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Alabama VIEW STATE →

REGULATORY ACTIVITY:

Alaska VIEW STATE →

FEE SCHEDULE NEWS:

  • Alaska Workers’ Compensation Division has published an updated Medical Fee Schedule manual and adopted new conversion factors effective January, 1, 2019.

Arkansas VIEW STATE →

REGULATORY ACTIVITY:

  • Announced that the 2019 Arkansas Workers' Compensation Commission Educational Conference will be held at the Little Rock Doubletree/Robinson Center in Little Rock, Arkansas on November 6-7.  To view the announcement, go to http://www.awcc.state.ar.us/index.html.

California VIEW STATE →

FEE SCHEDULE NEWS:

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

REGULATORY ACTIVITY:

  • The Workers’ Compensation Information System (WCIS) advisory committee meeting was held on October 30, 2018.  The agenda of the meeting included First and Subsequent Reports of Injury (FROI/SROI).  To view a copy of the agenda and the presentations, go to https://www.dir.ca.gov/dwc/WCIS/AdvisoryCommiteeMeetings.htm.
  • The California Division of Workers’ Compensation (DWC) is pleased to announce that registration for its 26th Annual Educational Conference is now open. The conference will take place February 11-12, 2019 at the Los Angeles Airport Marriott and February 28-March 1, 2019 at the Oakland Marriott City Center Hotel. Attendee, exhibitor and sponsor registration forms may be downloaded from the conference website : https://www.dir.ca.gov/dwc/educonf26/DWC_EducationalConference.html.
    Registration flyers were recently mailed to the names on the conference mailing list. These forms are also available at DWC district offices. This annual event is the largest workers’ compensation training in the state and allows claims administrators, attorneys, medical providers, return-to-work specialists, employers, human resources and others to learn firsthand about the most recent developments in the system. Attendees will be interested in learning about current topics from a variety of workers’ compensation experts (e.g. the DWC, other state and public agencies, and the private sector).  The DWC has applied for continuing educational credits by attorney, rehabilitation counselor, case manager, disability management, human resource and qualified medical examiner certifying organizations among others. Organizations who would like to become sponsors of the DWC conference can do so by going to the website.  The 2018 conference had 1,772 attendees and 128 exhibitors, so early registration is encouraged.
  • The Division of Workers’ Compensation (DWC) Eureka office has moved to the following address:  State of California Office Building 409 K Street, Room 201 Eureka, CA 95501.  The office phone numbers remain the same from the former location on H Street. The Eureka office is a satellite of DWC’s Santa Rosa district office, with a workers’ compensation judge and support staff. Information and Assistance and Disability Evaluation services are provided through coordination with the Santa Rosa and Redding office.

LEGISLATIVE ACTIONS:

  • Assembly Bill 2046

California’s existing law makes it a misdemeanor or a felony to engage in specified acts of fraud or material misrepresentation for the purpose of obtaining or denying workers' compensation, as specified. Existing law, the Workers' Compensation Insurance Fraud Reporting Act (the act), requires insurers and licensed rating organizations to release upon request to an authorized governmental agency, as defined, relevant information deemed important to the authorized governmental agency that the insurer or licensed rating organization may possess relating to any specific workers' compensation insurance fraud investigation. The act requires, under specified circumstances, an insurer or licensed rating organization to notify the local district attorney’s office and the Fraud Division of the Department of Insurance and authorizes that entity to notify any other authorized governmental agency, of suspected fraud, as specified. The act also requires the Employment Development Department to release, upon written request, to an authorized governmental agency, relevant information that the Employment Development Department may possess relating to any specific workers' compensation insurance fraud investigation. The act authorizes the governmental agency that is provided with information pursuant to those provisions to release or provide that information in a confidential manner to any other authorized governmental agency for purposes of investigation, prosecution, or prevention of insurance fraud or workers' compensation fraud.  This bill would require an authorized governmental agency that is provided with information pursuant to those provisions to release or provide that information, upon request, as described above, unless it would violate federal law or otherwise compromise an investigation. The bill would also require an authorized governmental agency that seeks to disclose this information to any other governmental agency that is not authorized to receive that information to obtain Employment Development Department approval prior to disclosure, as specified. Effective Date January 1, 2019.

