California VIEW STATE →

FEE SCHEDULE NEWS:

• The DWC has adopted a new Physician fee schedule and CCI edits with an effective date of July 1, 2018.  The next update is expected in October 2018.
• The DWC has adopted a new Outpatient and ASC fee schedule with an effective date of July 1, 2018.  The next update is expected in October 2018.
• The DWC has updated the DMEPOS fee schedule effective July 1, 2018. This update includes both the Medicare Interim Final Rule changes (CMS-1687-IFC) and the July 2018 DMEPOS rates. The next update is expected in October 2018.

REGULATORY ACTIVITY:

• The Division of Workers’ Compensation (DWC) has issued a notice of public hearing for proposed evidence-based updates to the Medical Treatment Utilization Schedule (MTUS), which can be found at California Code of Regulations, title 8, sections 9792.22 and 9792.24.5.  The public hearing is scheduled for Wednesday, July 18 at 10 a.m. in the auditorium of the Elihu Harris Building, 1515 Clay Street, Oakland. Members of the public may review and comment on the proposed updates no later than July 18.  The proposed evidence-based updates to the MTUS incorporate by reference the latest published guidelines from American College of Occupational and Environmental Medicine (ACOEM) for the following:  Traumatic Brain Injury (ACOEM November 15, 2017); General Approaches section of the MTUS: Prevention (ACOEM May 1, 2011); General Approach to Initial Assessment and Documentation (ACOEM July 25, 2016); Cornerstones of Disability Prevention and Management (ACOEM May 1, 2011). Although proposed evidence-based updates to the MTUS regulations are exempt from Labor Code sections 5307.3 and 5307.4 and the rulemaking provisions of the Administrative Procedure Act, DWC is required under Labor Code section 5307.27 to have a 30-day public comment period, hold a public hearing, respond to all the comments received during the public comment period and publish the order adopting the updates online.
• The Division of Workers’ Compensation (DWC) announces that the 2019 minimum and maximum temporary total disability (TTD) rates will increase on January 1, 2019. The minimum TTD rate will increase from $182.29 to $187.71 and the maximum TTD rate will increase from $1,215.27 to $1,251.38 per week.  Labor Code section 4453(a) (10) requires the rate for TTD be increased by an amount equal to percentage increase in the State Average Weekly Wage (SAWW) as compared to the prior year. The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury. In the 12 months ending March 31, 2018, the SAWW increased from $1,206.92 to $1,242.78—an increase of 2.971 percent.  Under Labor Code section 4659(c), workers with a date of injury on or after January 1, 2003 who are receiving life pension (LP) or permanent total disability (PTD) benefits are also entitled to have their weekly LP or PTD rate adjusted based on the SAWW.

Colorado VIEW STATE →

REGULATORY ACTIVITY:

• Colorado has adopted amended Rule 2 Workers' compensation Insurance Premium and Payroll Surcharges and Rule 7-3 Life Expectancy Table.  The adopted rules become effective July 1, 2018.  To view a copy of the adopted rules, go to https://www.colorado.gov/pacific/cdle/workers-compensation-proposed-and-adopted-rules.
• Posted notice regarding rules governing the Colorado Uninsured Employer's Fund. Notice is given of a public hearing to afford all interested persons an opportunity to be heard prior to the adoption of proposed amendments to the Workers’ Compensation Rules of Procedure, 7 C.C.R. 1101-3 as described below.  The Director of the Division of Workers’ Compensation has the authority to promulgate rules pursuant to the Workers’ Compensation Act as set forth in section §8-47-107.     Date and Time of Hearing: July 17, 2018      10:00 a.m.   Place of Hearing:   633 17th Street, Denver, CO.  To view the notice and rule, go to https://www.colorado.gov/pacific/cdle/workers-compensation-proposed-and-adopted-rules.
• Posted notice of hearings to consider amendments to Rule 16 Utilization Standards and Rule 18 Medical Fee Schedule.  Notice is given of a public hearing to afford all interested persons an opportunity to be heard prior to the adoption of proposed amendments to the Workers’ Compensation Rules of Procedure, 7 C.C.R. 1101-3 as described below.  The Director of the Division of Workers’ Compensation has the authority to promulgate rules pursuant to the Workers’ Compensation Act as set forth in section §8-47-107.    Date and Time of Hearing: August 14, 2018      10:00 a.m.   Place of Hearing:   633 17th Street      Denver, CO.  To view the notice and proposed rules, go to  https://www.colorado.gov/pacific/cdle/workers-compensation-proposed-and-adopted-rules.

Connecticut VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted the 2018 Official Connecticut Practitioner Fee Schedule effective on and after July 15, 2018.  The next update is expected in July 2019.

