical Services Review Committee will conduct a special joint meeting of the full board and MSRC, Friday, August 23, 2019. This meeting is open to the public, and will begin at 10:00am. The meeting will be held at the following location: Department of Labor Building, 3301 Eagle Street, Hearing Room 208, Anchorage, Alaska. The purpose of this special meeting is to discuss and make recommendations relating to Alaska medical fee schedule regulations. The Board will also conduct other business as necessary and useful. The public may attend these meetings in person or telephonically by calling 800-315-6338 and entering access code 92019 when prompted for the participant pin code. Public comment will be taken in person or telephonically from 10:45AM to 11:45AM on August 23, 2019 and might be extended to accommodate those present before 10:45AM who did not have an opportunity to comment.  To participate telephonically, call 800-315-6338, access code 92019. Individuals or groups of people with disabilities, who require special accommodations, should contact Alexis Newman at (907) 465-6059 or alexis.newman@alaska.gov by 4:30PM, Friday, August 16, 2019. Please provide advance notice in order for the Department of Labor and Workforce Development to accommodate your needs. For additional information regarding this meeting, please contact the Division of Workers' Compensation at 465-2790. To view this notice, go to https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194956

California VIEW STATE →

FEE SCHEDULE NEWS:

• The DWC has published a new file for Medi-Cal rates effective July 15, 2019. The next update is expected August 15, 2019.
• The DWC has adopted a new Pathology and Clinical Laboratory Schedule to conform to changes in the Medicare payment system with an effective date of July 1, 2019

REGULATORY ACTIVITY:

• The Division of Workers’ Compensation (DWC) held a meeting of the  Pharmacy and Therapeutics (P&T) Committee on Wednesday, July 24 from 12:30 to 2:30 p.m. in the Elihu M. Harris State Building, conference room #11 on the second floor, 1515 Clay Street in Oakland. The meeting was open to the public. The Pharmacy and Therapeutics Committee was established by Assembly Bill 1124 (2015) as an advisory body that will consult with the DWC Administrative Director on updates to the Medical Treatment Utilization Schedule (MTUS) Drug Formulary.
• The Division of Workers’ Compensation (DWC) Administrative Director George Parisotto has issued an order updating the Medical Treatment Utilization Schedule (MTUS) Drug List effective August 1, 2019 pursuant to Labor Code section 5307.29.  The Administrative Director’s update order adopts changes to the MTUS Drug List, based on the American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines, including the following: 
  • New drug recommendations addressed in the Post-Traumatic Stress Disorder Guideline
  • Designation of additional drugs as “special fill” eligible, due to treatment recommendation in the Post-Traumatic Stress Disorder Guideline
  • Deletion of codeine phosphate from the MTUS Drug List
  • New drug recommendations pertaining to diclofenac sodium and divalproex sodium.
• The updated MTUS Drug List v.5 and the Administrative Director order can be accessed on the DWC MTUS drug formulary web page at https://www.dir.ca.gov/dwc/MTUS/MTUS-Formulary-Orders.html. Questions and comments can be directed to Formulary@dir.ca.gov.
• The Division of Workers’ Compensation (DWC) is now accepting applications for the Qualified Medical Evaluator (QME) examination on October 19. 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 5, 2019.  For more information please contact the Medical Unit at 510-286-3700 or by email at QMETest@dir.ca.gov.
• The Division of Workers’ Compensation (DWC) has posted an order adopting regulations to update the evidence-based treatment guidelines of the Medical Treatment Utilization Schedule (MTUS). The updates, effective for medical treatment services rendered on or after August 11, 2019, incorporate by reference the American College of Occupational and Environmental Medicine’s (ACOEM’s) most recent treatment guidelines to the Clinical Topics section of the MTUS.   The ACOEM guidelines that are incorporated by reference into the MTUS are:
  • Low Back Disorders Guideline (ACOEM March 7, 2019)
  • Introduction to the Workplace Mental Health Guideline (ACOEM March 13, 2019).
• The administrative order consists of the order and two addenda: 
• • • Addendum one shows the regulatory amendments directly related to the evidence-based updates to the MTUS.
    • Addendum two contains hyperlinks to the updated ACOEM guidelines adopted and incorporated into the MTUS by reference.
• Health care providers treating, evaluating (QME), or reviewing (UR or IMR) in the California workers’ compensation system may access the MTUS (ACOEM) Guidelines and MTUS Drug List at no cost by registering for an account.  To view the order regulations and guidelines, go to https://www.dir.ca.gov/dwc/DWCPropRegs/MTUS-Evidence-Based-Updates-April2019/MTUS-Evidence-Based-Updates.htm.  The guidelines are effective for services provided on or after August 11, 2019.

• The Division of Workers’ Compensation (DWC) has issued a notice of public hearing for proposed evidence-based updates to the Medical Treatment Utilization Schedule (MTUS), which can be found at California Code of Regulations, title 8, section 9792.23. The public hearing is scheduled for Monday, August 26 at 11 a.m. in the auditorium of the Elihu Harris Building, 1515 Clay Street, Oakland. Members of the public may review and comment on the proposed updates no later than August 26. The proposed evidence-based updates to the MTUS incorporate by reference the latest published guideline from American College of Occupational and Environmental Medicine (ACOEM) for the Hip and Groin Disorders Guideline (ACOEM April 24, 2019).  The proposed evidence-based updates to the MTUS regulations are exempt from Labor Code sections 5307.3 and 5307.4 and the rulemaking provisions of the Administrative Procedure Act. However, DWC is required under Labor Code section 5307.27 to have a 30-day public comment period, hold a public hearing, respond to all the comments received during the public comment period and publish the order adopting the updates online.  To view the notice, proposed regulation and guideline, go to https://www.dir.ca.gov/dwc/DWCPropRegs/MTUS-Evidence-Based-Updates-August2019/MTUS-Evidence-Based-Updates.htm.
• The Division of Workers’ Compensation (DWC) has posted the 2018 ethics advisory committee's annual report on its website. The Workers’ Compensation Ethics Advisory Committee is a state committee independent from the DWC that is charged with reviewing and monitoring complaints of misconduct filed against workers’ compensation administrative law judges. The ethics advisory committee is required to make a public report each year summarizing activities in the previous calendar year. The 2018 annual report may be viewed or downloaded at the DWC website.

