Alabama VIEW STATE →

REGULATORY ACTIVITY:

• Posted Bulletin Number 2020-12 regarding producer, adjuster, and Title Ins Agent Licensing issues in light of the COVID-19 Emergency -Modifications of Bulletins number 2020-03 and Bulletin 2020-10.  Bulletin 2020-12 became effective May 25, 2020.  To view the bulletin, go to https://www.aldoi.gov/Legal/Bulletins.aspx.

LEGISLATIVE ACTIONS:

• Senate Bill 24 The legislation was enacted as a result of a sunset review of the Department of Insurance.  The legislation enacted continues the operation of the Department of Insurance through October 1, 2024.  Effective Date March 12, 2020.

Alabama Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published the adopted amendments to their Property Casualty Claims Standards. The rule amended is rule  482-1-125-.07 Standards for Prompt, Fair and Equitable Settlements Applicable to All Insurers.  The amended rule became effective May 16, 2020.  To view the adopted rule, go to https://www.aldoi.gov/Legal/.

Alaska VIEW STATE →

REGULATORY ACTIVITY:

• Updated the WC forms list.  To view the updated forms list, go to https://labor.alaska.gov/wc/pdf_list.htm.
• Published the WC Board meeting minutes of the January 9-10, 2020 Meeting. To view the minutes, go to https://labor.alaska.gov/wc/wcboard.htm.
• Published amended Bulletin 20-04 regarding the notice of enforcement suspensions from March 31 through June 30, 2020.  The Division of Workers’ Compensation Benefits Guaranty Fund is temporarily suspending collection of penalties for failure to insure and collection of compensation benefits paid by the Benefits Guaranty Fund on behalf of uninsured employees.  In addition, the Alaska Division of Workers’ Compensation Special Investigations Unit will temporarily suspend the pursuit of criminal charges for failure to insure for workers’ compensation liability. To view the bulletin, go to https://labor.alaska.gov/wc/bulletins.htm.
• Published the meeting agenda and claims packet for the May 20, 2020 meeting of Workers' Compensation Medical Services Review Committee.  To view the information, go to https://labor.alaska.gov/wc/med-serv-comm.htm.

LEGISLATIVE ACTIONS:

• Senate Bill 241 This legislation extends the March 11, 2020, governor's declaration of a public health disaster emergency in response  to  the  novel  coronavirus  disease  (COVID-19)  pandemic;  providing  for  a  financing plan;  making  temporary  changes  to  state  law  in  response  to  the  COVID-19  outbreak  in  the following  areas:  standing  orders  of the chief medical officer; occupational  and  professional licensing,  practice,  and  billing;  telehealth;  fingerprinting  requirements  for  health  care providers;  elections  in  calendar  year  2020;  permanent  fund  dividend  applications  and eligibility;  state  tax  filings,  payments,  and  penalties;  corporations;  state  and  municipal government  deadlines;  the  Alaska  regional  economic  assistance  program;  Medicaid  and public assistance; workers' compensation; sanitation standards for retail sellers; actions by the Regulatory  Commission  of  Alaska;  utilities  and  residential  utility  service;  power  cost equalization; forbearance of specified state loans; foreclosures; evictions; wills; repossessions; access  to  federal  stabilization  funds;  seafood  purchase  and  distribution;  homelessness; administrative  hearings;  and  liability  for  issuing,  providing,  or  manufacturing  personal protective equipment.  Effective Date May 18, 2020.

Arizona VIEW STATE →

REGULATORY ACTIVITY:

• The Industrial Commission of Arizona understands that some workers' compensation insurance carriers and self-insured employers may have limited experience adjusting workers' compensation claims involving contagious diseases, such as COVID-19.  Please be advised that COVID-19 workers' compensation claims cannot be categorically denied, and Arizona law requires all denials to be well-grounded in fact and warranted by existing law.  In an effort to prevent unnecessary litigation, the Commission recommends that carriers and self-insured employers evaluate COVID-19 claims in conjunction with Arizona law, considering factors including but not limited to:
  • The nature of the employment and the risk of contracting COVID-19;
  • Whether an identifiable exposure occurred at work;
  • Whether any identifiable exposure occurred outside of work;
  • The timing between an identifiable exposure and the development of COVID-19 symptoms; and
  • The reliability of medical or other evidence that the work-related exposure caused the disease.

To view this announcement, go to https://www.azica.gov/news-and-events/public-notices.

• On May 12, 2020, Governor Doug Ducey issued the "Stay Healthy, Return Smarter, Return Stronger" Executive Order. While the Executive Order promotes the gradual and safe reopening of Arizona, it continues to recommend physical distancing and compliance with federal and state health guidelines. Beginning Wednesday, May 27, 2020, the ICA buildings in Phoenix (800 W. Washington St.) and Tucson (2675 E. Broadway Blvd.) will resume in-person visits. In order to mitigate the risks associated with COVID-19, the ICA has implemented and continues to observe enhanced sanitation and physical distancing practices. Although ICA buildings will be reopened to the public, the ICA strongly encourages stakeholders and members of the public to avoid unnecessary visits to ICA buildings, particularly the elderly and individuals with underlying health conditions. The ICA recommends that stakeholders and members of the public continue to do business with the ICA remotely to the greatest extent possible, which includes using online resources such as ICA Community, including the "upload" feature, online forms, and the Online Payment Portal. The ICA website contains a library of online forms, which can be filled out and submitted to the ICA electronically.  Workers' compensation forms for injured workers, employers, and insurance carriers can be quickly and easily completed and submitted to the ICA in the ICA's new Claims/ALJ portal. In addition to fillable forms, the ICA Community allows interested parties to obtain complete access to Claims and ALJ records and electronically submit documents to the ICA. Payments to the ICA can be completed quickly and securely online by visiting the ICA Payment Portal. ICA Online FAQs and Support Resources - The ICA website (azica.gov) has been redesigned to make it faster and easier for stakeholders and customers to find needed information and get answers to their questions. For more information about Arizona's response to the spread of COVID-19, please visit the Arizona Department of Health Services here.
• On June 25, 2020, the Industrial Commission of Arizona will hold its Annual Fee Schedule Public Hearing pertaining to the annual review of the Physicians’ and Pharmaceutical Fee Schedule. See A.R.S. § 23-908(B). The public hearing will be conducted at 1:00 p.m. as part of the Commission’s regularly scheduled meeting that day.  The Commission Meeting and Public Hearing will be conducted telephonically.  Stakeholders and members of the public may join the meeting by calling 1-475-441-8746 and entering access code 956 944 817#.  A stakeholder or member of the public wishing to make a comment during the hearing is asked to send their name and the organization they represent, if applicable, to Kara Dimas by e-mail (Kara.Dimas@azica.gov) in advance of the meeting.

LEGISLATIVE ACTIONS:

• Senate Bill 1331 The enacted legislation extends the 10 percent deviation rate for calculating taxes or assessments paid by self-insured employers through calendar year 2022.  Effective Date August 26, 2020.

Arkansas VIEW STATE →

REGULATORY ACTIVITY:

• Due to the on-going COVID-19 crisis and per the Governor's Executive Order # (20-06), the Workers' Compensation Commission is extending the date of first assessment of penalties prescribed under Ark. Code §11-9-304(b) by forty-five (45) days. §11-9-304(b) states: "If the tax provided for under this section is not paid within thirty (30) days of the date provided in §11-9-306, there shall be assessed a penalty for each thirty (30) days the amount so assessed remains unpaid which is equal to ten percent (10%) of the unpaid amounts and which shall be collected at the same time as a part of the tax assessed." Summary: The premium tax was due April 1, 2020. The first assessment of penalties would normally be on May 1, 2020. The May 1, 2020 date is hereby extended forty-five (45) days to June 14, 2020. As this is a Sunday, if the tax is not received in our office by June 15, 2020, the first ten percent (10%) penalty will be assessed, and the self-insurer may be subject to immediate revocation of the self-insurance authority.
• The insurance department issued bulletin 24-2020 on May 11, 2020 regarding COVID-19 emergency bulletin affecting pharmacy benefit managers and pharmacy services. The Arkansas Insurance Commissioner is issuing this Bulletin to assist consumers with insurance policies affected by the outbreak of the COVID-19 virus in Arkansas, providers of health services attempting to treat and contain the outbreak, and entities regulated by the Arkansas Insurance Department as they deal with urgent needs caused by the occurrence of the virus in Arkansas. The Arkansas Insurance Department is committed to assisting its fellow state agencies, local health departments, emergency managers, and health care providers in providing for the health and welfare of the people of Arkansas. On May  5,  2020,  Governor  Asa  Hutchinson  issued  Executive  Order  20-25  declaring  a  statewide  state  of emergency for the purpose of extending the public health and disaster emergency and declaration of the State of Arkansas as a disaster area resulting from the state-wide impact of COVID-19 an additional forty-five (45) days from the issuance of EO 20-25. The  Order  may  impact  various  insurance  regulatory  statutes  so  that  the  Department  may  effectively  render maximum assistance to overcome any potential impediment to the rapid and orderly rendering of assistance to our citizens affected by the virus. To view this bulletin, go to https://insurance.arkansas.gov/resource-library/resources/.

California VIEW STATE →

FEE SCHEDULE NEWS:

• The DWC has published a new file for Medi-Cal rates effective May 15, 2020 however, no updates to the data were adopted. The next update is expected June 15, 2020.
• The Division of Workers’ Compensation (DWC) has posted an order adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to additional 2020 changes in the Medicare payment system as required by Labor Code section 5307.1 with an effective date of March 6, 2020.
• The Division of Workers’ Compensation (DWC) has posted an order dated May 7, 2020, adjusting the Physician and Non-Physician Practitioner Services section of the Official Medical Fee Schedule (OMFS) to conform to additional Medicare fee schedule changes pursuant to Labor Code section 5307.1 with a retroactive date of March 1, 2020. The Interim Final Rule adopts an expanded list of medical services (“Covered Telehealth Services for PHE for the COVID-19 pandemic effective March 1 2020-updated April 30 2020”) that may be billed for telehealth using video and audio technology, and includes identification of services that could be provided through audio-only where medically appropriate. The CMS Interim Final Rule temporarily increases fees for three telephone evaluation and management codes (CPT codes 99441, 99442, 99443) retroactive to March 1, 2020 to provide parity between these codes and evaluation and management codes for services rendered in person or by audio/video telehealth. DWC has adopted the retroactive increases for these three codes, which will support the provision of medical care for injured workers and further the goal of maintaining social distancing. The Administrative Director order also adopts the CMS revised 2020 Relative Value Unit file, “RVU20B (Updated 05/01/2020),” which replaces the initial quarter two RVU20B file. The revised file is substantially identical to the original file. The significant change for workers’ compensation services is the increase of the relative values for CPT codes 99441 through 99443 discussed above. Workers’ compensation claims administrators should adjust payment systems in light of the retroactive changes and set up a process to reevaluate claims for services rendered on or after March 1, 2020 that may have additional payment due so that the balance owing is remitted to the provider.
• The Division of Workers’ Compensation (DWC) has posted an order adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) to conform to additional Medicare updates to COVID-19 testing codes and fees as required by Labor Code section 5307.1. The Administrative Director update order dated May 21, 2020 adopts additional codes and fees to supplement the COVID-19 testing codes and fees adopted by the Order dated April 15, 2020. The OMFS adjustment adopts fees retroactively to the Medicare effective dates as follows: CPT Code 87635 (infectious agent detection by nucleic acid tests) - effective for services on or after March 13, 2020, CPT codes 86769 and 86328 (for antibody tests) - effective for services on or after April 10, 2020. The Administrative Director update Order can be found at the DWC OMFS Pathology and Laboratory Fee Schedule webpage.
• On March 30, 2020, the Administrative Director of the Division of Workers’ Compensation (DWC) issued an order that title 8, California Code of Regulations, section 9789.39, pertaining to the Hospital Outpatient Departments and Ambulatory Surgical Centers Fee Schedule portion of the Official Medical Fee Schedule, be adjusted to conform to changes in the Medicare system, effective for services rendered on or after April 1, 2020. Subsequently, on May 4, 2020, the Centers for Medicare, and Medicaid Services (CMS) issued a corrected Addendum B to supersede the previous document, effective April 1, 2020. The order is the second Administrative Director order for services rendered on or after April 1, 2020 to the Hospital Outpatient Departments/Ambulatory Surgical Centers Fee Schedule. The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Centers for Medicare & Medicaid Services (CMS) Medicare changes:     Adopt and incorporate by reference CMS’ HOPPS addendum B found in the April 2020 CORRECTION (ZIP) – updated 5/4/2020 file, in place of the original file, for services rendered on or after April 1, 2020, except that HCPCS Code C9803 is effective for services on or after March 1, 2020.     Certain sections of the CMS Medicare OPPS April 2020 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V21.1 R2 Apr 2020 quarterly update. On April 30, 2020, CMS issued the Interim Final Rule with Comment Period [CMS-5531-IFC] “Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program.” The Interim Final Rule with Comment Period [CMS-5531-IFC] adopts a wide variety of temporary emergency provisions to address the COVID-19 pandemic in order to increase access to needed care and appropriately reimburse medical providers. In the Interim Final Rule, CMS adopts a new COVID-19 specimen collection code, C9803, effective March 1, 2020, to be used by hospital outpatient departments during the public health emergency. The Administrative Director update order dated March 30, 2020 remains in effect for services rendered on or after April 1, 2020, except as modified by Administrative Director order dated May 15, 2020. The Orders and regulations can be found at the DWC website’s OMFS page.

REGULATORY ACTIVITY:

• Published notice of denial of petition by Joseph V. Capurro, California Applicants’ Attorney’s Assn. The DWC received Petitioner’s letter on March 17, 2020.  The  Petitioner  re- quests that the DWC amend a provision of former California Code of Regulations, title 8 (“8 CCR”), section 9785(b)  to  require  that  any  discharge  of  an  injured worker from further treatment by the primary treating physician must include a personal exam by the primary treating physician and that the discharge be documented in either a PR3, PR4 or Medical−Legal Report.
• The Insurance Commissioner Ricardo Lara issued a Bulletin extending his previous order requiring insurance companies to return partial insurance premiums to consumers and businesses and provide much-needed financial relief amid the ongoing COVID-19 pandemic. The Department of Insurance will review all premium adjustments to ensure they are fair and adequate and reflect policyholders’ reduced risk. The Bulletin now includes the month of May, having already included the months of March and April, covering at least six different insurance lines: private passenger automobile, commercial automobile, workers’ compensation, commercial multi-peril, commercial liability, medical malpractice, and any other insurance line where the risk of loss has fallen substantially as a result of the COVID-19 pandemic. The Commissioner’s Bulletin 2020-4 requires insurance companies to provide an adjustment to the premium in the form of a premium credit, reduction, return of premium, or other appropriate adjustment as soon as possible, and no later than August 11, 2020. For most if not all consumers, this will be a percentage of the premium — not 100 percent — and the Department of Insurance will validate each insurance company’s plan so that refunds are adequate and reflect the reduced risk.    To view the bulletin, go to  https://www.insurance.ca.gov/0250-insurers/0300-insurers/0200-bulletins/bulletin-notices-commiss-opinion/bulletins.cfm.
• The Division of Workers’ Compensation (DWC) announces its emergency regulations for medical-legal evaluations became effective on May 14, 2020 and will expire on January 12, 2021 (in accordance with Executive Order N-40-20) with two possible 150-day extensions, if Executive Order N-40-20 remains in effect. The emergency regulations can be found on the DWC website. DWC filed the emergency regulations with the state’s Office of Administrative Law (OAL) on May 4, 2020 and received public comment on the regulations through May 12, 2020. Based on public comments and feedback from OAL, slight edits were made to the regulations. The edits include § 78 was renumbered to § 46.2. Slight edits were also made to § 46.2(a) removing “and remunerated”; § 46.2(a) (2) (A) providing for clarification regarding form 110; § 46.2(a) (3) (E) providing the attestation be “in writing”; and § 46.2(e) providing for an assessment of stay-at-home orders in the jurisdiction where the injured worker resides or where the evaluation occurs. Slight edits were made to § 36.7(d) providing clarification of form 122 and § 36.7(e) changed the reference to regulation § 39 to § 39.5. These emergency regulations will help injured workers and employers continue to move their workers’ compensation claims towards a resolution and avoid additional and undue delay. The regulations concern how medical-legal evaluations may occur during this emergency period. Also provided in the regulations are alternative forms of service for required forms related to medical-legal evaluations and reports.   To view this notice, go to https://www.dir.ca.gov/dwc/dwc_home_page.htm.
• The Division of Workers’ Compensation (DWC) and Workers’ Compensation Appeals Board (WCAB) have updated certain forms to properly allow for identifying injuries related to COVID-19. Parties are required to list body part codes when filing these forms. The forms listed below have been updated to include the new body part code which should be used in addition to those indicating specific body parts or functions resulting from the injury. If filing a claim for COVID-19, the body part code is “900.” The new code may be found in the drop-down menu when listing body parts on the forms below. These forms may be found at https://www.dir.ca.gov/dwc/forms.html and are also available to e-filers for use beginning May 23, 2020.  The forms are:
  • Document Cover Sheet;
  • Application for Adjudication of Claim;
  • Compromise and Release; and
  • Stipulations with Request for Award (for injury on or after 1/1/2013).
• The American College of Occupational and Environmental Medicine (ACOEM) and MDGuidelines have released a Coronavirus (COVID-19) Clinical Practice Guideline. The Division of Workers’ Compensation (DWC) supports this guidance and plans to adopt and incorporate the ACOEM Coronavirus (COVID-19) Guideline into the Medical Treatment Utilization Schedule (MTUS).  At this time, however, the evidence-based management of this disease is fluid and evolving and as a result guidelines are published frequently. DWC will wait to adopt and incorporate ACOEM's COVID-19 Guideline into the MTUS until the frequency of updates slows to a point where the formal adoption process can be completed. In the meantime, for treatment recommendations pertaining to COVID-19, follow the MTUS Medical Evidence Search Sequence found in California Code of Regulations, title 8, section 9792.21.1. This regulatory search sequence requires a search of the most current version of ACOEM guidance. The ACOEM COVID-19 Guideline meets that criteria.  To view this notice, go to https://www.dir.ca.gov/dwc/dwc_home_page.html.
• The Division of Workers’ Compensation (DWC) and Workers’ Compensation Appeals Board (WCAB) continue to improve their operations during the COVID-19 pandemic. The following changes are going to be effective June 8:
  • Updated Hearing Procedures - Starting June 8 DWC will continue to hear all mandatory settlement conferences, priority conferences, status conferences, case-in-chief trials and expedited hearings telephonically via the individually assigned judges’ conference lines as announced in DWC’s Newslines issued on April 3 and April 28.
  • Beginning June 8, DWC will hear up to 3 lien conferences per judge per calendar session via the individually assigned judges’ conference lines. Lien conferences in excess of that number will be continued. All parties scheduled for a hearing should call the conference line for the judge in front of whom the case is set, at the designated time listed on the hearing notice. When prompted, the parties should enter the access code assigned to that line. DWC staff will instruct participants as to the procedure to follow during the call. All lien trials will be continued during this time. District offices will not hold in-person hearings.
  • Continuing Filing Procedures: DWC will not accept walk-in filings, walk-through documents, or in-person requests at this time. DWC will only accept electronic filing via EAMS and JET File, and paper filing by U.S. mail. DWC will accept limited email filings pursuant to WCAB’s en banc dated April 6 and its Newsline issued on April 23. Email filings are limited to documents that are subject to a statute of limitations that cannot otherwise be e-filed, JET filed, or filed by U.S. mail. DWC has posted additional information to assist parties with filing settlement documents in EAMS. Refer to the district office page for email and other contact information.  DWC will continue to accept an electronic signature on any settlement documents, applications, pleadings, petitions, or motions that are sent to the district offices or filed in EAMS. For all e-forms, parties should utilize “S signature” as shown in the E-forms Filing Reference Guide and the JET File Business Rules. Injured workers who are unable to file utilizing the available options or need assistance may contact DWC’s call center at (909) 383-4522. The WCAB Commissioners' office is closed to the public for in-person inquiries and requests until further notice. The Commissioners and staff are working remotely during the closure.

Colorado VIEW STATE →

FEE SCHEDULE NEWS:

• The Division of Workers’ Compensation adopted an emergency regulation to establish procedures for Workers’ Compensation applicable during the state of emergency declared by the Governor due to COVID-19.

REGULATORY ACTIVITY:

• Published the maximum temporary disability benefits for 2020.  The maximum rates for workers' compensation benefits for the year beginning July 1, 2020, through and including June 30, 2021. To view the publication, go to  https://www.colorado.gov/cdle/dwc.

Connecticut VIEW STATE →

REGULATORY ACTIVITY:

• The Workers' Compensation Commission is encouraging the use of telemedicine in response to the COVID-19 pandemic. Providers have been instructed to bill telemedicine visits with the appropriate CMS or CPT identified telemedicine code, utilizing modifier 95 together with place of service 02. Carriers have been advised to reimburse these visits at the fee schedule rate with no reduction (excluding contractual discounts).  Until further notice, the Workers' Compensation Commission is instructing that workers' compensation claims billed with place of service 02 shall be reimbursed at the non-facility rate.
• In order to comply with the social distancing measures made necessary to combat the spread of COVID-19 and the existing measures taken by the Workers’ Compensation Commission to dramatically reduce the need for in person hearings, the Compensation Review Board is now offering the following alternatives for the scheduled May 22, 2020 CRB docket. 1. Parties may file a motion to postpone oral argument. As always, we ask the parties to communicate if they are in agreement as to the postponement. Requests to postpone will be generally favored.  2. As always, parties may choose to waive oral argument and proceed on the basis of the papers submitted in the prosecution or defense of the scheduled appeal. It will be up to each party to individually decide if this is how they wish to proceed. Stated another way, if one side wishes to waive oral argument, the other side may choose to participate in oral argument. Thus, the legal argument of the party waiving oral argument will be considered on the basis of the papers submitted, and the oral argument of the other party will go forward as stated below.  3. Oral argument will be conducted via telephonic conferencing. We anticipate utilizing procedures that are similar to those used for district office hearings. In order to facilitate the process please email to Jackie Sellars at the Compensation Review Board the telephone number at which you may be reached for the telephone conference. Her email address is Sellars@ct.gov.  We envision that parties who participate in oral argument should anticipate a conference call at some point during the time period their appeal is slotted to be heard. E.G., if you are scheduled for a 9:00 AM hearing be prepared to participate in a conference call starting at sometime between 9:00 AM and 10:30 AM. We know that these are challenging times for all of us. We also know that our ability to accommodate your needs will be dependent on both our levels of staffing and consequently, may be subject to change. We appreciate your patience and understanding.