REGULATORY ACTIVITY:

• Issued Memorandum No. 2018-03 regarding peer reviews performed by Excel O.  The Connecticut Workers’ Compensation Commission has recently learned that a former New York based orthopedic surgeon, Spyros Panos, whose license to practice medicine was previously suspended, is accused of misappropriating another physician’s identity and fraudulently performing peer/utilization review services.  Currently, the matter is under investigation by federal and New York state authorities. We have reason to believe that a company identified as Excel O LLC may have acted as a peer/utilization review organization and utilized Panos’ assumed medical alter ego to perform peer/utilization reviews. We further believe that some Connecticut Workers’ Compensation insurance carriers may have utilized the peer/utilization review services of Panos under his assumed identity and the peer/utilization review entity known as Excel O LLC. At this juncture, we are aware that one of the insurers which utilized the allegedly fraudulently based peer/utilization review services of Panos/Excel O LLC is The Hartford. Additionally, there may be a number of other Workers’ Compensation insurance carriers who may have utilized these peer/utilization review services. The Connecticut Workers’ Compensation Commission has reached out to the Connecticut Insurance Department, the Attorney General and others advising them of this situation. In the meantime, if you are a Workers’ Compensation claimant and are concerned, you should contact the insurance carrier handling your claim. You should ascertain from the carrier if any peer/utilization review services related to your claim were performed as part of this alleged illegal scheme. We understand that the Hartford is investigating the matter and seeking to develop an action plan that will remediate this problem. We expect, and encourage, other insurance carriers and entities to self-report to this Commission any dealings they may have had with Panos, his associated organization and their fraudulent peer/utilization activities. Any parties impacted by the above that seek additional information or would like to report additional information to the Connecticut Workers’ Compensation Commission, should contact the Chairman’s office at (860) 493-1500.  To view the memorandum, go to  http://wcc.state.ct.us/memos/2018/2018-03.htm
• Issued Memorandum No. 2018-04 regarding co-signatures for physician's assistants. Effective June 1, 2018, the Workers’ Compensation Commission will no longer require the co-signature of a physician on forms (Forms 36, Voluntary Agreements, etc.) or medical reports signed by a physician’s assistant (PA). This action is being taken so as to reflect what appears to be the real-world custom and practice of medical providers. Forms will no longer be denied at the district office level solely for the lack of a co-signature. To view the memorandum, go to  http://wcc.state.ct.us/memos/2018/2018-04.htm.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• An order has been issued setting the assessment rate for the Special Disability Trust Fund and the Workers’ Compensation Administration Trust Fund for Calendar Year 2019.. The Department estimates the amount necessary for the administration of section 440.49(8), Florida Statutes, and the maintenance of the Special Disability Trust Fund for the calendar year 2019 is 0.42%. Beginning January 1, 2019, the assessment rate for the Special Disability Trust Fund is reduced from the 2018 calendar year rate of 0.91% to the 2019 calendar year rate of 0.42%.  The Department estimates the amounts necessary for the administration of chapter 440, Florida Statutes, based on the anticipated expenses of the administration of chapter 440 for calendar year 2019 is 0.90%.  To view a copy of the announcements, go to https://www.myfloridacfo.com/Division/WC/bulletins.htm.
• The Division of Workers' Compensation has received inquiries about the status of the 2017 editions of the three reimbursement manuals. A status of each reimbursement manual is provided below.

The Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2017 Edition was not ratified during the 2018 Florida Legislative Session and will not go in effect. Consequently, the 2016 edition remains in effect.

The Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), 2017 Edition was not ratified during the 2018 Florida Legislative Session and will not go in effect. Consequently, the 2015 edition remains in effect.

The Florida Workers' Compensation Reimbursement Manual for Hospitals, 2017 Edition was not ratified during the 2018 Florida Legislative Session and will not go in effect. Consequently, the 2014 edition remains in effect.

The reimbursement manuals can be found on the Division's website at https://myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Manuals/.

Georgia VIEW STATE →

REGULATORY ACTIVITY:

• COMING IN JULY 2018! State Board of Workers’ Compensation will be granting access to our Insurers, Self-Insured Employers, Group Funds, and Claims Offices (claims adjusters) through a phased implementation starting in July 2018! Please continue to check our website for updates! Please note: No EDI vendors or EDE personnel will be permitted to access ICMS II or participate in training. Our claim files may only be viewed by parties to the claim, i.e. employer, insurer, claims office (claims adjusters), claimant, and attorneys.