Colorado VIEW STATE →

REGULATORY ACTIVITY:

• Posted the legislative update for 2019 regarding legislation enacted during the 2019 calendar year.  To view the legislative update, go to https://www.colorado.gov.
• Notice is given of a public hearing to afford all interested persons an opportunity to be heard prior to the adoption of proposed amendments to the Workers’ Compensation Rules of Procedure, 7 C.C.R. 1101-3 as described below.  The Director of the Division of Workers’ Compensation has the authority to promulgate rules pursuant to the Workers’ Compensation Act as set forth in section §8-47-107.  Date and Time of Hearing: September 4, 2019 10:00 a.m.  Place of Hearing:   633 17th Street      Denver, CO. The public hearing will be held in accordance with the provisions of the Colorado Administrative Procedures Act, section 24-4-103, CRS.  Any interested party is invited to appear at the hearing and testify or to submit written data, arguments or position papers to Paul Tauriello, Director, Division of Workers’ Compensation, 633 17th Street, Suite 400, Denver, CO 80202.  Any written submissions should be submitted to the Director prior to the hearing.  The topics to be considered are:  Rule 16: Utilization Standards Rule and 18: Medical Fee Schedule.  The proposed rule changes will be available at the Department’s website on or before July 24, 2019.  Copies of the proposed rules will also be available by request at the Division’s Customer Service Office, 633 17th Street, 4th Floor, Denver, Colorado.  To view the notice and copy of the rules under consideration, go to https://www.colorado.gov/pacific/cdle/workers-compensation-proposed-and-adopted-rules. 

Colorado Auto VIEW STATE →

REGULATORY ACTIVITY:

Posted notice in the state register concerning amendments to Regulation 5-2-12 regarding automobile insurance consumer protections.  To view the posted rule, go to https://www.sos.state.co.us/CCR/RegisterContents.do?publicationDay=07/10/2019&Volume=42&yearPublishNumber=13&Month=7&Year=2019

Connecticut VIEW STATE →

FEE SCHEDULE NEWS:

• The new Official Connecticut Practitioner Fee Schedule has been adopted with an effective date of July 15, 2019. The next update is expected July 15, 2020.

REGULATORY ACTIVITY:

• Published memorandum number 2019-03 regarding utilization review. From the Chairman: As I’m sure you are aware, the use of utilization review within the confines of an approved medical care plan is permitted by the Workers’ Compensation Commission pursuant to the regulations established within Administrative Regulation Sec. 31-279-10. Outside the confines of a medical care plan, while there is no explicit prohibition on utilization review, the outcome is not binding, and the Commission is not held to an “arbitrary and capricious” standard to overturn a decision. It is, in these cases, the commissioner who makes the final determination as to the reasonableness and necessity of medical treatment. It has been brought to my attention that utilization review is being used more and more frequently outside of medical care plans. The entities performing these reviews are not holding to the timelines and standards established by the regulations yet seem to be placing expectations on both claimants and providers that they need to follow the appeal timelines and regulations that they have set. In the absence of a medical care plan, the claimant can simply take an adverse ruling by utilization review to a hearing and have a commissioner determine the reasonableness and necessity of the treatment in question. The extensive use of UR outside of medical care plans is causing unnecessary delays in medical treatment for claimants and placing unacceptable burdens on medical providers. As the providers are led to believe that they must follow UR companies’ appeals processes, they are forced to participate in peer-to-peer reviews as well as submit additional documentation in order to appeal adverse decisions within the timelines established by said entities. I am aware that many payers use third party vendors to perform their utilization review. It has been, and continues to be, the Commission’s policy that the payer is the party responsible for ensuring the timely and accurate processing of Workers’ Compensation claims. Should you choose to use a third-party vendor for your utilization review needs, the onus is on you to ensure that the vendor is aware of the Workers’ Compensation guidelines surrounding utilization review. In order that all parties may respond to an UR decision appropriately, payers MUST advise all parties, in particular medical providers, if the UR is not binding as there is no medical care plan in place. In short, it is imperative that payers review their utilization review policies and procedures to ensure that they remain in line with the guidelines established by the Workers’ Compensation Commission. In cases where there is no medical care plan in place, subjecting claimants to unnecessary UR and holding them to arbitrary time frames and appeals processes that delay treatment may subject the payer to fines and sanctions for undue delay. Should you require any additional information on this matter, please feel free to contact my office.  To view the memorandum, go to https://wcc.state.ct.us/memos/2019/2019-06.htm.
• Connecticut published bulletin PC-88.  This Bulletin is intended to clarify and supersede Bulletin  PC-66, dated December 21, 2009to reflect the provisions of Public Act No. 18-158, effective July 1, 20191 and Public Act No. 19- 125, effective July 1, 2019 concerning electronic notification  requirements.  In addition, the provisions in section I.D. below concerning conditional renewal notices have been generally codified in Conn. Gen. Stat. § 38a-323.  See Public Act No. 17-198.
• The Department of Insurance posted a notice to Workers' Compensation Insurers and Producers concerning changes to treatment of single member LLC's following the supreme court ruling in Gould v. City of Stamford. To view the notice, go to https://portal.ct.gov/CID/Public-Hearing-Notices/Latest-Notices.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice that rule amended rule 69L-3.009 became effective on June 25, 2019.  To view the notice, go to https://www.myfloridacfo.com/Division/WC/noticesRules.htm.

LEGISLATIVE ACTIONS:

• Senate Bill 426

Granting certain benefits to a firefighter upon receiving a diagnosis of cancer if certain conditions are met; requiring an employer to make certain disability payments to a firefighter in the event of a total and permanent disability; providing for death benefits to a firefighter’s beneficiary if a firefighter dies as a result of cancer or cancer treatments, etc. Effective Date July 21, 2019.

Hawaii WC VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 390

Makes permanent Act 172, Session Laws of Hawaii 2017, which: (1) grants employees the right to have a chaperone present during a medical examination relating to a workers' compensation work injury and, with the approval of the examining physician or surgeon, to record the examination; and (2) provides that if an employee or employee's chaperone obstructs the medical examination, the employee's right to workers’ compensation shall be suspended until the refusal or obstruction ceases. Effective Date June 29, 2019.

• House Bill 1272

Authorizes pharmacies to accept the return of any prescription drug for disposal via collection receptacles or mail-back programs; prohibits pharmacies from re-dispensing returned prescription drugs or accepting returned prescription drugs in exchange for cash or credit; requires the pharmacist-in-charge to ensure that only authorized reverse distributors acquire prescription drugs collected via collection receptacles or mail-back programs. Effective Date July 1, 2019.

Illinois VIEW STATE →

REGULATORY ACTIVITY:

• Posted in the June 28, 2019 State Register a Statement of Objection to Proposed Rule Making by the Department of Insurance regarding Workers' Compensation Electronic and Standardized Paper Billing.

LEGISLATIVE ACTIONS:

• Senate Bill 1596

Amends the Workers’ Compensation Act and the Workers' Occupational Diseases Act. Provides that specified Sections limiting recovery do not apply to injuries or death resulting from an occupational disease as to which the recovery of compensation benefits under the Act would be precluded due to the operation of any period of repose or repose provision. Provides that, as to any such injury occupational disease, the employee, the employee's heirs, and any person having the standing under law to bring a civil action at law has the nonwaivable right to bring such an action against any employer or employers.  Effective Date May 17, 2019.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• The Indiana Board of Pharmacy published notice that it was temporarily amending 856 IAC 2-2-5 to add drug compounds to Schedule IV Drugs. This notice will become effective 30 days after filing. Filing date was July 18, 2019. To view this rule, go to http://iac.iga.in.gov/iac/irtoc.htm?view=list&lsadocnum=19-380.