  • Assembly Bill 2705

Existing law establishes a workers’ compensation system to compensate an employee for injuries sustained in the course of employment. Existing law generally requires an employer to secure the payment of compensation, as specified, and makes it a misdemeanor to fail to secure the payment of compensation by one who knew, or should be reasonably expected to have known, of the obligation to secure the payment of compensation, punishable by imprisonment in the county jail for up to one year, a specified fine of not less than $10,000, or both. Existing law, except as specified, generally requires that prosecution for an offense not punishable by death or imprisonment in the state prison, as specified, be commenced within one year after commission of the offense.  Existing law, the Contractor’s State License Law, provides for the licensure and regulation of contractors by the Contractors’ State License Board in the Department of Consumer Affairs and requires an applicant for a contractor’s license, or a licensee, to have on file a current and valid Certificate of Workers’ Compensation Insurance or Certification of Self-Insurance. Existing law makes a violation of the provisions governing these certificates a misdemeanor. Existing law requires that prosecution for a violation of these provisions be commenced within 2 years after commission of the offense. This bill additionally would make it a misdemeanor violation not to secure the payment of compensation, as specified, by any licensee or agent or officer thereof, or by any person licensed in accordance with these provisions acting as a contractor and would make that violation subject to the 2-year statute of limitations. By expanding the scope of an existing crime and by creating a new crime, this bill would impose a state-mandated local program.  The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.  This bill would provide that no reimbursement is required by this act for a specified reason. Effective Date January 1, 1019.

  • Senate Bill 1086

California’s current law specifies the time period within which various proceedings may be commenced under provisions of law relating to workers’ compensation. With certain exceptions, a proceeding to collect death benefits is required to be commenced within one year from several circumstances, including, but not limited to, from the date of death if it occurs within one year from the date of injury. Existing law prohibits proceedings from being commenced more than one year after the date of death, and generally not more than 240 weeks from the date of injury. Existing law, for specified deceased members, including peace officers and active firefighting members, extends until January 1, 2019, the time period to commence proceedings to collect death benefits, if the proceedings are brought by, or on behalf of, a person who was a dependent on the date of death, from 240 weeks from the date of injury to no later than 420 weeks from the date of injury, not to exceed one year after the date of death for certain injuries, as specified. The enacted legislation deletes the January 1, 2019, date of repeal operation of the above-referenced extension.  Effective Date January 1, 2019.

California-Auto VIEW STATE →

REGULATORY ACTIVITY:

Colorado VIEW STATE →

REGULATORY ACTIVITY:

LEGISLATIVE ACTIONS:

  • House Bill 18-1308

The bill establishes an exemption from the 'Workers' Compensation Act of Colorado' for an out-of-state employer whose employees are working in Colorado on a temporary basis as long as:

  • The out-of-state employer furnishes coverage under the workers' compensation laws of the state in which the employee is regularly employed, which coverage applies to the employee while working temporarily in Colorado; and
  • The out-of-state employer's home state is contiguous to Colorado, recognizes the exemption, and provides a reciprocal exemption for Colorado employees temporarily working in that state.

The home state's workers' compensation laws are the sole remedy for an out-of-state worker who is injured while working temporarily in Colorado. The Division of Workers' Compensation in the Department of Labor and Employment is authorized to enter into an agreement with a contiguous state to carry out the extraterritorial application of the workers' compensation or similar law of the other state.   Effective Date April 30, 2018.

Connecticut VIEW STATE →

REGULATORY ACTIVITY:

  • In consultation with practitioners, insurers and the Medical Advisory Panel, medical protocols for Foot and Ankle injuries are being implemented. These protocols are not meant to be absolute and there must be room for medical judgment.  Medical providers are urged to contact the insurer if they feel that a treatment pattern other than the published protocol is required. It is expected that the payer will work with the provider to ensure that the injured worker receives the most appropriate treatment. These protocols will be used by the Commission to evaluate whether a treatment is reasonable and appropriate based on the diagnosis of injury. The effective date of these protocols was November 1, 2018. We are grateful to the medical professionals who have spent and continue to spend many hours working with us to bring the most appropriate and the highest standard of care to injured workers in Connecticut. The protocols can be found at http://wcc.state.ct.us/download/acrobat/protocols.pdf.
  • Published memorandum number 2018-09 regarding guidelines for mediation effective November 1, 2018.  This memo supersedes Memo number 2017-03.  To view the memo, go to https://wcc.state.ct.us/memos/2018/2018-09.htm.
  • The Commission’s newest Commissioner is Pedro E. Segarra, who has been active in the practice of law for over 30 years, in addition to his extensive experience in community activism, social work, and public service. After earning his Bachelor of Arts degree in Political Science from the University of Hartford and his Master’s degree in Social Work from the University of Connecticut, Segarra went on to earn his Juris Doctor from the University of Connecticut School of Law. From 1982-1986 Commissioner Segarra worked at Hartford Hospital as a Psychiatric/Medical Social Worker/Psychotherapist.  During the years 1986-2010, Segarra owned and operated a general practice of law in the areas of civil, criminal, real estate, probate, bankruptcy, disability, employment, and workers’ compensation law. Working in public service, Segarra worked in the State of Connecticut State’s Attorney’s Office as a Deputy Assistant State Attorney from 1989-1990, and served as Corporation Counsel for the City of Hartford from 1991-1995. From 2006-2010 he was Council President and Council Member of the City of Hartford, later serving as Mayor of the City of Hartford from 2010-2016. Since 2016, Segarra has served Office Counsel to the firm of Shimkus, Murphy & Rosenberger, specializing in the areas of real estate, zoning, probate and estate administration, landlord/tenant administration, organizational law, personal injury, criminal, and civil litigation. In addition to his work in the law, Segarra has been a co-founder of several organizations including Hogar Crea Drug/Alcohol Treatment Center, Connecticut Latinas/os Achieving Rights and Opportunities, and the Hispanic Health Council, and in 2012 he was recognized with a Service Award by the University of Connecticut Law School Alumni Association.