Delaware Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published notice of proposed rules regarding prohibited unfair claim settlement practices.  To view the proposed rule, go to https://insurance.delaware.gov/information/proposedregs/.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of a public hearing workshop to be held June 10, 2020. DEPARTMENT OF FINANCIAL SERVICES: Division of Workers' Compensation. RULE : 69L-31.002 Definitions; 69L-31.003  Petition Form; 69L-31.004 Carrier Response Form; 69L-31.005  Petition Requirements; 69L-31.006 Consolidation of Petitions; 69L-31.007 Service of Petition on Carrier and Affected Parties; 69L-31.008  Computation of Time; 69L-31.009 Carrier Response Requirements; 69L-31.010 Effect of Non-Response by Carrier; 69L-31.011 Complete Record; 69L-31.012 Joint Stipulation of the Parties: 69L-31.013 Petition Withdrawal; and 69L-31.014       Overutilization Issues Raised in Reimbursement Dispute Resolution. The DEPARTMENT OF FINANCIAL SERVICES announces a hearing to which all persons are invited. DATES AND TIMES: UPDATED: The Division of Workers’ Compensation has changed the hearing scheduled for Wednesday, April 8, 2020, 9:00 a.m. – 11:30 a.m. to, Wednesday, June 10, 2020, 9:00 a.m. – 11:30 a.m. This hearing was previously noticed in the Vol. 46/31, February 14, 2020 issue of the Florida Administrative Register. PLACE: DWC 1st Floor Conference Room, 1579 Summit Lake Drive, Tallahassee, FL 32317. GENERAL SUBJECT MATTER TO BE CONSIDERED: The hearing is being conducted to receive public input and consider proposed changes to the above-referenced rules. A copy of the agenda may be obtained by contacting: Theresa Pugh, telephone: (850)413-1721, email: Theresa.Pugh@myfloridacfo.com. 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).  To view this notice, go to https://www.flrules.org/gateway/View_Notice.asp?id=23077869.

Georgia VIEW STATE →

REGULATORY ACTIVITY:

• On May 11, 2020, the Honorable Harold D. Melton, Chief Justice of the Georgia Supreme Court, issued a Second Order Extending Declaration of Statewide Judicial Emergency which extends the judicial emergency through June 12, 2020.  Consistent with the Chief Justice’s order, the Board hereby extends its order dated April 7, 2020, through June 12, 2020, with the following clarifications, modifications, and directions.  To view the order, go to https://sbwc.georgia.gov/.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

• The Industrial Commission cancelled the May 20th Advisory Committee meeting due to COVID-19 concerns.. We are hopeful that conditions improve, and we can hold the August 12th meeting at the Chinden location. As that date gets closer, we will send out more information. The Commission has updated their IDAPAs. The new chapters can be found on our website: https://iic.idaho.gov/rules-and-legislation/. The Commission has also recently made other changes to business processes. Updated policy and procedures can be found at the above website. The August meetings are when elections typically occur. This year several memberships are up for election: 1 representative of Workers; 2 representatives of Employers; 1 representative of the Insurance industry; 1 Attorney representative of Workers; and 1 Attorney representative of Employers.
• The Commission issued an emergency order regarding Covid-19. On March 13, 2020, Governor Brad Little declared a State of Emergency in response to the novel coronavirus (COVlD-19). On March 23, 2020, the Idaho Industrial Commission entered its Order in response to the COVID-19 emergency to protect the health and safety of Commission employees, elected officials, and the general public. On March 25, 2020, Governor Little, citing community spread of COVID-19, issued a Statewide Stay-Home Order. The Idaho Industrial Commission hereby amends its March 23, 2020  and April 10, 2020  Orders, provides guidance, and ORDERS measures to be implemented from Monday, May 18, 2020, to Tuesday, June 30, 2020, or until further order of the Commission.  To view the order, go to https://iic.idaho.gov/.

LEGISLATIVE ACTIONS:

• Senate Bill 1262 The enacted legislation amends existing law to remove a provision regarding a labor department seal.  The bill also establishes a provision regarding an employer’s experience rating.  The legislation also revises a provision regarding registration of exempt corporate officers. Effective Date July 1, 2020.
• Senate Bill 1263 The enacted legislation amends the existing law regarding occupational diseases by removing the sunset provision enacted on 2016.  Effective Date July 1, 2020.
• Senate Bill 1321 The purpose of the enacted legislation is to add language to 72-209 I.C. to clarify the intent of the Idaho Legislature with respect to the "exclusive remedy" in workers' compensation. The Idaho Supreme Court has recently noted that there is a lack of clarity as to when a claim for compensation for a workplace accident may go outside of the workers' compensation process to file a regular tort claim. The Court specifically noted that the Legislature did not define the term "willful or unprovoked physical aggression". Previously it was understood that only those claims that could demonstrate an intention to commit harm to an employee were exempt from the exclusive remedy in the workers’ compensation system. The Court invited the Legislature to clarify the language of the statute. The language noted in this bill will preserve the integrity and balance of the "Grand Bargain" of workers’ compensation in Idaho. Effective Date July 1, 2020.

Illinois VIEW STATE →

REGULATORY ACTIVITY:

• June 2020 SPECIAL CIRCUMSTANCE ARBITRATION PROCEDURES: Based upon the continuing National Emergency and Worldwide Pandemic created by the COVID-19 virus, Arbitrators will conduct June 2020 monthly status calls and pre trials via WebEx. All trials will be held in person.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• Issued Bulletin 254 which extends the moratorium on policy cancellations and no-renewals established in Bulletin 252 to May 31, 2020.  To view the bulletin, go to https://www.in.gov/idoi/2591.htm.

LEGISLATIVE ACTIONS:

• Senate Bill 258 The enacted legislation requires the board of firefighting personnel standards and education to establish best practices to improve safety and health outcomes for firefighters. Establishes the best practices fund for the purpose of providing matching grants to political subdivisions and volunteer fire departments to purchase equipment and other gear to implement best practices. Provides that the workers’ compensation rating bureau of Indiana may recommend a premium or rate discount toward workers’ compensation insurance to political subdivisions and volunteer fire departments that implement best practices. Effective Date July 1, 2020.
• Senate Bill 269 The legislation as enacted provides that for workers' compensation and occupational diseases compensation, not later than 14 days from the date that the first installment of compensation is due, an employer or the employer's insurance carrier must file with the workers' compensation board (board) a report of payment of compensation. (Current law provides that not later than 15 days from the date that the first installment of compensation is due, an employer or the employer's insurance carrier must file with the workers' compensation board a compensation agreement.) Provides that for workers' compensation and occupational diseases compensation, the presentation to the employee or to the employee's dependents of certain payments from the employer or the employer's insurance carrier is sufficient tender of the workers' compensation or occupational diseases compensation. Provides that for workers' compensation and occupational diseases coverage, an employer must notify certain employees of the employer's intent to terminate the employee's temporary total disability benefits, and for all instances of termination of benefits, file an electronic notice with the board. (Current law provides that an employer must notify an employee of the employer's intent to terminate temporary total disability benefits in cases not included in statute.) Provides that for workers' compensation and occupational diseases compensation for injuries occurring on or after July 1, 1991, compensation amounts determined for visual impairments shall be: (1) based on the Functional Vision Score; and (2) except in cases of permanent and complete loss of vision by enucleation, be paid as a whole person rating. (Current law provides that for injuries occurring on or after July 1, 1991, compensation amounts determined for: (1) permanent reduction of the sight of an eye less than a total eye loss shall be paid in an amount proportionate to the degree of a permanent reduction without correction or glasses; and (2) 100% loss of vision shall be paid for 50% of the total loss of vision without glasses, plus an additional amount equal to the proportionate amount of the reduction with glasses). Removes from the compensation schedule for workers’ compensation and occupational diseases compensation, for injuries occurring on or after July 1, 1991, that a reduction of vision to 1/10 of normal vision with glasses is 35 degrees of permanent impairment. Provides that the board may dispose of all papers for files when compensation has been awarded either by agreement or upon hearing two years after the termination of the compensation period for files related to workers’ compensation and worker's occupational diseases compensation. (Current law provides for one year.) Provides that all records of insurance coverage related to workers' occupational diseases compensation shall be maintained for 35 years. (Current law provides the records be maintained for 45 years). Effective Date July 1, 2020.

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

• Published a memorandum regarding the extension of cancellation of in-person proceedings. On March 6, 2020, Governor Beshear entered Executive Order 2020-215 and declared a state of emergency in response to the Coronavirus (COVID-19) emergency in the Commonwealth.  On March 13, 2020, in order to further protect the health and safety of Department of Workers’ Claims (“DWC”) staff, Administrative Law Judges, court reporters, attorneys, and parties, the DWC cancelled all in-person benefit review conferences and formal hearings through April 20, 2020. The cancellation of those proceedings was subsequently extended to May 17, 2020. In light of the continuing state of emergency, all in-person benefit review conferences and hearings are hereby cancelled until further notice. Administrative Law Judges shall use telephonic or videoconference technology for necessary proceedings. The DWC will issue such further directives as may be appropriate. To view the memorandum, go to https://labor.ky.gov/comp/Pages/default.aspx.
• Issued a revised COVID-19 - Codes memo.  The memo adds an additional code that can be billed for testing and the amount of reimbursement amount for that code.  Providers may use HCPCS code U0001, U0002, U0003, as appropriate, when submitting claims for Covid-19 testing.  Any Covid-19 test administered in 2020 is eligible for payment. These codes and reimbursement rates will also be located in the 2020 edition of the Schedule of Fees, effective on July 1. 2020.  This edition will remain effective until July 1, 2022. Reimbursements for these codes are: U0001 $44.90; U0002 $64.16 and U0003 $125.00.

LEGISLATIVE ACTIONS:

• House Bill 186 The enacted legislation amends the statute to exclude direct sellers from the definition of employee in regard to payment of wages. Exempt for having to provide coverage for workers’ compensation insurance. The legislation also excludes direct sellers from “covered employment” in regard to unemployment insurance.  Effective Date July 15, 2020.
• Senate Bill 263 The enacted legislation amends the statute to set forth a process to refund excess assessments to coal mining employers.  Effective Date July 15, 2020.