LEGISLATIVE ACTIONS:

• House Bill 1182

Provides that, for workers’ compensation purposes, an employee who leaves work to serve as a volunteer firefighter or member of a volunteer emergency medical services association (volunteer member) is considered an employee of the firefighting unit while in the performance of duties as a volunteer firefighter or volunteer member. Increases the maximum amount of burial expenses that an employer must pay under the workers’ compensation act for the burial expenses of a covered employee who dies from an injury by an accident arising out of the employee's employment from $7,500 to $10,000. Increases the maximum amount of burial expenses that an employer must pay under the workers’ occupational diseases compensation act for the burial expenses of an employee who dies from an occupational disease arising out of the employee's employment from $7,500 to $10,000. Effective Date July 1, 2019.

Iowa VIEW STATE →

REGULATORY ACTIVITY:

• The Iowa Division of Workers' Compensation (DWC) is implementing mandatory electronic filing (eFiling) on the Workers' Compensation Electronic System (WCES). Release 3.1 EDI Website —Effective July 16, 2019, EDI filings must be made on the Release 3.1 EDI Website. For more information, go to https://www.iwddwcedi.info/.  Other filings — Effective July 22, 2019, other filings with the DWC (e.g., documents in contested case proceedings, settlement documents, and commutation documents) must be eFiled on WCES at: https://efile.iowaworkcomp.gov/.
• Changes to Rules:  To implement mandatory eFiling on WCES, the DWC amended existing rules and issued new rules. This week, the DWC adopted the changes to the rules in ARC 4472C. To view ARC 4472C, go to https://www.iowaworkcomp.gov/workers-compensation-electronic-system-wces-update-july-12-2019 .
• Forthcoming Order: The Iowa Workers' Compensation Commissioner will issue an order on the transition to WCES and deadlines for the eFiling of documents under the rules, as amended.

New Forms

• The DWC must change some of its forms due to the transition to WCES.
• The DWC will post the new forms on its website when they are finalized.
• The new forms will be required effective July 22, 2019.

To view this announcement, go to  https://www.iowaworkcomp.gov/news-and-updates.

• The Iowa Workers' Compensation Commissioner issued an order In the Matter of Certain Deadlines for Electronic Filing on the Workers' Compensation Electronic System.  To view the order, go to https://www.iowaworkcomp.gov/news-and-updates.  The order was filed on July 15, 2019 effective July 22, 2019.
• The Iowa Division of Workers' Compensation (DWC) is implementing mandatory electronic filing (eFiling) on the Workers' Compensation Electronic System (WCES) in contested cases effective July 22, 2019. As part of the transition to mandatory eFiling on WCES, the DWC has made changes to the Uniform Guidelines for Preparation of Hearing Exhibits (Uniform Guidelines). The new Uniform Guidelines take effect on July 22, 2019.  To view the guidelines, go to https://www.iowaworkcomp.gov/news-and-updates.

Kansas VIEW STATE →

REGULATORY ACTIVITY:

• The mileage reimbursement rate for state officers and employees is 58 cents per mile effective July 1, 2019.  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).
• Published the June edition of their ODG.  To view the publication, go to https://www.dol.ks.gov/WC/medservices/medical-services-and-fee-schedule-section/official-disability-guidelines.

Louisiana VIEW STATE →

REGULATORY ACTIVITY:

• Published in the July state register the weekly benefit limits as determined by the Louisiana Workforce Commission effective July 1, 2019. The average weekly wage $916.85; Maximum Compensation $688.00; Minimum Compensation $183.00 and mileage reimbursement is $0.58 per mile.  To view this notice, go to https://www.doa.la.gov/Pages/osr/reg/regs2019.aspx.

LEGISLATIVE ACTIONS:

• House Bill 285

The enacted legislation provides that any reserve police officer or deputy who volunteers for a municipal or parish law enforcement agency may be entitled to medical benefits pursuant to existing law if injured during the line of duty. It provides that a public entity may elect to provide coverage for volunteer reserve police officers or deputies by using its own funds and at its own discretion. The law provides that the injured reserve police officer or reserve deputy shall not be compensated for injuries occurring within the course of, or arising out of, the volunteer reserve officer's or deputy's other employment. It provides that the injured volunteer reserve officer or reserve deputy shall not be entitled to be compensated for lost wages. The enacted legislation defines the term "volunteer reserve officer" to mean an individual who is carried on the membership list of a municipal organization as an active participant in the normal functions of the law enforcement organization.  It defines the term "volunteer reserve deputy" as an individual who is a part-time, non-salaried, fully commissioned law enforcement officer who volunteers with a parish organization.  Effective Date August 1, 2019.  

• House Bill 288

The enacted legislation defines "collateral", "commercially reasonable", "deductible claim", "large deductible policy", and "other secured obligations". It requires, unless otherwise agreed by the responsible guaranty association, all large deductible claims, which are also covered claims as defined by the applicable guaranty association law, including those that may have been funded by an insured before liquidation, to be turned over to the guaranty association for handling. The law provides that, to the extent a guaranty association pays any deductible claim for which the insurer would have been entitled to reimbursement from the insured, a guaranty association shall be entitled to the full amount of the reimbursement and available collateral. It requires the receiver to collect reimbursements owed for deductible claims, take all commercially reasonable actions to collect the reimbursements, and promptly bill insureds for reimbursement of deductible claims. The law requires the receiver to use collateral, when available, to secure the insured's obligation to fund or reimburse deductible claims, other secured obligations, or other payment obligations.  New law further provides that a guaranty association is entitled to collateral to the extent needed to reimburse a guaranty association for the payment of a deductible claim.  It requires claims that are validly asserted against the collateral to be satisfied in the order in which the claims are received by the receiver and provides that excess collateral may be returned to the insured as determined by the receiver after a periodic review of claims paid, outstanding case reserves, and a factor for incurred but not reported claims. The enacted legislation authorizes the receiver to deduct from the collateral or from the deductible reimbursements reasonable and actual expenses incurred in connection with the collection of the collateral and deductible reimbursements. The law shall not limit or adversely affect any rights or powers a guaranty association may have under applicable state law to obtain reimbursement from certain classes of policyholders for claims payments made by the guaranty association, under policies of the insolvent insurer, or for related expenses the guaranty association incurs. Effective Date January 1, 2020.  

• Senate Bill 88

The enacted legislation requires that an appeal of the decision by the medical director or associate medical director must be made within 45 days of the date of the issuance of the decision. Effective Date August 1, 2019.

Maryland VIEW STATE →

FEE SCHEDULE NEWS:

• The state has reposted changes to the Medical Fee Schedule retroactive to January 1, 2019.