Hawaii WC VIEW STATE →

REGULATORY ACTIVITY:

• The Prepaid Health Care Advisory Council will meet on June 28, 2018.  To view the notice and agenda, go to http://labor.hawaii.gov/dcd/news/phc-advisory-council-meeting/.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice for self-insurance application guidelines for 2018. Please keep in mind that it is extremely important that you answer all of the questions on the application. All of the attachments and additional information requested in item 7 must be provided. Incomplete applications cannot be processed and will not be approved. The completed application should be returned to our office no later than July 31, 2018. Late and incomplete applications are subject to a late fee as described below. Please note the following regarding the supplemental forms attached to the application. Form SI-4 (Indemnity Agreement by the Parent Corporation for Wholly Owned or Majority Subsidiary) should be completed if you are adding or revising any subsidiaries. A valid surety bond or other approved security must be on file with the Board at all times. If we already have a bond (on the revised 2003 form) or other approved security, it is not necessary to include another with this application.; A current SI-3 (Certificate of Excess Insurance) must be on file with the Board at all times. If we already have a current SI-3 on file for your company, it is not necessary to include another with this application. If you are not specifically involved in the trucking industry, it is not necessary to complete the Form SI-5 (Truckers Supplemental Application). Pursuant to IC 22-3-5-1(b), renewal applications must be accompanied by a payment of $250.00. The agency will not accept cash payments. Checks or money orders must be payable to "Worker’s Compensation Supplemental Administrative Fund." Incomplete applications and renewal applications received after July 31, 2017, will be charged an additional $250.00 late fee. Deadline extensions shall be granted only under extraordinary circumstances and at the Board’s discretion. All renewal applications and enclosures should be sent to the attention of Mary Taivalkoski at the above address. If you have any questions, she can be reached at (317) 232-3811 or via email at mtaivalkoski@wcb.in.gov. To view this notice, go to https://www.in.gov/wcb/2367.htm.
• Posted notice of a new protocol for submitting settlement agreements to the Board will go into effect within the next 30-45 days.  A similar notice will be issued at that time. The Board is working with the Indiana Office of Technology to perfect the procedure and anticipates there may be slight changes; however, the Checklist should be followed whenever possible as of the date of this notice.  The new settlement procedure and check list can be viewed at https://www.in.gov/wcb/.

Kansas VIEW STATE →

REGULATORY ACTIVITY:

• Kansas is in the process of implementing IAIABC Claims Release 3.1, which will be adopted on November 29, 2018. The Kansas IAIABC R3.1 release date coincides with go-live of Kansas’ Online System for Claims Administration Research/Regulation (OSCAR). Kansas EDI data will be integrated into OSCAR and some of the new requirements in claims 3.1 are needed to support OSCAR functionality and processes.
• The tables are now available: Kansas R3.1 Event Tables Kansas R3.1 Element Requirements Kansas R3.1 Edit Matrix
• All trading partners submitting in Kansas are required to submit an updated Trading partner document to our vendor Ebix for Release 3.1 by November 12, 2018, or before starting testing.
• Trading Partner and EDI Vendor testing for Kansas DWC FROI/SROI IAIABC Claims EDI Release 3.1 will begin July 16, 2018 and continue through November 15, 2018. Please contact Ebix to set up testing by calling (866) 448-1776 or email KS-EDICoordinator@Ebix.com. EDI vendors that are already submitting in at least one R3.1 EDI state at the time of testing are only required to complete connectivity testing requirements.
• Testing – July 16, 2018 until November 15, 2018
• Updated Trading Partner Document is due by - November 12, 2018
• Go live date – November 2018

For additional information and access to the requirement tables, go to https://www.dol.ks.gov/WorkComp/edinews.aspx.

Kentucky VIEW STATE →

FEE SCHEDULE NEWS:

• The Department of Workers’ Compensation has updated the Medical Fee Schedule for Physicians with an effective date of July 1, 2018.  The 2018 Workers’ Compensation Schedule of Fees for Physicians will completely replace the 2016 fee schedule. 

REGULATORY ACTIVITY:

• For all Applications for Resolution of Claim filed on or after June 16, 2018, the Department of Workers' Claims will first issue a document titled "LMS ACCESS CODE NOTIFICATION," the purpose of which is to provide all parties the LMS access code assigned to that claim in order to allow the parties to associate to the claim for the purpose of filing pleadings. The Department of Workers' Claims will subsequently issue a document titled "NOTICE OF FILING OF APPLICATION" pursuant to 803 KAR 25:010 Section (2) (a).  This document will constitute notice that a claim has been filed for the purposes of filing a Notice of Claim Denial or Acceptance (Form 111) and Notice of Disclosure; assign the claim to an ALJ; schedule the date, time and location of the Benefit Review Conference; establish the schedule for proof-taking; and state the week during which a hearing is to be held.  To view this notice, go to https://labor.ky.gov/announcements/Pages/Announcement4.aspx.

