FEE SCHEDULE NEWS:

• The state adopted changes to their physician fee schedule rates with an effective date of December 1, 2017. The next update is expected in December 2018.

REGULATORY ACTIVITY:

• Published their 2018 Medical Fee Schedule Standards effective December 1, 2018.

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.

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.

REGULATORY ACTIVITY:

• Published the Utah Medical Fee Standard 2020 Edition.  To view the medical fee standard, go to https://laborcommission.utah.gov/divisions/industrial-accidents/medical-providers/.

FEE SCHEDULE NEWS:

• The state adopted changes to their physician fee schedule and guidelines with an effective date of January 1, 2020. The next update is expected in January 2021.

REGULATORY ACTIVITY:

• Posted notice in the November 15th issue of the state's bulletin of amendments to three rules: Rule R590-267 PIP Relative Values; R612-300 Medical Care and R612-400-5 WC Insurance Premiums.  The projected effective date for all three of the rules is December 23, 2019.
• R590-267 updates the conversion factors and publications for use in 2020 and 2021 with respect to personal injury protection services. This change adds conversion factors and publications for physicians, dentists, and  chiropractors to use when determining the reasonable value of services provided to patients on or after January 1, 2020 and removes the factors and publications that were to be used from 2016 through 2017.
• R612-300 - The purpose of this amendment is to adopt, with modifications, the Optum 2019   Essential   Resource-Based Relative Value Schedule (RBRVS), 2019 1st Quarter Update, and to adjust the conversion factors regarding certain medical specialties. The amendment incorporates by reference current versions of the RBRVS and adjusts certain conversion factors related to anesthesiology from $62 to $68 and other surgery from $43 to $53 per unit.
• R612-400-5 - Workers' compensation insurance premiums in Utah include assessments to fund the   Employer's Reinsurance Fund (ERF) and the Uninsured Employers' Fund (UEF).  These assessment rates are reviewed annually, and amended as appropriate, in order to ensure the funds, remain viable and are fully funded. These proposed changes establish these assessment rates for the 2020 calendar year.

FEE SCHEDULE NEWS:

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

LEGISLATIVE ACTIONS:

• Senate Bill 76

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

LEGISLATIVE ACTIONS:

• House Bill 154

The enacted legislation establishes a working group to study a first responder's workers' compensation claim due to mental stress.  The legislation defines first responder.  The legislation establishes a temporary working group to study a first responder’s workers’ compensation claim due to mental stress.  The working group at its’ conclusion shall make a report to the legislature. Effective Date March 22, 2019.

• Senate Bill 76

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

REGULATORY ACTIVITY:

• Just posted Bulletin -1-2018 regarding first aid clarification.  The bulletin was dated August 15, 2018 but was just posted on the agency website.  To view the bulletin, go to https://laborcommission.utah.gov/divisions/IndustrialAccidents/bulletins.html.

FEE SCHEDULE NEWS:

• The state adopted changes to their physician fee schedule rates with an effective date of January 1, 2019. The next update is expected in January 2020.