REGULATORY ACTIVITY:

• Posted notice of adoption of rules regarding Judicial Review Procedures in the July 5 publication of the states register. On June 13, 2019, the Workers’ Compensation Commission adopted amendments to Regulation .01 under COMAR 14.09.11 Judicial Review Procedures. This action, which was proposed for adoption in 46:6 Md. R. 352—353 (March 15, 2019), has been adopted with the non-substantive changes shown below. Effective Date: July 15, 2019.

  .01 Petition for Judicial Review.

  A.—B. (text unchanged)

  C. (proposed text unchanged)

  [[D. An employer seeking judicial review of a decision of the Commission pursuant to Labor and Employment Article, §9-409, Annotated Code of Maryland, shall serve a copy of the petition for judicial review on the Assistant Attorney General assigned to represent the Commission at the Commission’s principal office in Baltimore City. The judicial review shall be on the record of the Commission in accordance with Maryland Rule 7-206.1(b).]]

To view the notice and rule go to http://www.dsd.state.md.us/MDR/4614/Assembled.htm#_Toc12874261.

• Changes to the MDWCC Cost of Living Adjustment listing for calendar year 2020 are available at http://www.wcc.state.md.us/Adjud_Claims/Comp_Rates.html. The COLA increase is 2.0%.

LEGISLATIVE ACTIONS:

• House Bill 795

Requiring a covered employee, under certain circumstances, to provide the employer, the employer's insurer, or the Uninsured Employer's Fund certain notification at least 30 business days before undergoing medical treatment; requiring that medical treatment sought by the covered.

Massachusetts VIEW STATE →

FEE SCHEDULE NEWS:

• A new Payment on Account Factors (PAFs) for acute and nonacute hospital services rendered to industrial accident patients has been adopted with an effective date of July 1, 2019.

REGULATORY ACTIVITY:

• Effective Monday, July 29, 2019 the Boston DIA will be located at The Lafayette City Center, 2 Avenue de Lafayette, Boston, MA 02111. 

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

• Clinical Lab – CMS has posted new updates to the Clinical Lab fee schedule effective July 1, 2019.

Missouri VIEW STATE →

REGULATORY ACTIVITY:

• The Missouri Division of Workers’ Compensation (MODWC) will soon be transitioning from the IAIABC EDI Claims Release 1 standard to the IAIABC EDI Claims Release 3.1 standard for electronic reporting of workers’ compensation First Reports of Injury (FROI) and Subsequent Reports of Injury (SROI). The mandatory implementation is planned for July 2021, though the exact date will be announced later.  For additional information, go to https://labor.mo.gov/DWC.
• The State Average Weekly Wage (SAWW) used to determine maximum workers' compensation benefits for the fiscal year beginning July 1, 2019 and ending June 30, 2020 is $934.90. This SAWW produces the maximum weekly benefit rates for injury and illness occurring on or after July 1, 2019, as follows: Temporary Total Disability $981.65;  Permanent Total Disability $981.65;  Permanent Partial Disability $514.20; and  Death $981.65. The actual weekly wage rate necessary to attain the maximum benefit rate is $1,472.47 for Death, Temporary Total Disability and Permanent Total Disability and $771.29 for Permanent Partial Disability. Also, as of July 1, 2019, the mileage allowance for travel expenses is 55 cents per mile.

Montana VIEW STATE →

LEGISLATIVE ACTIONS:

House Bill 757

• A bill for an act entitled: "an act generally revising workers' compensation laws; requiring certification of workers' compensation claims examiners; requiring that all examiners pay a certification program fee; providing rulemaking authority; removing a termination date regarding options for extraterritorial workers' compensation coverage; amending section 39-71-320, MCA; repealing section 5, chapter8 315, laws of 2015; and providing effective dates." Effective Date July 1, 2019.  
• Senate Bill 351

The enacted legislation revised State Fund Board composition and term requirements.  Effective Date October 1, 2019.

Nevada VIEW STATE →

REGULATORY ACTIVITY:

• Has published the Actuarial Annuity Table effective July 1, 2019.  To view the new table, go to http://dir.nv.gov/WCS/Important/.
• Posted a memorandum regarding changes to the Nevada law governing benefits for certain permanently and totally disabled workers in Nevada.  The bill became effective on July 1, 2019. As a result of the new law insurers and TPAs are no longer required to submit the Permanent Total Disability Claims report that had been due in August each year. The Workers’ Compensation Section (WCS) annual PT data call associated with this repealed statute will not be distributed in July 2019 or thereafter.  To view the memorandum, go to http://dir.nv.gov/WCS/Important/.

LEGISLATIVE ACTIONS:

• Assembly Bill 370

An act relating to industrial insurance; authorizing the use of money in the Fund for Workers' Compensation and Safety in the State Treasury to make certain payments; eliminating the authority of the Administrator of the Division of Industrial Relations of the Department of Business and Industry to make certain payments from the Uninsured Employers' Claim Account in the Fund for Workers' Compensation and Safety; revising provisions providing for an annual increase in benefits for permanent total disability; authorizing assessments against certain employers to defray the costs of certain compensation for permanent total disability; repealing provisions authorizing annual payments to certain persons who are entitled to compensation for permanent total disability; and providing other matters properly relating thereto. Effective Date July 1, 2019.

• Senate Bill 33

An act relating to the support of children; imposing certain requirements on insurers and self-insurers relating to certain claimants owing past-due child support.  Effective Date January 1, 2020.

• Senate Bill 377

An act relating to industrial insurance; authorizing the use of money in the Fund for Workers' Compensation and Safety in the State Treasury to make certain payments; eliminating the authority of the Administrator of the Division of Industrial Relations of the Department of Business and Industry to make certain payments from the Uninsured Employers' Claim Account in the Fund for Workers' Compensation and Safety; revising provisions providing for an annual increase in benefits for permanent total disability; authorizing assessments against certain employers to defray the costs of certain compensation for permanent total disability; repealing provisions authorizing annual payments to certain persons who are entitled to compensation for permanent total disability; and providing other matters properly relating thereto. Effective Date July 1, 2019.

New Hampshire VIEW STATE →

REGULATORY ACTIVITY:

• Posted a notice in the register of proposed rule regarding the current Form, 8WC “Employer’s First Report of Injury” adopted in December 2014 and is incorporated by reference in Lab 504.02 (c) & (d).  It reflects a general e-mail address for the Department of Labor Workers’ Compensation Division.  The Department of Labor has established an e-mail address specific to the receipt of First Reports of Injuries.  The Department of Labor therefore proposes to readopt with amendment Form 8WC to reflect the change in the e-mail address and to add the Department’s fax number to the form.  Having the ability to fax a first report of injury form to the Department will better serve the employers of New Hampshire by providing additional avenues for employers to comply with the filing requirements of this law.  To view this notice, go to http://gencourt.state.nh.us/rules/register/2019/2019.htm.

LEGISLATIVE ACTIONS:

• Senate Bill 59

An act adding post-traumatic stress disorder and acute stress disorder to the definition of "injury" for purposes of workers' compensation and reestablishing the commission to study the incidence of post-traumatic stress disorder in first responders. Effective Date January 1, 2020. 