Maine VIEW STATE →

REGULATORY ACTIVITY:

• In light of Governor Mills’ announcement of a staged approach to restarting Maine’s economy, questions have arisen regarding when the Board will begin to conduct in-person proceedings.  While it is impossible to give a definitive answer, we are presenting an outline that represents our best estimate of when we will be able to offer in-person proceedings.  Please keep in mind that the following outline is based on what we know today and is subject to change.  We will monitor future events and make adjustments as needed. With that in mind, we expect all proceedings in May and June to be conducted via remote technology.   July is the earliest the Board is likely to begin offering the option of in-person hearings.  As we do so, these hearings are likely to be limited to formal hearings where the parties agree in-person witness testimony is necessary.  Other proceedings such as lump sum settlements and mediations will be phased in at a later date. In developing our plan, we are trying to balance the need for in-person hearings, in some situations, with the need to protect the health and safety of our employees and the public that relies on our services.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• Pursuant to the authority granted by COMAR 14.09.17, on 5/01/20, Chairman Aumann issued Administrative Order 2020-02 regarding extension of deadlines.  To view the order, go to https://www.wcc.state.md.us/.
• Pursuant to Open Meeting requirements, the Commission announces that the Medical Fee Guide Committee will hold a virtual meeting on Monday, June 8, 2020 at 1:00 pm. The meeting will be held using Microsoft Teams and will discuss reimbursement rates for telehealth procedure codes. If you would like to telephonically observe the meeting, please dial 1(443)961-6421 and at the prompt, enter 454770597 plus the pound sign. If you have any questions about the meeting or plan on attending, please email jvanderpuije@wcc.state.md.us.  To view this notice, go to http://www.wcc.state.md.us/.
• The Commission announces that we may be resuming in-person hearings effective June 8, 2020. The hearings will be staggered in order to accommodate physical distancing. Exhibits shall continue to be submitted electronically three days prior to the hearing. There is no need to email the exhibits to the Commission or the parties.  Public access is strictly limited to claimants, attorneys, parties, and witnesses to hearings scheduled on that particular day. The Commission will continue to hold video hearings daily for those participants who are uncomfortable attending in-person hearings. If you are scheduled for an in-person hearing and wish to request a VRH instead, you must request a postponement of the in-person hearing and file an Emergency Hearing Request and follow the instructions for a VRH posted on the webpage. Social distancing will be required and highlighted for everyone visiting the Commission hearing sites and offices. Your cooperation and assistance in this regard will be appreciated. We request that parties arrive shortly before their scheduled in-person hearing and depart immediately after. While the Commission will allow documents to be hand-delivered to the Public Service area in Baltimore, they must be dropped off on a table on the fourth floor set up for this purpose. There will be no waiting on site for these documents to be processed. They will be returned via mail. If attorneys, claimants, witnesses, or anyone else is sick or not feeling well, STAY HOME; do not come to the Commission. Continuances will be granted, and the case will be reset as quickly as possible. We appreciate your cooperation with the new rules as we slowly get back to normal operations in a safe and measured manner.   To view this notice, go to https://www.wcc.state.md.us/Adjud_Claims/Notices_and_Announcements/May_2020_Notices.html.
• When requesting a Video hearing (VHR), you must notate in the justification section if an interpreter will be needed and the required language.
• Updated the state's video remote hearing instructions.  To view the updated instructions, go to http://www.wcc.state.md.us/.

LEGISLATIVE ACTIONS:

• House Bill 99; Senate Bill 616 The enacted legislation requires that the Injured Workers’ Insurance Fund to be the third–party administrator for the State’s Self–Insured Workers’ Compensation Program for State Employees under a contract with the State.  The legislation authorizes the Fund to use nonsupervisory employees of the Chesapeake Employers’ Insurance Company. It further authorizes nonsupervisory employees of the Company to be assigned to perform certain functions under a certain contract.  The legislation requires the Company and the Fund annually to execute an agreement.  It alters the membership of the Board for the Fund by providing that the terms of certain members of the Board for the Fund are the same as the members’ terms on the Board for the Company.  The legislation requires the Board for the Fund to adopt certain rules, bylaws, policies, and procedures. It requires the President of the Fund to be an employee of the Fund, rather than the President of the Company. Effective Date October 1, 2020.

• House Bill 685 The legislation was enacted for the purpose of providing for enhanced workers’ compensation benefits for a Baltimore County correctional officer, a Baltimore County detention officer, a Harford County deputy sheriff, a Harford County correctional officer, and a Harford County detention officer for a compensable permanent partial disability of less than a certain number of weeks; providing for the application of this Act; and generally relating to workers’ compensation benefits for Baltimore County correctional officers and detention officers and Harford County deputy sheriffs, correctional officers, and detention officers.  Effective Date October 1, 2020.

• House Bill 810 The legislation was enacted for the purpose of providing that a member of a volunteer company in Washington County who is at least a certain age and is enrolled in a certain fire and rescue academy program is a covered employee for the purpose of receiving workers’ compensation benefits; and generally relating to workers’ compensation insurance for members of volunteer companies in Washington County. Effective Date July 1, 2020.

• Senate Bill 8 The enacted legislation alters the percentage of the additional assessment that the Uninsured Employers’ Fund Board may direct the Workers’ Compensation Commission to impose on certain awards and settlements if the Board determines that the reserves of the Uninsured Employers’ Fund are inadequate to meet anticipated losses; and generally relating to assessments related to the Uninsured Employers’ Fund. Effective Date July 1, 2020.

• Senate Bill 80 The legislation renames the Maryland Emergency Management Assistance Compact to be the Maryland Intrastate Emergency Management Assistance Compact.  It alters the purpose of the Compact.  The legislation requires a certain official to designate more than one authorized representative for a certain purpose.  It alters the information that must be provided by a certain written request. The enacted legislation repeals the authority of a certain official to advise the Maryland Emergency Management Agency of certain requests and provide copies of certain requests. It alters the circumstances under which certain provisions of law take effect and continue in effect.  The exacted legislation alters certain definitions. Effective Date October 1, 2020.

• Senate Bill 784The enacted legislation alters the time period within which a covered employee must report to the employer a hernia caused by an accidental personal injury or by a strain arising out of and in the course of employment for the purpose of filing a claim for compensation. It authorizes a covered employee to file a claim for compensation for a hernia caused by an accidental personal injury within a certain time period under certain circumstances.  The enacted legislation makes conforming changes.  It provides for the application of this Act and generally relating to workers’ compensation and hernia claims.  Effective Date October 1, 2020.

Massachusetts VIEW STATE →

REGULATORY ACTIVITY:

• Effective Monday May 18th, for inquiries about medical bills (not payments) please contact Diane.Neelon@mass.gov.

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

• Physicians - CMS has posted the Physician Fee Schedule effective July 1, 2020.
• Clinical Lab – CMS has posted Medicare Administrative Contractor (MAC) pricing for COVID-19 codes 86328, 86769 and 87635.
• CCI, MUE and Add-on Edits – CMS has posted the CCI, MUE and Add-on edits effective July 1, 2020.
• ASP Drugs – CMS has posted the ASP Drug file effective July 1, 2020 and reposted the ASP Drug files effective July 1, 2019, October 1, 2019, January 1, 2020 and April 1, 2020.

Michigan VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of proposed amendment to Health Care Services Rules.  Along with the notice published the Division also published minutes of their last meeting which sets forth the areas that will be under review specifically for consideration of updating.  The changes are not expected until September of 2020.
• Posted notice in the state register notice of request for rule making for pending rule set 2020-26 LE regarding workers' compensation health care services.  The filing date and effective date have not been established.   To view the notice, go to  https://dtmb.state.mi.us/ARS_Public/Transaction/RFRTransaction?TransactionID=154.
• Posted notice in the state register notice of request for rule making for pending rule set 2020-31 LE regarding workers' disability compensation general rules.  The filing date and effective date have not been established.  To view the notice, go to https://dtmb.state.mi.us/ARS_Public/Transaction/RFRTransaction?TransactionID=159.

Minnesota VIEW STATE →

REGULATORY ACTIVITY:

• The Minnesota Department of Labor and Industry (DLI) has adopted expedited rules governing treatment for post-traumatic stress disorder (PTSD), Minnesota Rules, part 5221.6700, and amending general treatment parameters, Minn. R., part 5221.6050. The rules were approved by the Office of Administrative Hearings on March 26, 2020. The rules were published in the State Register and are effective May 4, 2020. A copy of the adopted rule is available on the DLI rulemaking docket page. More information about the PTSD treatment rules is provided on the PTSD treatment rule checklist.  To view the rule and checklist, go to http://www.dli.mn.gov/about-department/rulemaking/rulemaking-docket-minnesota-rules-chapter-52216700-2019?utm_medium=email&utm_source=govdelivery.
• The Department of Labor and Industry (DLI) continues to move forward with its plans for Work Comp Campus, the new workers' compensation claim portal, scheduled for go-live in August. DLI is also reviewing business processes to optimize the overall experience of attorneys and stakeholders who work most closely with DLI, the Office of Administrative Hearings (OAH) and the Workers' Compensation Court of Appeals (WCCA).
• Increased security: State government agencies and businesses have implemented largely remote work arrangements in the wake of the COVID-19 pandemic and Gov. Tim Walz's resulting executive orders. This shift in resources to the online space has also required increased day-to-day efforts and safeguards to promote cyber security and ensure the integrity of information related to workers' compensation cases and claims.
• State 'ZZ' email accounts decommissioned June 1: With increased security in mind, effective June 1, all state "ZZ" email accounts, which attorneys currently use to enter unavailable time, will be decommissioned and no longer supported by Minnesota IT Services (MNIT), the information technology agency for Minnesota's executive branch. Eliminating these email accounts will reduce security risks to the state and promote the overall security of state IT systems. What we are doing instead: Eliminating ZZ accounts also presents an opportunity to expedite a shift in how attorneys communicate with both DLI and OAH. In Campus, it was already intended that attorneys would manage their own calendars. Empowering attorneys to take ownership of their scheduling will ultimately result in a more straightforward user experience for all attorneys.
• At DLI: Effective June 1, and as a precursor to the Campus launch in August, attorneys and their designated staff members should forward unavailable schedule details to DLI by email to workcomp@state.mn.us. DLI will then use this information to try to ensure mediations and administrative conferences are scheduled at times that work for all parties.
• At OAH: OAH will no longer review attorneys' unavailability prior to scheduling. If parties have a conflict with a scheduled proceeding at OAH, they should file a Motion for Continuance to request rescheduling.
• After Campus goes live: After Aug. 31, attorneys can enter their unavailable time directly into Campus. The information in Campus will be available to both DLI and OAH.
• The Department of Labor and Industry (DLI) is adopting Version 3.1 of the Claims Release Standard (ACORD XML format) published by the International Association of Industrial Accident Boards and Commissions (IAIABC), and the corresponding Minnesota implementation guide, for purposes of reporting workers' compensation claims information to DLI on or after Aug. 31, 2020.The Notice of Adoption of Version 3.1 of the IAIABC Claims Release Standard and the corresponding Minnesota implementation guide will be published in the June 1, 2020, edition of the State Register.  A copy of the Notice of Adoption is available on DLI's website.  A copy of the adopted Minnesota implementation guide is available on DLI's website and provides details about how to electronically submit workers' compensation claims reporting to DLI on or after Aug. 31, 2020. Additional information about electronic data interchange (EDI) is on DLI's website. If you have questions or would like more information, contact DLI at campus.ediguide.dli@state.mn.us or 651-284-5011.