Louisiana VIEW STATE →

REGULATORY ACTIVITY:

• Has adopted rules regarding workers' compensation second injury board forms in the June 2018 issue of the Louisiana Register. To view the adoption notice, go to  http://www.doa.la.gov/Pages/osr/reg/Regs2018.aspx and select the June edition.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• The Commission has posted notice that Grant/Deny Postponement Request response has been added to our eNotice service for Online Services subscribed Attorneys.  To view additional information, go to http://www.wcc.state.md.us/WFMS/eNotice.html
• We are implementing changes to our WFMS Online Services on Tuesday, June 19th to replace the current Online Services Document Viewer with a simpler and better method to view and/or save documents.  When selecting a document, you will see a single PDF Portable Document Format file) handled by your web browser like any other PDF. Depending on your browser settings it will open in the browser PDF viewer or prompt you to open/save the downloaded file. You can simply view the document, "Save As" to your PC, print directly or otherwise as you normally manage a PDF.  No matter how many pages in the document, it will be a single PDF file. Large documents in excess of 25 pages may require a few extra seconds to prepare and download.  This improvement will make it easier for you to manage electronic versions of WCC documents and should not be affected by future web browser changes or updates.  Please plan to take some extra time on Tuesday or Wednesday to acquaint yourself with the new feature. As always, please contact us via email: websupport@wcc.state.md.us with any questions or issues you may encounter.
• The Online Services PDF Viewer change scheduled for 6/19/18 has been postponed; updated information will post when a new date has been determined.

Maryland-Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published draft proposed regulations for Title 31 Maryland Insurance Administration Subtitle 15 Unfair Trade Practices Chapter 12 Valuation of Motor Vehicles.  Comments close on July 16, 2018.  To view a copy of the draft regulation, go to http://insurance.maryland.gov/Pages/newscenter/RegulatoryActivity.aspx.

Massachusetts VIEW STATE →

REGULATORY ACTIVITY:

• Issued notice of a public hearing on 105 CMR 700.00 regarding controlled substances. The proposed amendments update the regulations, which implement M.G.L.  c.  94 C, the Controlled Substances Act which sets forth consistent standards for the safety, security and storage of controlled substances; outlines the requirements for practitioners   and facilities to receive a Massachusetts Controlled Substances Registration; and manages the Prescription Monitoring Program.  The proposed amendments add provisions made necessary by legislative initiatives; create exemptions for certain low risk activities; clarify existing regulations; and create transparency regarding application for and issuance of waivers regarding these regulations.  To view the notice, go to http://www.sec.state.ma.us/spr/sprpub/pubhear.htm.

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

• OPPS – CMS has posted new updates with an effective date of July 1, 2018. The next expected update is set of October 1, 2018.
• ASC – CMS has published a new ASC module with an effective date of July 1, 2018. The next update is expected on October 1, 2018.
• Clinical Laboratory – CMS has posted an updated Clinical Lab fee schedule effective July 1, 2018. The next update is expected in October 2018.

Michigan VIEW STATE →

REGULATORY ACTIVITY:

• Posted a memorandum regarding Medicaid Recovery. If you experience difficulty obtaining Medicaid recovery information from the subrogation vendors for either Meridian Health Plan of Michigan or Blue Cross Complete, you may contact the following individuals:   Meridian Health Plan of Michigan: Emily Decker     313-324-3700 x22429 ;  Blue Cross Complete:  Dionne Wadi Title:  Manager, 3rd Party Liability & Sub Rec, Ops TPL & Subrogation E-mail: dwaddy@amerihealthcaritas.com Phone: 215-863-5837 .   Before utilizing these contacts, we are asked to be sure to make every attempt to obtain the recovery information directly through the managed care plan.   If you need further assistance, you may contact the Michigan Department of Health and Human Services, Managed Care Plan Division directly at 517-284-1162. They ask that you be prepared to provide support that you have worked directly with the plan to resolve any problems and that the problem remains unresolved. They will request the name of the managed care plan, the beneficiary name, the date you first contacted the plan, and the name of the plan employee you have worked with.  To view a copy of the memorandum, go to https://www.michigan.gov/wca.
• Published an updated application for Mediation or Hearing, DWC from WC - 104C. Please note the addition of a new “check box” option for users of Form WC-104C, Application for Mediation or Hearing .  This new option can be found in the section that allows for adding another employer.  It remains the goal of The Workers’ Compensation Agency and the Board of Magistrates to continue our efforts to streamline operations and procedures to better serve our customers.  The change to Form WC-104C is a new check box option titled, “Add non-employer entity.”  Until this addition, petitioners could add another employer, but found it difficult to simply add another party to the case.  Utilizing this new check box will allow users to more easily indicate their intentions, and aid in processing. Please begin using this new form immediately.  If you have form templates created by outside entities, please have your templates updated, or simply utilize the form from the WCA website for future submissions.  The updated form can be viewed at https://www.michigan.gov/wca/0,4682,7-191--471542--,00.html.