• Senate Bill 99

The enacted legislation provides for a definition for gainful employment which means employment which reasonably conforms with the employee's age, education, training, temperament and mental and physical capacity to adapt to other forms of similarly remunerative labor than that to which the employee was accustomed. Effective Date January 1, 2020.

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

• Governor Phil Murphy released a comprehensive report from the Task Force on Employee Misclassification, vowing to intensify efforts to curtail the widespread and illegal practice of misclassifying workers as independent contractors instead of employees, which cheats some workers out of benefits and wages, hurts law-abiding business owners, and costs the state tens of millions of dollars a year in lost employment-related tax revenue.  To view this notice and report, go to https://www.nj.gov/labor/lwdhome/press/2019/20190709_missclassreport.shtml.
• Published that the Maximum Compensation Rate for 2020 is $945.00.  The Minimum Compensation Rate for 2020 is $252.00.

LEGISLATIVE ACTIONS:

• Senate Bill 716

This bill creates a rebuttable presumption of workers’ compensation coverage for public safety workers and other employees in certain circumstances.  The bill affirms that if, in the course of employment, a public safety worker is exposed to a serious communicable disease or a biological warfare or epidemic-related pathogen or biological toxin, all care or treatment of the worker, including services needed to ascertain whether the worker contracted the disease, shall be compensable under workers' compensation, even if the worker is found not to have contracted the disease.  If the worker is found to have contracted a disease, there shall be a rebuttable presumption that any injury, disability, chronic or corollary illness or death caused by the disease is compensable under workers' compensation.  The bill affirms workers’ compensation coverage for any injury, illness or death of any employee, including an employee who is not a public safety worker, arising from the administration of a vaccine related to threatened or potential bioterrorism or epidemic as part of an inoculation program in connection with the employee’s employment or in connection with any governmental program or recommendation for the inoculation of workers. The bill creates a rebuttable presumption that any condition or impairment of health of a public safety worker which may be caused by exposure to cancer-causing radiation or radioactive substances is a compensable occupational disease under workers' compensation if the worker was exposed to a carcinogen, or the cancer-causing radiation or radioactive substance, in the course of employment. Employers are required to maintain records of instances of the workers deployed where the presence of known carcinogens was indicated by documents provided to local fire or police departments under the “Worker and Community Right to Know Act,” P.L.1983, c.315 (C.34:5A-1 et seq.) and where events occurred which could result in exposure to those carcinogens. In the case of any firefighter with seven or more years of service, the bill creates a rebuttable presumption that, if the firefighter suffers an injury, illness or death which may be caused by cancer, the cancer is a compensable occupational disease. The bill provides that, with respect to all of the rebuttable presumptions of coverage, employers may require workers to undergo, at employer expense, reasonable testing, evaluation and monitoring of worker health conditions relevant to determining whether exposures or other presumed causes are actually linked to the deaths, illnesses or disabilities, and further provides that the presumptions of compensability are not adversely affected by failures of employers to require testing, evaluation or monitoring.  The public safety workers covered by the bill include paid or volunteer emergency, correctional, fire, police and certain medical personnel.  Effective Date July 8, 2019.

New Mexico VIEW STATE →

FEE SCHEDULE NEWS:

• The New Mexico Gross Tax Receipts effective for the period of July 1, 2019 through December 31, 2019 have been published. A new update is expected January 1, 2020.

REGULATORY ACTIVITY:

The NM WCA has published a NEW guide for health care providers who are new to the workers’ compensation system or who might be interested in becoming a provider for injured workers. Please help us to circulate this guide to the medical community. And, as always, we welcome your feedback on this on all of our publications. Access the HCP guide electronically: https://workerscomp.nm.gov/sites/default/files/documents/publications/HCP_Guide.pdf

New York VIEW STATE →

FEE SCHEDULE NEWS:

• A new update to the EAPG data tables has been released with an effective date of July 1, 2019. The next update is expected October 1, 2019.

REGULATORY ACTIVITY:

• The New York State Workers’ Compensation Board has prepared proposed revisions to the medical fee schedules to incorporate the expanded list of medical providers that can be authorized to treat injured workers in the New York State workers' compensation system. The proposal was published in the State Register on July 3, 2019, and the Board will accept comments from the public for 60 days. Please note these are proposed changes and have not yet been formally adopted. Therefore, the current fee schedule that became effective April 1, 2019, continues to remain in effect. The Board encourages the public, injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys and licensed representatives, medical providers, and labor and business organizations to provide comment. Please submit your comments on or before September 3, 2019, to regulations@wcb.ny.gov. Following the public comment period, the Board will evaluate all comments received, and consider any necessary revisions. When final regulations are adopted, the Board will announce an effective date for the revised schedules. To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1184.jsp.
• To align with payers’ business practices, the Board has developed a process to enable insurance carriers, self-insured employers, and third-party administrators (TPAs) to provide an electronic signature on a Section 32 Waiver Agreement. A new form, Section 32 – Electronic Signature (Form C-32E), will be used by the payer to affirm that the electronic signature used on the Section 32 Waiver Agreement conforms to the requirements in Form C-32E and is binding for the Section 32 waiver agreement. The person who electronically signs Section 32 Waiver Agreements on behalf of the payer executes the Form C-32E on one occasion. The original signed version of Form C-32E should be maintained by the payer. When a payer is preparing to submit a Section 32 Waiver Agreement that has an electronic signature the payer should copy Form C-32E and complete the case information.  The complete Form C-32E must be submitted with the Section 32 Waiver Agreement that has an electronic signature. A Section 32 Waiver Agreement with an electronic signature that is submitted without Form C-32E attached will be returned. To learn more about the process and view the form, go to http://www.wcb.ny.gov/content/main/Workers/Section32_Workers.jsp to  Section 32 Waiver Agreements. Section 32 Waiver Agreements can be submitted to the Board by U.S. mail, fax, email, or web upload. U.S. mail: NYS Workers’ Compensation Board Centralized Mailing Address PO Box 5205 Binghamton, NY 13902-5205; Fax (877) 533-0337; Email wcbclaimsfiling@wcb.ny.gov.  If you have any questions about the electronic signature process, please contact Customer Service at (877) 632-4996. You may also email questions to claims@wcb.ny.gov.

New York No-Fault VIEW STATE →

FEE SCHEDULE NEWS:

• A new update to the EAPG data tables has been released with an effective date of July 1, 2019. The next update is expected October 1, 2019.

REGULATORY ACTIVITY:

• Posted notice on the state's web site regarding of emergency adoption of certain workers' compensation fee schedules.  To view the notice on the web site, go to https://www.dfs.ny.gov/industry_guidance/regulations/emergency_insurance.  The notice was filed with the secretary of state on July 5, 2019 and was in the state register on July 24, 2019.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Registration is now open for the 24th Annual North Carolina Workers' Compensation Educational Conference, which will take place at the Raleigh Convention Center on Wednesday-Friday, October 2-4, 2019. The conference is presented by the North Carolina Industrial Commission, in association with the International Workers' Compensation Federation.  For additional information, go to http://www.ic.nc.gov/news.html#hot.