LEGISLATIVE ACTIONS:

• House File 4537 The enacted legislation states that certain employees who contract COVID-19 are presumed to have an occupational disease covered by the Minnesota workers’ compensation law.  A new paragraph (f) is added to Minnesota Statutes § 176.011, subdivision 15, of the workers’ compensation law, which applies to occupational diseases. According to this new law, an employee who contracts COVID-19 is presumed to have an occupational disease arising out of and in the course of employment if the employee meets the requirements in clauses 1 and 2. This part of the new law requires that the employee must be employed in one of the following occupations to qualify for the presumption: a licensed peace officer under Minn. Stat. § 626.84, subd. 1, firefighter, paramedic or emergency medical technician; a nurse or health care worker, correctional officer or security counselor employed by the state or a political subdivision at a corrections, detention or secure treatment facility; a health care provider, nurse or assistive employee employed in a health care, home care or long-term care setting, with direct COVID-19 patient care or ancillary work in COVID-19 patient units; or a person required to provide child care to first responders and health care workers under  Executive Order 20-02 and Executive Order 20-19. The employee’s contraction of COVID-19 must be confirmed by a positive laboratory test or, if a test was not available for the employee, as diagnosed, based on the employee’s symptoms, by a licensed physician, licensed physician’s assistant or licensed advanced practice registered nurse (APRN).  A copy of the positive test or documentation of the diagnosis must be provided to the employer or the employer’s workers’ compensation insurer. If the employee meets the requirements of clauses 1 and 2: the employer or insurer shall only rebut the presumption that the employee’s contraction of COVID-19 is an occupational disease by showing the employee’s employment was not a direct cause of the disease; and if the insurer denies liability for the workers’ compensation claim, the denial must meet the requirements for denials in Minn. Stat. § 176.221, subd. 1. The date of injury for an employee who has contracted COVID-19 is the date the employee was unable to work due to contraction of COVID-19 or was unable to work due to symptoms that were later diagnosed as COVID-19, whichever occurred first.  An employee who has contracted COVID-19 but does not meet the requirements of clauses 1 and 2, is not prohibited from claiming an occupational disease as provided in other paragraphs of the occupational disease law (Minn. Stat. § 176.011, subd. 15) or from claiming a workers’ compensation injury under subdivision 16. The commissioner of the Department of Labor and Industry must provide a detailed report by Jan. 15, 2021, about the handling of COVID-19 workers’ compensation claims. The commissioner must give the report to the Workers’ Compensation Advisory Council, and the chairs and ranking minority members of the House of Representatives and Senate committees with jurisdiction over workers' compensation. This law is effective for employees who contract COVID-19 on or after the day following final enactment and sunsets May 1, 2021.  Effective Date April 8, 2020.

Missouri VIEW STATE →

REGULATORY ACTIVITY:

• Published notice of adoption of an emergency rule that creates a presumption that First Responders infected by or quarantined due to COVID-19 are deemed to have contracted a contagious or communicable occupational disease arising out of and in the course of the performance of their employment.  To view the rule, go to https://www.sos.mo.gov/default.aspx?PageID=9845.
• Published Insurance Bulletin 20-15 regarding the extension of Bulletin 20-07 - Services Provided via Telehealth.  To view the bulletin, go to https://insurance.mo.gov/laws/bulletin/.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• Issued an administrative order regarding trials and evidentiary hearings in June.  To view the order, go to https://www.wcc.ne.gov/home/court-news.

New Hampshire VIEW STATE →

REGULATORY ACTIVITY:

• DOL Hearings Update: May 11, 2020: Effective immediately the Department is not conducting in person hearings. This applies to all administrative hearings at the Department. Scheduled hearings will either be conducted either by Cisco WebEx video conference or via telephone. Parties who are scheduled to appear for a first level workers' compensation hearing or a wage claim hearing are encouraged to email DOLhearings@dol.nh.gov with any questions. Questions regarding the scheduling of a Workers' Compensation Appeals Board hearing should be directed to Danielle.Albert@dol.nh.gov and Terry.Beyer@dol.nh.gov.

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

• Published a notice to the New Jersey Bar. This notice announces additional statewide steps by the New Jersey Division of Workers’ Compensation to address the ongoing public health crisis surrounding the COVID-19 coronavirus outbreak in New Jersey. In accordance with Governor Murphy’s Executive Orders to slow the spread of the virus, all N.J. workers’ compensation courts shall continue to be closed to the public and to nonessential court personnel until Tuesday, May 26, 2020. All twenty-six Judges of Compensation previously assigned by the Director and Chief Judge of Compensation shall continue to hear as many workers’ compensation matters as possible in their assigned vicinage by telephonic conferencing, and if possible by video conferencing, including all emergent and non-emergent matters, including trials, pre-trial conferences, motions for medical and temporary benefits, general motions, and settlements. There will be no in-person Workers’ Compensation Court proceedings (except for extremely limited emergent matters and certain ongoing motions for medical and temporary benefits and trials, in which case social distancing will be enforced). Court offices will remain closed for in-person submissions. Filings will continue to be accepted electronically through COURTS On-line. Please contact each individual workers’ compensation court if you have questions about a scheduled hearing, motion, conference, or other matter by email, fax, or telephone.  To view this notice, go to https://www.nj.gov/labor/wc/content/notices.html#covid19_0526.
• Effective May 11, 2020, in addition to the twenty-six (26) Judges of Compensation previously assigned as per the Division’s Notice to the Bar of April 28, 2020, the following three (3) workers’ compensation judges shall hear as many workers’ compensation matters as possible in the assigned vicinages by telephonic conferencing, and if possible by video conferencing, including all emergent and non-emergent matters, including trials, pre-trial conferences, motions for medical and temporary benefits, general motions, and settlements: Hon. Sarah Minor - Bridgeton Vicinage, Hon. D. Gayle Loftis - Mt. Arlington Vicinage, and Hon. Dawn Shanahan - Trenton Vicinage.  To view this notice, go to https://www.nj.gov/labor/wc/wc_index.html.
• All N.J. Workers’ Compensation Courts shall continue to be closed to the public and to non-essential court personnel until Monday, June 8, 2020.  Judges of Compensation shall continue to hear as many workers’ compensation matters as possible by telephonic and video conferencing, including emergent and non-emergent matters, such as, trials, pre-trial conferences, motions for medical and temporary benefits, general motions, and settlements.  There will be no in-person Workers’ Compensation Court proceedings except limited emergent matters and limited ongoing trials and motions for medical and temporary benefits, in which case masks shall be worn by all parties and social distancing shall be enforced. Court offices will remain closed for in-person submissions. Filings will continue to be accepted electronically through COURTS On-line.  Please contact each individual workers’ compensation court if you have questions about a scheduled hearing, motion, conference, or other matter by email, fax, or telephone.

New Mexico VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 6 The legislation expands permissible expenditures from the law enforcement protection fund. It provides that the penalty for a felon in possession of a firearm or destructive device is a third-degree felony.  It increases the sentencing enhancements for brandishing of a firearm in a noncapital felony. The enacted legislation creates a presumption that post-traumatic stress disorder is proximately caused by employment for law enforcement officers and emergency medical services first responders.  Effective Date July 1, 2020.

New York VIEW STATE →

REGULATORY ACTIVITY:

• The next chapter in the modernization of the New York State Workers’ Compensation Board, the Business Information System (BIS) Project, is well underway. The new system will bring improved and expanded access to real-time claim data, new electronic self-service features for interacting with the Board, and a reduction in the amount of overall paper forms to improve system responsiveness to stakeholder needs – just to name a few features. With the new system, the majority of our paper forms will be replaced by e-Forms, requiring our stakeholders to manually enter and submit data to the Board online. We know that many of you use computer software to automatically generate our paper forms. This new system will also have the ability to connect with your software to submit data to the Board online through an Application Programming Interface (API), eliminating the need for manual data entry, and offering you significant opportunities to automate and transform your claims processing and workflows.
• The Chair has adopted the amendment of 12 NYCRR 324.2 incorporating new Medical Treatment Guidelines (Elbow Injuries, Foot & Ankle Injuries, Hip & Groin Injuries, and Interstitial Lung Disease) by reference. The Notice of Proposed Rule Making was published in the July 31, 2019, edition of the State Register. A Notice of Revised Rule Making was published in the March 18, 2020, edition of the State Register. A Notice of Adoption was published in the May 20, 2020, edition of the State Register. These Medical Treatment Guidelines will be effective for care provided on or after January 1, 2021. To view this notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1298.jsp.
• The maximum weekly benefit rate for workers' compensation claimants is two-thirds of the New York State average weekly wage for the previous calendar year, as determined by the New York State Department of Labor (Workers' Compensation Law §§ 2(16); 15(6)).The Department of Labor reported to the Superintendent of the Department of Financial Services that the New York State average weekly wage for 2019 was $1,450.17. Accordingly, the maximum weekly benefit rate is $966.78 for compensable lost time for workers' compensation claims with dates of accident during the period from July 1, 2020, through June 30, 2021.  To view the notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/subjectNos.jsp.
• Issued bulletin Subject Number 046-1301 regarding emergency adoption of addition of 12 NYCRR 329-1.3(d) [COVID-19 Testing]. The Chair has adopted on an emergency basis, the addition of subdivision (d) to 12 NYCRR 329-1.3. This addition will allow reimbursement for COVID-19 testing, when there is a claim for workers' compensation benefits due to workplace exposure to COVID-19. A Notice of Emergency Adoption will be published in the June 3, 2020 edition of the State Register. This emergency rule-making is effective for 90 days upon filing May 18, 2020.    To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1301.jsp.  To view the rule, go to http://www.wcb.ny.gov/content/main/wclaws/COVID-19Testing/.

LEGISLATIVE ACTIONS:

• Senate Bill 6555 The enacted legislation relates to terms and conditions of employment for members of the collective negotiating unit consisting of investigators, senior investigators, and investigative specialists in the division of state police. It relates to the employee benefit fund for members of such unit.  The legislation makes an appropriation therefore (Part A). It provides for the adjustment of stipends of certain incumbents in the state university of New York and designating moneys therefore. The legislation continues a doctoral program recruitment and retention enhancement fund. It continues work-life services and pre-tax programs. It continues a professional development committee.  The legislation continues a comprehensive college graduate program recruitment and retention fund. It continues a fee mitigation fund. The legislation continues a downstate location fund. It continues a joint labor management advisory board and continues an accidental death benefit. It provides compensation for certain state employees in the state university that are designated, stipulated, or excluded from negotiating units as managerial or confidential pursuant to article 14 of the civil service law and certain employees of contract colleges at Cornell and Alfred Universities.  Effective Date January 1, 2020.

• Senate Bill 6959 The enacted Legislation authorizes the New York black car operators' injury compensation fund, Inc. to provide additional health benefits, consistent with its plan of operation, for all black car operators entitled thereto pursuant to this chapter, provided that the fund shall have complied with all applicable statutory and regulatory requirements; and provides for the expiration and repeal of a chapter of the laws of 2019 related thereto. Effective Date April 17, 2020.