Delaware Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued Auto Bulletin 30 regarding reimbursing towing companies for "recovery costs".  This Bulletin reminds automobile liability insurers that when their policy holder is the at-fault driver in an automobile accident, Delaware law requires the insurer to cover the costs of removing both the at-fault and not-at-fault vehicles from a roadway or from property adjacent to a roadway after an accident (sometimes referred to as "recovery costs"), even if the at-fault driver’s liability policy does not include full collision coverage.  Note that "recovery costs” do not include the cost of towing the at-fault vehicle from the scene of the accident.  To view the bulletin, go to https://insurance.delaware.gov/information/bulletins/.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

  • A public meeting was held on Tuesday November 27, 2018 at 9:00 a.m. in Room 102 of the Hartman Building, 2012 Capital Circle SE, Tallahassee, Florida.  The purpose of the hearing was to allow comments for a new rule that is being introduced due to the passage of CS/CS/SB 376, which added subsections (5) and (6) to section 112.1815, Florida Statutes (F.S.). Section 112.1815(5)(f), F.S., requires the Department of Financial Services to adopt rules specifying injuries qualifying as grievous bodily harm of a nature that shocks the conscience.  To view the notice, go to https://www.myfloridacfo.com/Division/WC/noticesRules.htm.  To view a copy of the proposed rule, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-3.009.
  • Notice of Change/Withdrawal: Department of Financial Services; Division of Workers' Compensation Rule number: Rule Title: 69L-3.009: Injuries that Qualify as Grievous Bodily Harm of a Nature that Shocks the Conscience: NOTICE OF CORRECTION: Notice is hereby given that the following correction has been made to the proposed rule in Vol. 44 No. 210, October 26, 2018 issue of the Florida Administrative Register. The correction has been made to include language that was omitted regarding legislative ratification of the rule, the appropriate Rulemaking Authority, and the scheduled date, time, and location of the hearing, to be held if requested within 21 days of publication of the Notice.
  • Published notice in the state register regarding changes being made to the Florida Workers' Compensation Reimbursement Manual for Hospitals. The purpose of the changes being made to Rule 69L-7.501, F.A.C., is to incorporate the 2018 version of the Florida Workers’ Compensation Reimbursement Manual for Hospitals. This manual contain the updated list of Maximum Reimbursement Allowances for various medical services, pursuant to section 440.13(12)(a), Florida Statutes. To view a copy of the notice, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-7.501
  • Posted notice in the state register regarding proposed rule amendments that are intended to incorporate the 2018 editions of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers and the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. The manuals contain the updated lists of Maximum Reimbursable Allowances for various medical services. The proposed rule amendments adopt and incorporate by reference the 2018 edition of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers and adopt and incorporate by reference the 2018 edition of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual.  To view a copy of the notice, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-7.020.
  • Posted notice of proposed rule which amends rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates a rule, and repeals five rules. The major changes proposed include: adding a rule for defined terms; simplifying requirements for submission of reimbursement disputes; repealing rules related to consolidation of petitions, joint stipulations, and non-response by a carrier; and adopting revised forms. To view the notice and proposed rule, go to https://www.flrules.org/gateway/ruleNo.asp?id=69L-31.002..
  • Notice is hereby given that the following correction has been made to the proposed rule in Vol. 44 No. 217, November 6, 2018 issue of the Florida Administrative Register. The correction has been made to include language that was omitted: The Division of Workers’ Compensation conducted an economic analysis of the proposed rules’ potential impact and determined that both rules therefore require legislative ratification pursuant to section 120.541(3), F.S.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

  • The Industrial Commission receives guidance from the Workers' Compensation Advisory Committee. The Committee will seek public input and participation in its deliberations. Recommendations for adding legislation or other concerns should be submitted to Kamerron Monroe, Commission Secretary. Please include supporting documentation such as a statement of the problem, draft legislation, or other information that would help. To view the notice, go to https://iic.idaho.gov/.