North Dakota VIEW STATE →

FEE SCHEDULE NEWS:

• New Medical Provider, Outpatient Hospital and Physician, APC and Ambulatory Surgical Centers fee schedule have been released with an effective date of July 1, 2019.

REGULATORY ACTIVITY:

• Posted notice announcing the implementation of a secure provider portal called myWSI. A provider's use of myWSI is highly encouraged, as WSI is working toward the adoption of more electronic functionality to improve efficiency.  
• Effective August 15, 2019, WSI is implementing plan limits for maximum daily dosages for Lyrica® (Pregabalin). This is applicable to both a new and existing prescription. The WSI formulary, available under Pharmacy Services, will reflect this change. Daily dosage limits of Lyrica® will be as follows: Immediate release: 25mg, 50mg, 75mg, 100mg: 3 per day; 150mg, 200mg, 225mg, 300mg: 2 per day; controlled release: 82.5mg, 165mg, 330mg: 1 per day.  If you have questions about this article, please send an email to wsipr@nd.gov. To view this notice, go to https://www.workforcesafety.com/news/implementation-maximum-daily-dosage-limits-lyricar-pregabalin.
• WSI recently revised the Medical Provider Payee Registration form, which a practice must submit to receive payment from WSI. The requirement applies to all practices, including those previously registered with WSI under the former registration process. If a practice does not submit an updated registration form, WSI will deactivate the existing payee account and deny payment. If a practice is uncertain whether WSI has received an updated registration, contact customer service at 800-777-5033.

Ohio VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of rule for 5-year review. Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: Package Title: Chapter 4123-5 (5YRR) Rule Numbers: 4123-5-01 Assignment of duties to the bureau's operational units. 4123-5-11 Employer's reports must be signed by officer or person in employ of employer. 4123-5-13 Expenses related to the death of an injured worker. 4123-5-18 Medical proof required for payment of compensation. 4123-5-20 Payment of compensation when advancements are made during period of disability. 4123-5-21 Abatement of claims. To view this notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Posted notice of rule for 5-year review. Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Package Title: Chapter 4123-14 (5YRR) -Rule Numbers: 4123-14-01 Non-complying employers within the meaning of the law. 4123-14-02 Procedures for the collection of premiums from non-complying employers. 4123-14-03 Requests for waiver of a default in the payment of premium, for approval of the original workers' compensation coverage retroactively, and for abatement of penalties. 4123-14-04 Procedure to recover from a non-complying employer the amount of money paid out of the state insurance fund for an industrial injury, occupational disease and/or death. 4123-14-05 Settlement of liability of a non-complying employer. 4123-14-06 Bureau of workers’ compensation adjudicating committee. To view this notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Posted notice of rules proposed to BWC Board of Directors for consideration. Rules proposed are 4123-6-34 Payment for Treatment of Concussion Injuries.  The rule is open for comment through August 15, 2o19.  To view the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.

Oklahoma VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 1095

The enacted legislation amends the Oklahoma Employment Security Act to apply the 20-factor test used by the IRS in determining whether an employer-employee relationship exists.  Effective Date January 1, 2020. 

• Senate Bill 274

The enacted legislation reduces the balance of the Self-insurance Guaranty Fund at which the Workers’ Compensation Commission may levy an assessment against each private self-insurer and group self-insurance association from below $2 million to below $750,000. The measure increases the maximum assessment rate from 1% to 2% of actual paid losses of the preceding calendar year. Effective Date November 1, 2019.  

• House Bill 2367

The enacted legislation modifies definitions compensable injury, course and scope of employment, cumulative trauma, employee, employer, and objective findings. It Extends applicability of the Administrative Workers’ Compensation Act to federally owned lands. Precludes employees making a claim in another jurisdiction to pursue benefits under the Administrative Workers’ Compensation Act. Allows Commission to send notice to health care providers regarding compensability of injury electronically. Removes prohibition that Commissioners may not receive an increase in salary. Authorizes Commission to take certain actions regarding meetings and administrative business. Caps first time violation of employers to seek workers’ compensation coverage to $50,000. Authorizes Commission to institute a collection proceeding against an employer’s assets. Extends temporary total disability benefits to 156 weeks. States that employee’s temporary total disability benefits will be permanently terminated if he/she abandons treatment for 60 days. Increases permanent partial disability benefits to $350/week and then $360/week beginning in 2021. Extends permanent partial disability benefits to 360 weeks. Removes provisions related to reductions of awards. Directs Commission to update the Fee Schedule, in conjunction with consultants, every two years and report amended Fee Schedule to Governor and Legislature. Modifies provisions related to filing requirements.  Allows for hearings to occur in any county in the state.  Provides that each party shall be responsible for legal services and expenses.  Allows incarcerated persons to receive medical benefits. Provides that Workers’ Compensation Court of Existing Claims will consist of one judge beginning in 2020 to be appointed by the Governor. Allows for Governor to appoint Administrator of the Court and provides duties, including submitting an annual report regarding awards made to the Governor, Supreme Court, and Legislature. Directs the Court of Existing Claims to contract with the Commission in order to integrate records, to be completed in 2022.  Authorizes Commission to hold executive sessions. Modifies provisions related to assessments against employers for the purpose of providing secure funding sources for Multiple Injury Trust Fund. Increases maximum assessment rate against insurers to 7% for a three-year period. Allows Commission to assess uninsured employers a temporary assessment. Provides that annually $1 million will be transferred from the Multiple Injury Trust Fund to the Oklahoma Department of Labor for the purpose of administering the Oklahoma Occupational Health and Safety Standards Act.  Provides conditions and filing requirements employee must meet in order to file a claim against the Multiple Injury Trust Fund.  Authorizes Multiple Injury Trust Fund Director to hire necessary employees and provide results of audit reports to the Commission annually.  Allows for $4 million to be transferred to the Workers’ Compensation Commission Revolving Fund from the Multiple Injury Trust Fund. Allows for $1.75 million to be transferred to the Worker’s Compensation Administrative Fund from the Multiple Injury Trust Fund.  Repeals guidelines related to annual reports by the Attorney General to the Workers’ Compensation Commission regarding fraud investigations, by the Workers’ Compensation Commission to the Legislature and Governor for evaluation of administration of act. Repeals stipulation that contractor shall be liable for a subcontractor’s employees. Repeals Oklahoma Employee Injury Benefit Act.  Effective Date May 23, 2019.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• The Oregon WCB Case News & Notes Current Issue for June 2019 is now available.  To view the publication, go to https://www.oregon.gov/wcb/Pages/news-notes.aspx.
• The Oregon Workers’ Compensation Division has scheduled time for comprehensive review of: OAR 436-030, Claim Closure and Reconsideration, and OAR 436-060, Claims Administration. Please RSVP to fred.h.bruyns@oregon.gov if you would like to join for one or both of the following meetings: To review and discuss OAR 436-030 – Oct. 7, 2019, 9 a.m. - 4:30 p.m. PDT OSHA Training Room (first   floor) 16760 SW Upper Boones Ferry Rd, Portland, Oregon 97224. To review and discuss OAR 436-060 – Oct. 14, 2019, 9 a.m. - 4:30 p.m. PDT OSHA Training Room (first floor) 16760 SW Upper Boones Ferry Rd, Portland, Oregon 97224. If you will submit agenda topics, please record them on this form, https://wcd.oregon.gov/laws/Documents/5141_final_pdf_form.pdf, and send to Fred Bruyns – by Aug. 9, if possible. This will give time to research the issues and options before the October meetings. Topics submitted later on or at the meetings may be discussed if time allows, but related rule changes, if any, may be deferred until the next opening of the rules.
• Published the July 2019 edition of WCD Today Newsletter.  To view the newsletter, go to https://wcd.oregon.gov/Pages/wcd-today.aspx.