Michigan Auto VIEW STATE →

REGULATORY ACTIVITY:

• Issued bulletin 2018-13-INS regarding disputes between No-Fault automobile insurers and health care providers.  This bulletin supersedes bulletin 90-03 issued on October 23, 1992. Bulletin 92-03 contained statements regarding the obligations of auto insurers to their insureds. This bulletin clarifies those obligations in light of recent case law interpreting certain provisions of the Insurance Code (Code).   On May 25, 2017, the Michigan Supreme Court issued an opinion in Covenant Medical Center, Inc v State Farm Mutual Auto Ins Co, 500 Michigan 191; 895 NW2d 490 (2017), in which it held that health care providers do not have a statutory cause of action against no-fault insurers for recovery of personal protection insurance benefits. See Covenant, 895 NW2d at 505.  To view the bulletin, go to https://www.michigan.gov/difs/0,5269,7-303-12900_12906---,00.html.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice that the Court's Statistical Report 2008-2017 is now available. This report summarizes information reported to the court by employers and insurers for work-related injuries and illnesses that occurred during calendar years 2008 through 2017, regardless of the year in which the reports were filed.  To view the report, go to https://www.wcc.ne.gov/news/nwcc_news.aspx.

New Hampshire VIEW STATE →

LEGISLATIVE ACTIONS:

House Bill 407

The enacted legislation requires workers’ compensation to cover prophylactic treatment for exposure.  The enacted legislation sets forth that all expenses associated with the medical evaluation and recommended post- exposure prophylaxis treatment for emergency response/public safety workers shall be paid by the employer’s insurance carrier or third-party administrator. Such medical evaluation and prophylaxis treatment shall be provided without prejudice as to the issue of the causal relationship of any subsequently diagnosed blood borne disease or airborne disease to the emergency response/public safety worker’s work and without prejudice to the compensability of the blood borne disease or airborne disease as an occupational disease or an accidental injury for the purposes of the workers’ compensation statute. Effective Date January 1, 2019.

House Bill 1740

The enacted legislation clarifies the provision of the workers’ compensation statute relating to the costs of blood testing orders when certain individuals have been exposed to another person’s bodily fluids. The enacted legislation clarifies that the insurer shall be responsible for covering such costs.  Effective Date June 8, 2018.

Senate Bill 84

The enacted legislation authorizes payment of compensation under the workers’ compensation law to be made to the injured worker by direct deposit, if the injured worker elects to receive compensation payment by that method. Effective Date January 1, 2019.

Senate Bill 351

The enacted legislation clarifies the qualifications of an injury management facilitator affiliated with managed care programs under workers' compensation.  Effective Date January 1, 2019.

Senate Bill 553

The enacted legislation establishes a commission to study the incidence of post-traumatic stress disorder in first responders and whether such disorder should be covered under workers' compensation.  The commission shall be made up of one member of the senate, three members of the house of representatives, labor commissioner, commissioner of safety, insurance commissioner, representative of the municipal association, representative of the association of counties, representative of the national alliance of mental illness, fire chief appointed by the association, one member appointed by the police chiefs association, one member of the police association, a representative of the professional firefighters, a representative of EMTs, a representative of the public risk managers, and an attorney appointed by the association for justice . The commission shall submit its recommendations and findings in a report along with any recommendations for proposed legislation to the president of the senate, speaker of the house, senate clerk, house clerk, governor and the state library.   Effective Date June 12, 2018.

New-Mexico-Auto VIEW STATE →

REGULATORY ACTIVITY:

• Issued bulletin 2018-006 regarding interest rate applicable to unpaid claims 45 days after required proof of loss has been furnished.  To view a copy of the bulletin, go to https://www.osi.state.nm.us/InsuranceBulletins/bulletins.aspx.