• Senate Bill 8091 The enacted legislation provides provisions for certain employee benefits when such employee is subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19. Effective March 18, 2020.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• The Commission held the Public Hearing on the proposed amendments to 11 NCAC 23A.0108, .0109, .0302, 11 NCAC 23B .0104and .0105, and 11 NCAC 23L.0101, .0102, .0103, and .0105 on May 6, 2020. To view the transcript, go to http://www.ic.nc.gov/news.html#hot.
• Policies as of June 1, 2020 for Full Commission Hearings, Deputy Commissioner Medical Motion Hearings, and Executive Secretary’s Office Informal Hearings: Full Commission Hearings. Full Commission oral arguments scheduled in June 2020 will be conducted by teleconference. The Full Commission panel chair will provide the parties with a toll-free number and access code to dial into the conference call. Deputy Commissioner Medical Motion Hearings. Deputy Commissioner hearings on medical motions arising under G.S. §97-25(f) will be conducted in June 2020 with all parties appearing by teleconference, unless the Deputy Commissioner advises that the hearing will be conducted via WebEx videoconference(details regarding WebEx hearings will be provided in the near future). Based upon the parties’ stipulated facts and exhibits, the presiding Deputy Commissioner may excuse the parties from appearing at the G.S. §97-25(f) hearing if the parties and the Deputy Commissioner agree that no lay witnesses are needed to decide the case. If the parties are excused from appearing at the hearing because no lay witnesses are needed, the parties should proceed as usual with obtaining any expert medical testimony needed to close the record. Executive Secretary’s Office Informal Hearings. Consistent with normal operating procedures, the Executive Secretary’s Office will conduct informal hearings by teleconference. Deputy Commissioner Hearings (Non-Medical Motion Hearings) and Mediation: Policies as of June 1, 2020 will be Announced Shortly. Deputy Commissioner Hearings (Non-Medical Motion Hearings). On May 21, 2020, Chief Justice Beasley directed judicial officials to “make use of remote hearing technology to the greatest extent possible to limit in-person appearances.” In light of this Order, the Commission is developing hearing polices for June 2020 and future months that will be announced shortly. Mediation. The Dispute Resolution Commission is meeting on Thursday May 28, 2020, regarding remote attendance at mediation conferences during the COVID-19 pandemic. The Commission will adopt mediation policies that are consistent with the policies of the Dispute Resolution Commission. To view this notice, go to http://www.ic.nc.gov/news.html#hot.
• The Commission is pleased to announce that Deputy Commissioners will resume hearing all types of workers’ compensation cases in June 2020 through the use of WebEx technology. This policy is consistent with Chief Justice Cheri Beasley’s May 21, 2020 Order directing judicial officials to “make use of remote hearing technology to the greatest extent possible to limit in-person appearances” and will help prevent a future backlog of Deputy Commissioner cases. June 2020 Docket: For cases on the June 2020 docket where both parties are represented, the parties may jointly request a WebEx hearing by emailing the presiding Deputy Commissioner, and the Deputy Commissioner will make every effort to proceed with the WebEx hearing in June. If the Deputy Commissioner is unable to hold the WebEx hearing in June, the case will be set for a WebEx hearing in July or as soon as possible thereafter. Any case scheduled for June that is not heard via WebEx will be continued to be reset on a future docket. A Continuance Order will not be filed in each case, but the parties will be notified via email or U.S. mail (if email is not available) that the case has been continued. There will be no in-person hearings held in June unless otherwise ordered by the Commission. Note: The above applies to regular workers’ compensation hearings and NOT medical motion hearings arising under G.S. §97-25(f). For information regarding medical motion hearings, please see the prior announcement. July 2020 and Future Dockets: Beginning in July of 2020 and continuing until further notice, the Commission plans to docket all Deputy Commissioner hearings as WebEx hearings. If a party believes that a hearing should be held in-person while the State court system is under COVID-19 emergency directives, the party may file a motion for an in-person hearing with the presiding Deputy Commissioner. The moving party must show good cause as to why an in-person hearing should be allowed in light of the emergency directive to “make use of remote hearing technology to the greatest extent possible to limit in-person appearances.”  If a party believes that a case is neither appropriate for a WebEx hearing nor appropriate to be heard in-person at the present time, the party may file a motion to temporarily remove the case from the hearing docket with the presiding Deputy Commissioner. Consistent with existing Commission procedure, if the motion is granted, the case will be removed for an indefinite period of time, and it will not be necessary to file a new Form 33 to return the case to the hearing docket. Upon notification to the Clerk’s Office by the party requesting the temporary removal, the case will be set on the next available hearing docket. WebEx Hearing Requirements: The Commission will need an email address and phone number for each person who will participate in the WebEx hearing, including each witness who may be called to testify at the hearing. Each WebEx hearing participant will be sent a WebEx hearing invitation via email. The WebEx hearing can be joined by clicking on a link in the email. The only technological requirements for participation in a WebEx hearing are an email address, a computer or other device (such as a tablet or smart phone) equipped with a camera, and an internet connection. A free WebEx application is available to install on computers and other devices, but it is not necessary for participation. Hearing participants experiencing poor audio quality (or who have no microphone on their computer or other device) may establish an audio connection using a mobile phone or land line. Note: Regardless of how a participant connects for purposes of audio, the participant must appear by video, and therefore a computer or other device equipped with a camera is required.  To view this notice, go to http://www.ic.nc.gov/index.html.

Ohio VIEW STATE →

FEE SCHEDULE NEWS:

• The Bureau of Workers’ Compensation has adopted new Outpatient and ASC Fee Schedule with an effective date of May 1, 2020. The next update is expected in May 2021.

Oklahoma VIEW STATE →

FEE SCHEDULE NEWS:

• The Workers’ Compensation Commission has adopted and released a new Medical and Hospital fee schedule with an effective date of July 1, 2020.  The Medical Fee Schedule sets the maximum allowable rates of reimbursement for hospitals and medical services treating workers’ compensation injuries. “This is the first update of the State’s Fee Schedule since 2012, and the first of what should become a regular, biannual update,” said Commissioner Jordan Russell, who shepherded the schedule through the update process. The 2020 Medical Fee Schedule is available on the WCC’s website 2020 Medical Fee Schedule. Questions about the new Fee Schedule can be emailed to feeschedule@wcc.ok.gov. “In 2019, the Legislature enabled us to contract with an objective, outside entity to review the maximum fees medical professionals can charge in work injury cases and to update the codes assigned to each medical procedure,” said Commissioner Mark Liotta, Chair of the WCC. Since September 2019, the WCC worked with consulting firm, FAIR Health, to review and update the Fee Schedule. To ensure an impartial review, FAIR Health developed a data-driven approach through regional and nationwide comparisons of Oklahoma’s existing rates. They compared market information from a variety of sources, including public and private payers. “The WCC provided two 30-day public comment periods to gather information from community stakeholders and to ensure we heard from all affected parties,” said Commissioner Megan Tilly.

REGULATORY ACTIVITY:

• The Workers’ Compensation Commission (WCC) voted in a public special meeting on April 16, 2020, to amend the WCC’s previously extended filing deadlines and procedures, including statutes of limitation, and continue the extension until May 15, 2020. This extension mirrors a portion of the Oklahoma Supreme Court’s Emergency Joint Order (SCAD 2020-29) issued on March 27, 2020. The WCC will remain open in a limited capacity. All current emergency measures will remain in place until the WCC resumes normal operations.

LEGISLATIVE ACTIONS:

• Senate Bill 1375 The enacted legislation includes chiropractic services in the list of services required for employers to provide to employees with compensable injuries. Effective Date September 1, 2020.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• The department of Insurance the prescribed statistical plan to include the most recent COVID-19 related revisions filed by the National Council on Compensation Insurance (NCCI).  To view this notice, go to https://dfr.oregon.gov/laws-rules/Pages/adopted-rules.aspx.   The updated plan is effective May 1, 2020 through October 24, 2020.
• Published Bulletin No. 111 Revised. This bulletin provides updated benefit rates based on the Oregon average weekly wage for 2020.  This bulletin replaces Bulletin No. 111 dated May 17, 2019.  In conjunction with the bulletin the state also published form 5332," Notice to Beneficiary of Entitlement to Benefits" (not revised): https://wcd.oregon.gov/WCDForms/5332.docx. To view the bulletin and form, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• Published Bulletin No. 356 Revised.  This bulletin publishes the attorney fee matrix under Oregon Administrative Rule (OAR) 436-001- 0410(1)(d) for attorney fees awarded under Oregon Revised Statute (ORS) 656.385(1). This bulletin replaces Bulletin No. 356 issued May 17, 2019.   To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• Published Bulletin No. 124. This bulletin provides forms, examples, checklists, and a chart for insurers and vocational assistance providers to use under Oregon Administrative Rules (OAR) 436-120. This bulletin is revised to provide an updated cost-of-living matrix and fee schedule for vocational assistance expenditures, effective July 1, 2020. This bulletin replaces Bulletin 124 dated May 17, 2019.  To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• The Workers’ Compensation Board will hold a meeting at 1:30 p.m. on Tuesday, June 23, 2020 at its Salem Office.  (Some of the Members may be participating by telephone.)  Because the Board meeting will likely be subject to “social distancing” requirements, arrangements will be made to allow parties/practitioners to participate in the meeting by a “phone conference” link. To view the notice and proposed amendments, go to https://www.oregon.gov/wcb/Pages/meetings-minutes.aspx.
• On May 23, 2020, the Department of Consumer and Business Services issued emergency orders for insurance companies providing property and casualty, long-term care, and life and disability insurance. The orders require insurance companies providing these policies to do the following: Provide at least a 60-day grace period to pay any past-due premiums; Pay claims for any covered losses during the first 30 days of the grace period; Extend all deadlines for reporting claims and other communications, and provide members with communication options that meet physical distancing standards. The orders are effective through June 23 but can be extended in 30-day increments as needed to address the COVID-19 outbreak. Finally, the original emergency order that was issued on March 25 has been extended to June 23. That order applies to all lines of insurance other than health, property and casualty, long-term care, and life and disability insurance. This emergency order requires all other lines of insurance companies to postpone policy cancellations, extend grace periods for premium payments, and extend deadlines for reporting claims.
• Published a temporary administrative order regarding COVID-19 Update to Statistical Plan for Workers' Compensation Insurance regulations. ORS 737.225 states that the director shall prescribe by rule the statistical plan for workers’ compensation insurance. Accordingly, OAR 836-042-0045 currently prescribes the Statistical Plan for Workers’ Compensation and Employer Liability Insurance, 2008 Edition, filed by the National Council on Compensation Insurance, with revisions through January 1, 2018. This rulemaking changes the date in the current administrative rule from January 1, 2018 to May 1, 2020, the effective date of revisions reflected in NCCI’s new filing. This order is effective May 1, 2020 through October 24, 2040.  To view the temporary order, go to https://dfr.oregon.gov/laws-rules/Pages/adopted-rules.aspx.
• The Oregon Department of Consumer and Business Services’ Division of Financial Regulation issued emergency orders for property and casualty, long-term care, and life and disability insurance. The orders mean that the most common insurance policies, such as auto, home, term and whole life, and long-term care have specific minimum grace periods to pay premiums and protect consumers by mandating how long claims must be paid. “Grace periods are an important resource for people during this pandemic, and the assurance that claims will be paid provides critical peace of mind,” said Andrew Stolfi, insurance commissioner and acting DCBS director. “It is encouraging to see insurance companies provide grace periods and coverage while Oregonians work to keep their insurance premiums current and the state works to reopen.” These orders transition the most common insurance policies from rolling 30-day grace periods established by the original March 25 emergency order to specific grace periods and specific numbers of days that claims must be paid for each type of insurance. This process provides two important protections for Oregon consumers:  A sustainable way for insurance customers to keep up with premium payments without falling too far behind. Insurance protection for a specific number of days for customers that are in a grace period. In addition to these orders, the department issued a similar order for health insurance earlier this month.  Oregonians are encouraged to visit the division’s COVID-19 consumer page for more information on these orders and several other insurance and financial services topics. If you have questions about your insurance coverage, contact your insurance provider. If you have questions about an insurance company or agent or need to file a complaint, contact the division’s advocacy team at 888-877-4894 (toll-free).
• Published Bulletin Number 383 regarding self-insured base rates and choice of method used for determination of premium assessment. This bulletin notifies self-insured employers of the base rates to be used for calculating the premium assessment for quarters occurring during the period from July 1, 2020, through June 30, 2021. In addition, this bulletin provides reporting instructions and rating plan options.   The forms and rates referenced in this bulletin are not effective until July 1, 2020. Refer to Bulletin 381 in order to complete the second quarter (April, May, June) 2020 Workers’ Compensation Payroll and Assessment Reports. IMPORTANT CHANGES:  When related to the COVID-19 pandemic, administrative leave pay or wage continuation for furloughed employees should be treated as vacation pay and excluded from gross wages.   Class code changes effective with this bulletin include:  8829 is eliminated, replace with 8824; 1860 is merged, replace with 4279; 4282 is merged, replace with 4279; 4360 is merged, replace with 7610; 4670 is merged, replace with 4683; 5508 is merged, replace with 5507; and 5474, Painting NOC & Shop Operations, Drivers has a new class description – Painting Aircraft & Shop Operations, Drivers.   To view a copy of the bulletin and forms, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.