LEGISLATIVE ACTIONS:

• House Bill 3003

Permits Director of Department of Consumer and Business Services to release surety bond or other security on deposit with director if self-insured employer or self-insured employer group obtains paid-up insurance policy satisfactory to director. Effective Date January 1, 2020.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• The new hospital rates effective July 1, 2019 have been published. A new update to hospital rates is expected in July 2020.

REGULATORY ACTIVITY:

• The Workers’ Compensation Division, under the authority granted by Section 37‐13(c) of Title 28 of the General Laws of Rhode Island, 1956, as amended, granting the Director of the Department of Labor and Training (“Director”) the power and discretion to determine Workers’ Compensation assessment rates,  the assessment rate shall be reduced to 5.00%. In the development of the proposed assessment rate, consideration was given to the projected expenditures for the current fiscal year and for the next fiscal year in determining what percentage is needed to provide sufficient funds, in conjunction with appropriations from the general fund, if any, to fulfill the purposes enumerated in RIGL §28‐37‐1 (b) pursuant to RIGL §28‐37‐13(c). This notice was published in Information Letter 2019-04.  To view this notice, go to http://www.dlt.ri.gov/wc/infoletters.htm.

Tennessee VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 539

As enacted, requires the consideration of the 20-factor test in IRS Revenue Ruling 87-41 to determine whether an employer-employee relationship exists in certain employment arrangements. - Amends TCA Title 50.  Effective Date January 1, 2020.

Texas VIEW STATE →

FEE SCHEDULE NEWS:

• A new Home Health and Dental Fee Schedule effective July 1, 2019 have been adopted. The next update is expected in October 2020.

REGULATORY ACTIVITY:

• The Texas Department of Insurance, Division of Workers' Compensation (DWC) is readopting all sections within the “Old Law” chapters, Chapters 41-69, of Title 28, Part 2 of the Texas Administrative Code. This re-adoption is in compliance with Texas Government Code §2001.039, which require a state agency to review each of its rules every four years and to readopt, readopt with amendment, or repeal the rule.  A notice of rule review was published in the April 5, 2019, issue of the Texas Register (44 Tex. Reg. 1719 (2019).   DWC received eight comments on the review.  The comments support readopting the rules and propose amending the medical fee guidelines.  Any repeals or suggested amendments identified during the review of these rules may be considered in future rulemaking in accordance with the Administrative Procedures Act, Texas Government Code Chapter 2001.
• The Texas Department of Insurance, Division of Workers' Compensation (DWC) will review all sections within 28 Texas Administrative Code (TAC) Chapters 102 – 116.  DWC is accepting public comments on whether rules within 28 TAC Chapters 102 – 116 still have reason to exist and whether these rules should be repealed, readopted, or readopted with amendments as required under Texas Government Code §2001.039.  To comment on this rule review project, submit written comments by 5 p.m., Central time, on August 8, 2019. Comments received after that date will not be considered. Send written comments or hearing requests by email to rulecomments@tdi.texas.gov or by mail to Texas Department of Insurance, Division of Workers' Compensation Cynthia Guillen Office of General Counsel, MS – 4D 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1645. Any repeals or suggested amendments identified during the review of these rules may be considered in future rulemaking in accordance with the Administrative Procedures Act, Texas Government Code Chapter 2001.  To view this notice, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.

LEGISLATIVE ACTIONS:

• House Bill 29

The enacted legislation gives patients the right to receive direct access to treatment from a physical therapist for a maximum of 30 consecutive calendar days. After 30 days, the therapist could only continue treatment with a referral from a primary care physician. Multiple studies show giving patients direct access to physical therapy treatment increases access to care, decreases patient costs and wait times, and correlates with a much lower risk of being prescribed opioids. Effective Date September 1, 2019. 

• House Bill 387

It has been noted that, although the workers' compensation system allows advance practice registered nurses (APRNs) to treat injured workers, APRNs are not currently authorized to complete and sign work status reports, which may create unnecessary delays for patients and additional paperwork burdens for delegating physicians. H.B. 387 seeks to make the documentation process more efficient by authorizing a licensed APRN to complete and sign such a report. The enacted legislation amends current law relating to submission of reports by an advanced practice registered nurse under the workers' compensation system. Effective Date September 1, 2019.  

• House Bill 1665

The enacted legislation eliminates unnecessary reporting requirements to DWC. DWC accepts and stores the DWC Form-84 but does not use it to make decisions or prove claims. Eliminating this reporting requirement will help clarify DWC's statutory responsibilities and allow system stakeholders and DWC to reallocate resources to more meaningful obligations.  Effective Date May 23, 2019. 

• House Bill 2143

The enacted legislation provides that post-traumatic stress disorder suffered by a first responder is a compensable injury. Effective Date September 1, 2019.  

• House Bill 2503

The enacted legislation provides benefits for life to a surviving spouse of a first responder who died in the course and scope of employment even if the spouse remarries.  This applies regardless of date of injury.  Effective Date September 1, 2019. 

• Senate Bill 612

The enacted legislation provides for the continuation of the funding and operation of the State Office of Risk Management. Effective Date September 1, 2019. 

• Senate Bill 619

The enacted legislation adjusts when sunset review will occur on state agencies to 12 to 14 years. The legislation adjusts when the Division of Workers’ Compensation Commission is to be reviewed from September 1, 2021 to September 1, 2023. Effective Date June 10, 2019. 

• Senate Bill 935

The enacted legislation remedies a situation whereby a federal military treatment facility is balance billing an injured worker because the insurer is limited to payment not to exceed the state fee schedule. The enacted legislation  remedies this situation from occurring in the future by providing a definition of "federal military treatment facility" and clarifying that medical care provided in these facilities is exempt from certain workers' compensation statutory requirements related to network participation, medical billing, and reimbursements. It would also set the reimbursement rates at these facilities as the same as provided by federal law. Effective Date September 1, 2019. 