New York VIEW STATE →

REGULATORY ACTIVITY:

• Published bulletin Subject Number 046-1071 regarding comment period for proposed medical fee schedule. Date: June 6, 2018: As announced on April 17, 2018, in Subject Number 046-1058 Proposals to Improve Medical Care for Injured Workers, the New York State Workers' Compensation Board (Board) proposes to increase reimbursement fees paid to medical providers. The proposed changes to the Medical Fee Schedule have been published in the June 6, 2018, State Register, and the Board will accept comments from the public for 60 days. The proposal includes updated Current Procedural Technology (CPT) codes, increased conversion factors and amended Ground Rules, which are available under the Medical Fee Schedules section on the Board's website. Those who do not have access to CPT codes with descriptions can arrange to review them in person at Board offices by contacting regulations@wcb.ny.gov. The Board encourages the public, injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys, medical providers, and labor and business organizations to provide comment. Please submit your comments on or before August 6, 2018, to regulations@wcb.ny.gov. The Board will evaluate all comments received and will consider necessary revisions as the process advances.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/subjectNos.jsp.  To view the proposed rule, go to https://docs.dos.ny.gov/info/register/2018/jun6/toc.html.

New York No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of emergency adoption of regulation regarding supplementary uninsured/underinsured motorist insurance.  To view the notice, summary of the rule and the emergency rule, go to https://www.dfs.ny.gov/insurance/rproindx.htm.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Registration is now open for the Twenty-Third Annual North Carolina Workers' Compensation Educational Conference, which will take place at the Raleigh Convention Center on Wednesday-Friday, October 10-12, 2018. The conference is presented by the North Carolina Industrial Commission, in association with the International Workers' Compensation Federation.

North-Carolina-Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published notice regarding the requirement to filed data to the department of insurance.  To view the proposed rule, go to http://www.oah.state.nc.us/rules/register/.

North Dakota VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the APC, ASC, Dental, DME, Clinical Laboratory, Medical Provider Fee Schedule, Outpatient and Physician Drug modules with an effective date of July 1, 2018. The next update is expected in October 2018.

REGULATORY ACTIVITY:

• Department of Labor and Regulation:  Division of Insurance: (May 29, 2018) intends to amend rules to update the sources referenced in rule, and the definition of “health organization” to include “hospital.”  The general authority for these rules, as cited by the department, is SDCL §§ 58-3-11, 58-3-26, 58-4-48, 58-6-75, 58-26-13.1, 58-26-45.1,  58-26-46, 58-27-7, and 58-27-108.  A public hearing was held in the West River Conference Room, 124 South Euclid Avenue, 2nd Floor, Pierre, South Dakota, on June 18, 2018, at 2:00 p.m. CT. Copies of the proposed rules may be obtained without charge from and written comments sent to South Dakota Division of Insurance, Administrative Rules, 124 S. Euclid Avenue, 2nd Floor, Pierre, SD 57501. Electronic copies are also available by email to mallori.barnett@state.sd.us, and online at   https://dlr.sd.gov/insurance/admin_rules/public_hearings.aspx.  The comment period will remain open for ten days following the public hearing and will close on June 28, 2018.

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

• This alert is issued to inform that the Workers' Compensation Commission is in the process of promulgating emergency rules and forms pertaining to the Oklahoma Legislature's enactment of SB1249 (2018) creating the Affidavit of Exempt Status (in lieu of a Certificate of Noncoverage) and Cancellation of an Affidavit of Exempt Status.  If you would like to submit comments to the Commission regarding the proposed rules, you may email them to rules@wcc.ok.gov through July 13, 2018. A public hearing will be held at 3:30 p.m., Friday, July 13, 2018, in Commission Chambers on the 2nd floor of the Denver Davison Building, Oklahoma City, OK. Interested parties must sign in at the door. Thank you for your interest in the Commission's rulemaking process.  To view the proposed emergency rules, go to https://www.ok.gov/wcc/Legal/Governing_Documents_/index.html.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• Updated Bulletin No 111 (Revised_ June 6, 2018) regarding computation of temporary disability, permanent disability, and death benefits based on Oregon's state average weekly wage.  This bulletin provides updated benefit rates based on the Oregon average weekly wage for 2018.  This bulletin replaces Bulletin No. 111 dated March 6, 2018.  To view a copy of the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• Posted notice of adoption of two amended rules.  The Division adopted OAR 436-050 Employer/Insurer Coverage Responsibility and OAR 436-180 Worker Leasing.  The rules become effective July 1, 2018.  To view the rules, go to https://wcd.oregon.gov/laws/Pages/proposed-rules.aspx.
• Posted an industry notice regarding timely payment of temporary disability.  To view the notice, go to https://wcd.oregon.gov/Pages/industry-notices.aspx.
• The Oregon Workers' Compensation Division has added the new state average weekly wage (SAWW) to the temporary disability (TTD and TPD) and permanent partial disability (PPD) calculators and posted them to the division's website: https://wcd.oregon.gov/insurer/Pages/disability-calculators.aspx.
• Effective July 1, 2018, the SAWW used to compute workers’ compensation benefits is $1,007.05.
• The division updates these calculators annually before July 1, and no action is required on your part if you use the calculators posted to the division's website. However, if you have downloaded a PPD calculator, you will need to download an updated calculator each year or simply enter the new SAWW, as published in Bulletin 111, into the "SAWW" worksheet of the workbook. Because these calculators are always kept current, we do not plan to issue this notice in the future.  Feel free to contact us at 503-947-7717 or fred.h.bruyns@oregon.gov, if you have questions.