Pennsylvania WC VIEW STATE →

FEE SCHEDULE NEWS:

• Posted an update to their fee schedule regarding COVID-19 information. As Pennsylvania and the nation continue to implement mitigation efforts to slow the spread of COVID-19, the Department of Labor & Industry, Bureau of Workers' Compensation has taken rapid and impact able measures to keep the workers' compensation system operating in Pennsylvania. The fee schedule now includes the following six (6) new CPT/HCPCS codes (87635/U0001/U0002/G2023/ G2024/T5999) in the Part B Fee Schedule for payment relating to the COVID-19 testing. These new codes are effective for dates of service on or after January 1, 2020. There are no rates currently established for these codes, so please refer to §127.102 of the Medical Cost Containment regulations regarding payment.

REGULATORY ACTIVITY:

• The Insurance Department (Department) has determined that no contributions will be required during 2020 to maintain the balance of the Workers' Compensation Security Fund (Fund). Section 9(1) of the Workers' Compensation Security Fund Act (act) (77 P.S. § 1059(1)) states ‘‘[I]f, due to the payment of liabilities or claims, the balance of the fund is reduced below $500,000,000, the department shall require contributions to maintain the actuarial soundness of the fund and to restore, in a timely manner, the balance of the fund to a level at or above $500,000,000.'' As of the evaluation of December 31, 2019, the balance of the Fund exceeded $500,000,000. Therefore, insurers writing workers' compensation insurance in this Commonwealth will not be required to submit contributions to the Fund in 2020. The act may be viewed at ncigf.org (select ''Resources,'' then ''Laws and Law Summaries'') and 31 Pa. Code Chapter 165 (relating to the Workers' Compensation Security Fund) may be viewed at www.pacodeandbulletin.gov Additional information regarding the Fund is located on the Department's web site at www.insurance.pa.gov. Acknowledgement of this notice is not required. JESSICA K. ALTMAN, Insurance Commissioner.  To view this notice, go to https://www.pacodeandbulletin.gov/Display/pabull?file=/secure/pabulletin/data/vol50/50-19/651.html&search=1&searchunitkeywords=.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• Under Rhode Island Executive Order 20-06 Expanding Access to Telemedicine Services and Rhode Island Insurance Bulletin 2020-5 Emergency Telemedicine Measures – Covid-19 the following telemedicine codes will be assigned temporary fee schedule reimbursement rates increasing rates for telephonic (CPT codes 99441-99443) and online digital (CPT codes 99421- 99423 and 98970-98972) evaluation/assessment, management services and Physical/Occupational Therapy to mirror payment rates for an equivalent office visit. When billing for these codes use modifier 95 or CR (catastrophe response) and place of service code 02 (telehealth). Providers should reflect the length of the interaction in their supporting documentation.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Issued and advisory notice regarding in person commissioner hearings and informal conferences. To view the advisory, go to https://wcc.sc.gov/news/2020-05/advisory-notice-person-commissioner-hearings-and-informal-conferences

South Dakota VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 1005 The enacted legislation defines telehealth as the use of secure electronic information, imaging, and communication technologies by a health care professional to deliver health care services to a patient, including interactive audio-video, interactive audio with store and forward, store-and-forward technology, and remote patient monitoring. Telehealth does not include the delivery of health care services through electronic means under the provisions of chapter 27A-10, or the delivery of health care services through an audio-only telephone, electronic mail message, text message, mail service, facsimile transmission, or any combination thereof. It also places restrictions regarding prescribing drugs. By stating that without a proper provider-patient relationship, a health care professional using telehealth may not prescribe a controlled drug or substance, as defined by § 34-20B-3, solely in response to an internet questionnaire or consult, including any encounter via telephone. Effective Date July 1, 2020.

Tennessee VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 1727/Senate Bill 1649 The legislation as enacted extends the advisory council on workers’ compensation to June 30, 2021.  Effective Date April 1, 2020.

Texas VIEW STATE →

REGULATORY ACTIVITY:

• Issued notice of review of all sections 28 Texas Administrative Code Chapters 126-128. DWC is accepting public comment on whether the rules in 28 TAC Chapters 126-128 still have reason to exist or should be repealed, readopted, or readopted with amendments as required under Texas Government Code §2001.039.  To comment on this rule review project, submit your written comments by 5 p.m., Central time, on June 8, 2020. .  To view this notice, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.
• The Texas Department of Insurance has issued a bulletin reminding insurers, agents, agencies, and adjusters that a sponsor for someone with a temporary license is: responsible for the acts of the temporary or emergency licensee; expected to review the applicant’s background to ensure suitability for licensure; and expected to monitor behavior and provide required training.  To view this bulletin, go to https://www.tdi.texas.gov/bulletins/2020/B-0026-20.html.
• Issued a memorandum regarding per-authorization extensions.  On March 22, 2020, Governor Greg Abbott issued Executive Order No. GA-09, directing all licensed health  care professionals and facilities to postpone all surgeries and procedures not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, the patient.  On April 17, 2020, Governor Abbott issued Executive Order No. GA-15, allowing elective surgeries and procedures under certain circumstances.   To help injured employees receive medical care they need to treat their work-related injuries without an unnecessary administrative delay, the Division of Workers’ Compensation encourages Texas workers’ compensation insurance carriers and utilization review agents to extend pre-authorizations issued before March 22, 2020, without a request from a health care provider, and provide injured employees and health care providers with written notice of updated authorizations. These extensions do not apply to one-time pre-authorizations for medical care that has already been completed, new preauthorization requests, or pharmacy pre-authorizations.  Workers’ compensation certified networks and political subdivision health plans under Labor Code Section  504.053(b)(2) are encouraged to extend injured employee referrals for specialists, therapy, and other medically necessary services to prevent disruptions in the continuity of their medical care.  Please direct questions to compconnection@tdi.texas.gov.
• TDI issued an order adopting National Council on Compensation Insurance (NCCI) Item 01-TX-2019—Revisions to Basic Manual for Workers’ Compensation and Employers Liability Insurance and Forms Manual of Workers’ Compensation and Employers Liability Insurance in Texas. The filing eliminates references to relativities, revises the rate basis for payroll for Texas special Code 0923—Domestic Workers—Residences—Payroll Basis, and makes minor updates to some references and outdated sections of the manual. The changes apply to new and renewal workers' compensation policies effective on and after July 1, 2020.
• The Texas Department of Insurance, Division of Workers' Compensation (DWC) is readopting all sections in 28 Texas Administrative Code Chapters 120, 122, and 124.   This re-adoption complies with Texas Government Code §2001.039, which requires a state agency to review each rule every four years and readopt, readopt with amendments, or repeal the rule. A notice of rule review was published in the January 31, 2020, issue of the Texas Register.   DWC has determined that the reasons for adopting the chapters continue to exist. The notice of read option will be published in the June 5, 2020, issue of the Texas Register.
• The National Council on Compensation Insurance (NCCI) filed Item B-1441 – Revisions to NCCI Manual Rules Related to the COVID-19 (Coronavirus) Pandemic. The filing revises and establishes rules for the treatment and reporting of employer payments for employees furloughed due to the pandemic. NCCI proposes that Item B-1441 apply to policies effective on and after March 1, 2020.
• The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is required to monitor workers’ compensation system participants’ compliance with the Texas Labor Code and DWC rules. Compliance objectives are achieved through Performance Based Oversight (PBO), data monitoring, complaint handling, audits, and enforcement actions. As part of the overall compliance plan, Texas Labor Code §402.075 requires DWC to assess the performance of system participants in meeting the key regulatory goals established by the commissioner of workers’ compensation. Based on the performance assessment, health care providers are placed into regulatory tiers: poor performers, average performers, and high performers. DWC focuses its regulatory oversight on the poor performers. The 2021 PBO assessment will evaluate health care providers on the following categories: • DWC Form-073, Work Status Report; and • DWC Form-069, Report of Medical Evaluation. To view this announcement, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.

Texas Auto VIEW STATE →

REGULATORY ACTIVITY:

• TDI posted a rule proposal that repeals and amends requirements for the delivery or renewal of named driver automobile policies. This rule implements legislation passed in 2019, which prohibits named driver automobile policies beginning January 1, 2020. To view the proposed rule, go to https://www.tdi.texas.gov/rules/2020/index.html.

Utah No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Published Bulletin 2020-11 regarding telehealth consideration and R590-267, personal injury protection relative value study rule.  To view this notice, go to https://insurance.utah.gov/consumer/legal-resources/bulletins.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

• Issued Bulletin 2020-05 affecting insurers offering healthcare or workers' compensation insurance regarding opioid prescribing policy reporting.  To view the bulletin, guides to filing out the report and the reporting form, go to https://insurance.utah.gov/consumer/legal-resources/bulletins.

LEGISLATIVE ACTIONS:

• Senate Bill 138 This bill creates and amends definitions.  The enacted legislation requires pharmacy benefit managers and insurers to use unique identifiers for plans managed by a Medicaid managed care organization. It prohibits a pharmacy benefit manager from prohibiting certain actions by an in-network pharmacy.  The legislation prohibits a pharmacy benefit manager from charging an insured customer more for use of a pharmacy that offers delivery or mail-order services.  It prohibits certain actions by a pharmacy benefit manager or third party with respect to a 340B entity. Effective Date May 15, 2020.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

• Issued Insurance Bulletin #210 Revised: this bulletin is intended to ensure that health insurance plans regulated by the Department of Financial Regulation continue to provide access to prescription drugs during the COVID-19 pandemic. This bulletin applies to health insurers, as that term is used in 18 V.S.A. § 9402, and pharmacy benefit managers, as that term is used in 8 V.S.A. § 4089j.  To view this bulletin, go to https://dfr.vermont.gov/reg-bul-ord/covid-19-prescription-drug-refills.
• Issued a memorandum regarding the applying/clarifying IME Requirements during the COVID-19 pandemic. This Memorandum is necessary because evidently some individuals did not realize that the Guidance previously provided for applying Rule 12 was intended to extend to IME examinations by implication. As the Vermont Department of Health has stated: Patients must be confident that the environment where they will receive care is safe.