• Senate Bill 1336

The enacted legislation amends the Insurance Code to remove the requirement for the Texas Department of Insurance (TDI) to establish classification relativities, for purposes of the workers' compensation classification system for workers' compensation insurance rate filings, applicable to an employer's payroll in each of the classes of hazards at levels adequate to the risks to which the relativities apply. The bill repeals the requirement for TDI to develop and publish classification relativities specifically designed for the risks insured by an insurer of last resort. The bill changes the frequency at which TDI is required to revise the workers' compensation classification system from at least once every five years to as necessary to carry out the purposes of provisions relating to rates for workers' compensation insurance.  The legislation applies only to an insurance policy that is delivered, issued for delivery, or renewed on or after July 1, 2020.  Effective Date September 1, 2019. 

• Senate Bill 1588

The enacted legislation amends the Government Code to extend the applicability of provisions relating to a determination of whether the disability or death of an applicable firefighter or emergency medical technician resulted from a disease or illness contracted by the firefighter or emergency medical technician in the course and scope of employment for purposes of certain benefits to peace officers who satisfy the same conditions as an applicable firefighter or emergency medical technician. The bill extends to peace officers the entitlement of a firefighter or other governmental employee who operates an ambulance or responds to emergency medical calls to preventative immunization for a disease to which the employee may be exposed in performing official duties and for which immunization is possible. Effective Date September 1, 2019. 

• Senate Bill 1742

The enacted legislation amends multiple sections of the labor code and the insurance code affecting utilization review for workers’ compensation in the state of Texas. In regards to the labor code it amends 408.003 by requiring a person described by Subsection (a)(1), (2), or (3), (relating to doctors performing certain reviews) who reviews the service with respect to a specific workers' compensation case, notwithstanding Subsection (b) (relating to requiring a reviewer to hold appropriate certifications), if a health care service is requested, ordered, provided, or to be provided by a physician, to be of the same or a similar specialty as that physician. Amends insurance code 1305.351 by authorizing a utilization review agent or an insurance carrier that uses doctors to perform reviews of health care services provided under this chapter (Workers' Compensation Health Care Networks), including utilization review, or peer reviews under Section 408.0231(g) (relating to requiring the commissioner of insurance to adopt rules regarding doctors who perform peer review functions for insurance carriers), Labor Code, to only use doctors licensed to practice in this state, rather than authorizing, notwithstanding Section 4201.152 (Utilization Review Under Direction of Physician), a utilization review agent or an insurance carrier that uses doctors to perform reviews of health care services provided under this chapter, including utilization review, or peer reviews under Section 408.0231(g), Labor Code, to only use doctors licensed to practice in this state.  Amends insurance code 1305.355 by authorizing Authorizes an independent review organization that uses doctors to perform reviews of health care services under this chapter, rather than authorizing, notwithstanding Section 4202.002 (Adoption of Standards For Independent Review Organizations), an independent review organization that uses doctors to perform reviews of health care services under this chapter, to only use doctors licensed to practice in this state. Amends labor code 408.023 by authorizing a utilization review agent or an insurance carrier that uses doctors to perform reviews of health care services provided under this subtitle (Texas Workers' Compensation Act), including utilization review, rather than authorizing, notwithstanding Section 4201.152, Insurance Code, a utilization review agent or an insurance carrier that uses doctors to perform reviews of health care services provided under this subtitle, including utilization review, to only use doctors licensed to practice in this state.  Amends labor code 413.031 by authorizing an independent review organization that uses doctors to perform reviews of health care services provided under this title (Workers' Compensation), rather than authorizing, notwithstanding Section 4202.002, Insurance Code, an independent review organization that uses doctors to perform reviews of health care services provided under this title, to only use doctors licensed to practice in this state.  Effective Date September 1, 2019.

Utah WC VIEW STATE →

FEE SCHEDULE NEWS:

• Published the ambulance fee schedule for the state effective July 1, 2019.

LEGISLATIVE ACTIONS:

• Senate Bill 76

This bill enacts provisions related to add-on fees in workers' compensation cases. This bill repeals provisions authorizing the Labor Commission to award attorney fees; defines terms; in certain workers' compensation cases, authorizes the Labor Commission to award an add-on fee to a claimant to be paid by the workers' compensation insurance carrier; and if the Labor Commission awards an add-on fee, establishes the amount of the add-on fee. Effective Date March 11, 2019.

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• The proposed changes and proposed medical fee schedule to be adopted January 1, 2020 have been published. A comment period is open until August 30, 2019.
• Released the 2018 Annual Report.  To view the report, go to http://www.workcomp.virginia.gov/news/VWC-Annual-Report

Washington VIEW STATE →

REGULATORY ACTIVITY:

• The Washington State Department of Labor & Industries has adopted a new Health Technology Clinical Committee coverage determination regarding SI joint fusion. Effective September 1, 2019, SI joint fusion for chronic sacroiliac joint pain related to degenerative sacroilitis and/or sacroiliac joint disruption is not a covered benefit.  For additional information, go to http://www.lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/SacroiliacJointFusion.asp?utm_medium=email&utm_source=govdelivery.
• The Washington State Department of Labor & Industries has adopted a new Health Technology Clinical Committee coverage determination regarding peripheral nerve ablation. Effective September 1, 2019, peripheral nerve ablation for limb pain is not a covered benefit.  For additional information, go to http://www.lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/PeripheralNerveAblationforLimbPain.asp?utm_medium=email&utm_source=govdelivery.
• The rulemaking adopts an amendment in chapter 296-14 WAC, Industrial insurance. Specifically, this rulemaking amends WAC 296-14-400, Re-openings for benefits, due to the State of Washington Court of Appeals decision Ronald V. Ma'ae v. State of Washington Dept of Labor And Industries, 2019 WL 1492822 that found the department cannot prohibit non-MPN providers from submitting re-opening applications. This rule amendment allows L&I to be in compliance with the Ma’ae decision and is effective upon filing per RCW 34.05.380(3) (a). The changes were adopted 7/23/2019 and became effective on 7/23/2019. To view is notice, go to http://www.lni.wa.gov/LawRule/WhatsNew/Proposed/default.asp?RuleID=371.

LEGISLATIVE ACTIONS:

• House Bill 1909

The enacted legislation provides that if an employer or employer's authorized representative reveals information in an injured worker's claim file regarding a mental health condition or treatment to any person other than an authorized representative, the employer is subject to a civil penalty of one thousand dollars for each occurrence. Requires the department of labor and industries to ensure that employers and workers are notified of their rights and responsibilities regarding claim files. Effective Date July 28, 2019.

West Virginia VIEW STATE →

REGULATORY ACTIVITY:

• The National Council on Compensation Insurance (NCCI), West Virginia’s rating and statistical agent has filed a proposed workers’ compensation loss cost decrease of 1.6% effective November 1, 2019. This premium reduction results in a projected $3 million in savings to West Virginia employers.  To view the notice, go to https://www.wvinsurance.gov/Workers-Compensation.