Pennsylvania WC VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changes to the PAWC Part A and Part B Fee Schedule Services with an effective date of July 1, 2018. The next update is expected in October 2018.

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted changed to the inpatient, ASC and emergency room hospital fee schedule rates effective July 1, 2018. The next expected update is scheduled for July 2019.

REGULATORY ACTIVITY:

• Published Information Letter 18-03 regarding Notice of Proposed Assessment Rate.  The Workers’ Compensation Division, under the authority granted by Section 37‐13(c) of Title 28 of the General Laws of Rhode Island, 1956, as amended, granting the Director of the Department of Labor and Training (“Director”) the power and discretion to determine Workers’ Compensation assessment rates, proposes that the assessment rate be reduced to 5.25%.  To view the entire the entire information letter, go to http://www.dlt.ri.gov/wc/infoletters.htm.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Published the full agenda for the Commission business meeting held on June 18 at 10:30 A.M. in Commission Hearing Room A at 1333 Main Street, 5th Floor Columbia, South Carolina.  To view the agenda and materials discussed at the meeting, go to http://www.wcc.sc.gov/Pages/default.aspx.
• Published a memo regarding letter of representation. Attorneys must write the Commission’s Judicial Department to notify the Commission of their representation of a party pursuant to Reg. 67-1202.  This may be done by letter or by using eCase, the electronic notice function available through the Commission’s On-Line Reporting Interface. The Judicial Department encourages attorneys to use eCase rather than submit a letter to fulfill this requirement.
  Using eCase to notice the Commission of an Attorney’s representation ensures that the Attorney is promptly added to the correct file in a time efficient and accurate manner.  Written letters of representation printed out and physically sent to the Commission by mail are costly, time-consuming, and at greater risk of being recorded in error.  Please use eCase to notify the Judicial Department electronically of the Attorney’s representation.

South Dakota VIEW STATE →

FEE SCHEDULE NEWS:

• The state has adopted a new Medical Fee Schedule effective June 25, 2018. The fee schedule is based on the 2018 Relative Value for Physicians and 2009 edition of the Relative Values for Dentists.

Texas VIEW STATE →

FEE SCHEDULE NEWS:

• The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) adopted amendments to §134.500, 134.530 and 134.540 requiring preauthorization for drugs created through compounding with an effective date of July 1, 2018.

REGULATORY ACTIVITY:

• Just published regarding the publication of a new report by the Research and Evaluation Group of the Texas Department of Insurance entitled "Injured Employees with Multiple Injuries and Claims in the Texas Workers' Compensation System".  To view a copy, go to http://www.tdi.texas.gov/alert/whatsnew/index.html.
• The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) held a public hearing on Monday, June 18, 2018 in the Tippy Foster Room at the TDI-DWC Central Office, 7551 Metro Center Drive, Suite 100 in Austin, Texas.  The purpose of the meeting was to receive comments on the following rules: Amended 28 TAC §127.1.  Requesting Designated Doctor Examinations. Amended 28 TAC §127.5.  Scheduling Designated Doctor Appointments. Amended 28 TAC §127.10.  General Procedures for Designated Doctor Examinations. Amended 28 TAC §127.100.  Designated Doctor Certification. Amended 28 TAC §127.110.  Designated Doctor Re-certification. Amended 28 TAC §127.130.  Qualifications Standards for Designated Doctor Examinations. Amended 28 TAC §127.140.  Disqualifying Associations. Amended 28 TAC §127.220.  Designated Doctor Reports.  To view the notice of public hearing, go to http://www.tdi.texas.gov/alert/whatsnew/index.html.
• Governor Greg Abbott has appointed Cassie Brown as Commissioner of Workers' Compensation at the Texas Department of Insurance (TDI) for a term set to expire on February 1, 2019. TDI's Division of Workers' Compensation regulates the workers' compensation system in Texas, ensuring injured workers receive the necessary benefits to quickly return to work, and that workers' compensation costs are kept at a reasonable level for Texas employers. Cassie Brown of Austin is deputy commissioner for Regulatory Policy at the Texas Department of Insurance, where she has served since 2011. Previously, she served as a policy advisor to Governor Rick Perry. Brown received a Bachelor of Arts in political science from St. Edward’s University and attended the Governor’s Executive Development Program at The University of Texas LBJ School of Public Affairs.
• Texas posted notice of proposed amendments t 28 TAC 180.26 and 180.8.  The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) is accepting public comments on the proposed amended 28 Texas Administrative Code (TAC) §180.26 and §180.8. The public comment deadline has been extended to July 18, 2018.  If you want to comment on the proposal, submit your written comments by 5:00 p.m. Central time on July 18, 2018. A request for a public hearing must be sent separately from your written comments. Send written comments or hearing requests by email to Rulecomments@tdi.texas.gov or by mail to:
  Texas Department of Insurance, Division of Workers' Compensation Maria Jimenez Workers' Compensation Counsel MS – 4D 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1645.  The proposal was published in the May 18, 2018 issue of the Texas Register and is available at sos.state.tx.us/texreg/index.shtml. A courtesy copy is also available on the TDI website at www.tdi.texas.gov/wc/rules/2018rules.html. The TDI-DWC proposes amendments to 28 TAC §180.26 and §180.8 to implement Senate Bill (SB) 1895, 85th Legislature, Regular Session.  SB 1895 revised Texas Labor Code §415.021(c) by requiring the commissioner to consider whether the administrative violation has negative impact on the delivery of benefits to an injured employee and the history of compliance with electronic data interchange requirements. SB 1895 also added Texas Labor Code § 415.021(c-1) which requires the commissioner to adopt rules to communicate to the person the subject of a penalty information about the penalty, including: (1) the relevant statute or rule violated; (2) the conduct that gave rise to the violation; and (3) the factors considered in determining the penalty. By including the factors considered in determining the penalty, the proposed amendments necessarily incorporate the additional factors required by SB 1895 when assessing an administrative penalty.  To view a copy of the notice, go to http://www.tdi.texas.gov/alert/whatsnew/index.html.  To view a copy of the rule, go to http://www.tdi.texas.gov/wc/rules/2018rules.html.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