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• VWC Converts All Hearings Scheduled May 1-June 10 to Video Hearings.  To view the announcement, go to http://www.workcomp.virginia.gov/news/VWC-Converts-All-Hearings-Scheduled-May-1-June-10-to-Video-Hearings.

LEGISLATIVE ACTIONS:

• House Bill 169The enacted legislation adds correctional officers and full-time sworn members of the enforcement division of the Department of Motor Vehicles to the list of public safety employees who are entitled to a presumption that certain infectious diseases are compensable occupational diseases. Effective Date July 1, 2020.
• House Bill 438The enacted legislation provides that post-traumatic stress disorder incurred by a law-enforcement officer or firefighter is compensable under the Virginia Workers' Compensation Act if a mental health professional examines a law-enforcement officer or firefighter and diagnoses the individual as suffering from post-traumatic stress disorder as a result of the individual's undergoing a qualifying event, defined as an incident or exposure occurring in the line of duty on or after July 1, 2020, (i) resulting in serious bodily injury or death to any person or persons; (ii) involving a minor who has been injured, killed, abused, or exploited; (iii) involving an immediate threat to life of the claimant or another individual; (iv) involving mass casualties; or (v) responding to crime scenes for investigation. Other conditions for compensability include (a) if the post-traumatic stress disorder resulted from the law-enforcement officer or firefighter acting in the line of duty and, in the case of a firefighter, such firefighter complied with certain federal Occupational Safety and Health Act standards; (b) if the law-enforcement officers or firefighters undergoing of a qualifying event was a substantial factor in causing his post-traumatic stress disorder; (c) if such qualifying event, and not another event or source of stress, was the primary cause of the post-traumatic stress disorder; and (d) if the post-traumatic stress disorder did not result from any disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action of the officer or firefighter. The measure also establishes requirements for resilience and self-care technique training. Effective Date July 1, 2020.

• House Bill 617The enacted legislation directs the Virginia Workers' Compensation Commission to engage an independent and reputable national research organization to examine the implications of covering workers' injuries caused by repetitive motion through the Virginia workers' compensation system. Effective Date July 1, 2020.
• House Bill 1558The enacted legislation authorizes the Virginia Workers' Compensation Commission to create an Ombudsman program and appoint an ombudsman to administer such program. The program's purpose is to provide neutral educational information and assistance to persons who are not represented by an attorney, including those persons who have claims pending or docketed before the Commission. Effective July 1, 2020.
• Senate Bill 561The enacted legislation provides that post-traumatic stress disorder incurred by a law-enforcement officer or firefighter is compensable under the Virginia Workers' Compensation Act if a mental health professional examines a law-enforcement officer or firefighter and diagnoses the individual as suffering from post-traumatic stress disorder as a result of the individual's undergoing a qualifying event, defined as an incident or exposure occurring in the line of duty on or after July 1, 2020, (i) resulting in serious bodily injury or death to any person or persons; (ii) involving a minor who has been injured, killed, abused, or exploited; (iii) involving an immediate threat to life of the claimant or another individual; (iv) involving mass casualties; or (v) responding to crime scenes for investigation. Other conditions for compensability include (a) if the post-traumatic stress disorder resulted from the law-enforcement officer or firefighter acting in the line of duty and, in the case of a firefighter, such firefighter complied with certain federal Occupational Safety and Health Act standards; (b) if the law-enforcement officers or firefighters undergoing of a qualifying event was a substantial factor in causing his post-traumatic stress disorder; (c) if such qualifying event, and not another event or source of stress, was the primary cause of the post-traumatic stress disorder; and (d) if the post-traumatic stress disorder did not result from any disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action of the officer or firefighter. The measure also establishes requirements for resilience and self-care technique training. Effective Date July 1, 2020.

Washington VIEW STATE →

REGULATORY ACTIVITY:

• The Department of Labor & Industries (L&I) will continue to use the fees listed in the 2019 fee schedule through September 2020. Changes to the fee schedule and payment policies will be effective October 1, 2020. L&I normally announces changes to the fee schedule and payment policies in June of each year. We shifted the dates in 2020 so we can put added focus on our coronavirus (COVID-19) response.
• Labor & Industries (L&I) is temporarily allowing independent medical examiners to deliver exams via telehealth using a real-time audio and video connection. The temporary record review and Independent Medical Exam (IME) payment policy is now available on the Medical Aid Rules and Fee Schedules (MARFS) Updates and Corrections website. You can also find updated COVID-19 (coronavirus) information for healthcare providers on our website. This temporary IME payment policy helps slow the spread of the coronavirus by allowing the use of the worker's home as an origination site when they are scheduled for an IME. The IME provider must determine telehealth is the most appropriate option for the exam, and the use of telehealth must be agreed to by all parties. Here are some additional details about this temporary policy change:  L&I will not provide the worker with or reimburse the worker for equipment. If a worker does not have access to high-speed internet via computer or a camera phone with reliable connectivity, the provider must work with the worker to identify an alternative. Use the Place of service –02 modifier when submitting bills. This indicates the worker’s home was the origination site for telehealth services. Do not use the –GT modifier when billing for telehealth.  Questions about the payment policy? Contact us at HPPM@lni.wa.gov.

LEGISLATIVE ACTIONS:

• House Bill 2409The enacted legislation is directed to self-insured employers and their third-party administrators. Self-insured employers' options for claims administration are specified.  The Department must license TPAs, establish certification for all claim’s administrators, and issue related rules.
• Penalties. Employer penalties are increased to be a maximum of: the greater of $1,000 or 25 percent of the amount due, for a self-insurer who unreasonably delays or refuses to pay benefits; the greater of $1,000 or double the amount of premiums incurred, for failure to pay premiums; $1,000 for failure to comply with a statutory provision or Department rule; and $500 for various recordkeeping and reporting violations, including a physician's or licensed advanced registered nurse practitioner's  failure to file a required treatment report. The assessment of penalties for a self-insurer's failure-to-pay is specified to be per act and requires the Department to weigh certain factors.  The Department may waive first-time or de minimums violations of recordkeeping and reporting provisions. All penalties must be adjusted every three years based on changes in the Consumer Price Index. Effective Date September 1, 2020.
• House Bill 2758This legislation recognizes posttraumatic stress disorders of 911 emergency dispatch personnel. The rule excluding claims based on mental conditions or mental disabilities caused by stress does not apply to PTSD claims of public safety telecommunicators who receive calls for assistance and dispatch emergency services.  For public safety telecommunicators hired after the effective date of the act, the exemption applies only if the individual submitted to a psychological exam that ruled out the presence of PTSD from preemployment exposures.  If the employer does not provide the exam, the exemption applies.  "Public safety telecommunicators" are individuals who receive and respond to telephone or other electronic requests for emergency assistance and dispatch appropriate emergency responders. Effective Date June 1, 2020.
• Senate Bill 6440The enacted legislation concerns industrial insurance medical examinations.  A worker must submit to an examination by a physician selected by L&I (IME) whenever L&I or the self-insurer deems it necessary to:  (1) make a decision on claim allowance or reopening, (2) resolve a new medical issue, an appeal, or case progress, or (3) evaluate the worker's permanent disability or work restriction.  A new medical issue means a medical issue not covered by a previous medical examination requested by L&I or the self-insurer such as an issue regarding medical causation, medical treatment, work restrictions, or evaluating permanent partial disability. L&I may not assess a no-show fee against the worker if the worker gives at least five business days' notice of the worker's intent not to attend the IME.  The exam must be at a place reasonably convenient to the injured worker, which means at a place where residents in the injured worker's community would normally travel to seek medical care for the same specialty as the examiner, or use telemedicine if L&I determines telemedicine is appropriate for the IME.  L&I must address in rule how to accommodate the worker if no approved medical examiner in the specialty needed is available in that community.  L&I must adopt rules, policies, and processes governing the use of telemedicine for IMEs.  It may include a pilot project.  Consideration should be given to all available research regarding the use of telemedicine for IMEs. Any IME report must also be given to the worker and the attending physician, in addition to the person ordering the report. Examination means a physical or mental examination by a medical care provider licensed to practice medicine, osteopathy, podiatry, chiropractic, dentistry, or psychiatry at the request of L&I, the self-insurer, or by order of the board of industrial insurance appeals. Work Group. An IME work group is established with members as follows: two members from the House of Representatives, one member appointed by the speaker of the House of Representatives from each of the two largest caucuses; two members from the Senate, one appointed by the president of the Senate from each of the two largest caucuses; one business representative representing employers participating in the state fund; one business representative representing employers who are self-insurers; two labor representatives; a representative of an association representing both physicians who perform IMEs and panel companies; and one attorney who represents injured workers. The representatives are appointed by L&I. The work group must develop strategies for reducing the number of medical examinations per claim while considering claim duration and medical complexity and for improving access to medical records, including records and reports created during or pursuant to the IME; consider whether L&I should do all the IME scheduling, the circumstances for which examiners should be randomly selected or specified, and worker's rights, including attendance, specialist consultants, recordings, distance and location of exams; recommend changes to improve the efficiency of the IME process; and identify barriers to increasing the supply of in-state IME physicians. L&I must report its findings and recommendations to the Legislature by December 31, 2020. Effective June 11, 2020.

West Virginia VIEW STATE →

REGULATORY ACTIVITY:

• Published the FY2021 Self-Insured Regulatory Surcharge Rate.  The rate for FY 2021 is 0.15%.  To view the notice, go to https://www.wvinsurance.gov/.

LEGISLATIVE ACTIONS:

• House Bill 4409The enacted legislation amends and reenacts  §33-3-33a of the Code of West Virginia, 1931, as amended, relating to transferring remaining funds from the Volunteer Fire Department Workers’ Compensation Premium Subsidy Fund, at its existing sunset date of June 30, 2020, to the Fire Service Equipment and Training Fund and the State Auditor’s Chief Inspector’s Fund. Effective Date June 2, 2020.

• Senate Bill 534The enacted legislation amends and reenacts §21A-1A-17 of the Code of West Virginia, 1931, as amended, relating to employees serving the Legislature on a temporary basis, or in support of the legislative session, are not exempt from unemployment benefits coverage. Effective Date May 28, 2020.

• Senate Bill 545The enacted legislation authorizes the transfer of moneys from the Insurance Commission Fund to the Workers’ Compensation Old Fund.  Effective March 4, 2020.

Wyoming VIEW STATE →

LEGISLATIVE ACTIONS:

• House Bill 137 The enacted legislation relates to workers’ compensation.  It provides workers’ compensation coverage for legislators. It provides a definition of member of the legislature. Member of the legislature" means a duly elected or appointed member of the Wyoming legislature commencing when the member's term begins if elected or upon being sworn into office if appointed and until such time as the member's seat is vacated as provided in W.S. 22‑18‑101 or the member's term ends. Effective Date January 2, 2023.

• Senate File 89 The enacted legislation directs the department of workforce services shall establish a premium credit for any employer who has made all required workers’ compensation payments for the period beginning January 1, 2019 and ending December 31, 2019.  To qualify for the credit, an employer shall be in good standing with the workers’ compensation division within the department of workforce services for all required workers’ compensation payments by June 15, 2020.  Premium credits granted under this act shall become effective on August 1, 2020 and may be used for premium reporting periods from July 1, 2020 through December 31, 2020.  Any unused credit will expire January 31, 2021.  Effective Date March 24, 2020.