• The new Form 28(FY19) and the Form 28A (FY19), which you should use to update claimant’s rates as of July 1, 2018, are now available.  You can download both forms from our web site at:  http://labor.vermont.gov/forms/#comp.  Please make copies as needed.  The new maximum for those injuries arising after June 30, 1986 is $1,311.00.  The new maximum for injuries prior to that date is $874.00.  The minimum in all cases is $437.00.  Historical wage rates are available http://labor.vermont.gov/wordpress/wp-content/uploads/historicalrates.pdf . Please be aware of the requirement to forward a copy of the Form 28 to the injured worker or dependent.

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• Pursuant to Va. Code Sec. 65.2-605.1(H), the Commission has developed a proposed regulation to provide a legal framework for electronic billing, processing, and payment of medical services and products provided to an injured worker subject to the Virginia Workers' Compensation Act. The proposed regulation will expedite the submission, processing, and payment of bills for medical services rendered to injured workers pursuant to the Virginia Workers' Compensation Act utilizing nationally recognized standards. The proposed regulation is available in the June 11, 2018 edition of the Virginia Register of Regulations at http://register.dls.virginia.gov/details.aspx?id=6921. The Commission will accept public comment on the proposed regulation through August 10, 2018. Written comments may be sent by mail to James J. Szablewicz, Chief Deputy Commissioner, Virginia Workers' Compensation Commission, 333 East Franklin Street, Richmond, VA 23219, or by email to james.szablewicz@workcomp.virginia.gov. Additionally, the Commission will hold a public hearing on the proposed regulation at 1 p.m. on August 7, 2018, in the Commissioner’s Conference Room, 333 East Franklin Street, Richmond, VA 23219. To view a copy of the published documentation, go to http://register.dls.virginia.gov/.

Washington VIEW STATE →

FEE SCHEDULE NEWS:

• The Department of Labor & Industries has adopted a new medical and ASC fee schedule with an effective date of July 1, 2018. The next update is expected in July 2019.

West Virginia VIEW STATE →

REGULATORY ACTIVITY:

• Published benefit rates for Fiscal Year 2019.  The state wide average weekly wage effective July 1, 2018 is $823.14. To view the benefit rates for FY 2019, go to http://www.wvinsurance.gov/Workers-Compensation.
• Published Information Letter 200 regarding legislation enacted during the 2018 legislative session.  The letter contains information on all insurance matters.  To view the letter, go to http://www.wvinsurance.gov/Resources/Informational-Letters.

Wyoming VIEW STATE →

REGULATORY ACTIVITY:

• The Department of Workforce Services has posted notice of proposed rules regarding Chapter 7: Benefits. To view the proposed rule, go to https://rules.wyo.gov/Search.aspx and enter search term ‘Chapter 7 Benefits’.