Illinois VIEW STATE →

REGULATORY ACTIVITY:

  • The Department of Insurance posted notice of adoption of rules regarding utilization review in workers' compensation.  The adopted rule became effective on November 1, 2018.  To view the notice, go to http://www.cyberdriveillinois.com/departments/index/register/home.html and go to issue #46.
  • Effective immediately, Arbitrator Frank Soto will be assigned to Zone VI (Elgin, Geneva and Wheaton) to cover the dockets previously presided over by Arbitrator Ketki Steffen. Until further notice all correspondence for these dockets should be sent to Arbitrator Soto at the following address:

Arbitrator Frank Soto

100 W Randolph St Suite 8-200

Chicago, IL 60601

Email: Frank.Soto@illinois.gov

For December 2018, Arbitrator Soto’s Chicago Docket will be presided over by Arbitrator Charles Watts. Correspondence for the December Chicago docket should be sent to Arbitrator Watts at the following address:

Arbitrator Charles Watts

100 W Randolph St Suite 8-200

Chicago, IL 60601

Email: Charles.Watts@illinois.gov

Illinois-Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued Company Bulletin 2018-08 regarding updating all company bulletins.  The Illinois Department of Insurance ("DOI") intends for Company Bulletins to provide timely, relevant, and helpful guidance to insurance companies based on information existing at the time the Bulletin is issued.  Company Bulletins are not updated when the underlying regulations change, and DOI anticipates companies will implement the guidance provided shortly after the Bulletin is issued.   No Company Bulletin should be relied upon as the primary or current source of law or regulation. In an effort to alleviate confusion and burdens on Companies, DOI recently reviewed the Company Bulletins available on DOI's website. Company Bulletins that no longer meet the above intended purposes were to be removed from DOI' s website on October 15, 2018. Although certain Bulletins will no longer be available on DOI's website, the Bulletins may be obtained through a FOIA request.  To view the bulletin, go to http://insurance.illinois.gov/cb/CompanyBulletins.html.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

Kansas VIEW STATE →

REGULATORY ACTIVITY:

  • In-person and Webinar training sessions are available to those interested in enrolling and using the Online System for Claims Administration Research/Regulations (OSCAR) scheduled to launch Nov. 30, 2018. All paper forms and judicial filings previously submitted by mail will instead be filed using the OSCAR system. Attorneys who represent claimants, employers or insurers in Kansas are required to enroll and use the OSCAR system to submit all judicial filings. Employers responsible for submitting elections, records requests, self-insurance information, in addition to users who want to view active case information related to their employer must also enroll in the OSCAR system. Insurers responsible for submitting annual paid loss reports, records requests and payments to the division, must also enroll in OSCAR. Claims Administrators and Third-Party Administrators responsible for checking the statuses of submitted claims and view active case information related to these claims are also required to enroll in OSCAR. Register for in-person training or join a Webinar now!
  • Published in the state register notice of permanent administrative regulations regarding Article 1 forms.  To view the regulation, go to  http://www.kssos.org/pubs/pubs_kansas_register.asp.
  • The following reminder was published:  The Kansas Division of Workers’ Compensation will adopt the IAIABC Claims Release 3.1 Standard 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 Kansas Division of Workers’ Compensation will adopt the IAIABC Claims Release 3.1 Standard 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.  For additional information, go to https://www.dol.ks.gov/WorkComp/edinews.aspx.

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

  • Published the Workers' Compensation Benefit Schedule for 2019.  The increase in maximum income benefits under all provisions of the Workers' Compensation Act for the year 2017 over the year 2016 did amount to $2.00 or more; therefore, the maximum weekly indemnity benefits for calendar year 2019 shall be $955.32. There was an increase of $1.00 or more in minimum income benefits; therefore, the minimum weekly indemnity benefits, where applicable under the Act, shall be $173.69 for calendar year 2019.
  • Pursuant to KRS 342.265(3), upon lump-sum settlement of future periodic payments, the discount rate used in the calculation of the settlement amount shall be fixed by the commissioner. Before Jan. 1 of each year, the commissioner shall fix the discount rate to be utilized in the succeeding year based at one-half of one percent (0.5%) below the interest rate paid upon 10-year United States Treasury Notes as of Aug. 1 of the preceding year. However, upon lump-sum settlement of future periodic payments in weekly amounts that are $40 or less, the commissioner shall fix the discount rate used in the succeeding year based at the interest rate paid upon 10-year United States Treasury Notes as of Aug. 1 of the preceding year. Accordingly, for the calendar year of 2019, the discount rate for lump-sum settlements of future periodic payments in weekly amounts that are $40 or less is fixed at 2.875 percent.  For the calendar year of 2019, the discount rate for lump-sum settlements of future periodic payments in weekly amounts greater than $40 is fixed at 2.375 percent.

Maine VIEW STATE →

REGULATORY ACTIVITY:

  • Maine is proposing amendments to Chapter 5, Medical Fees; Reimbursement Levels; Reporting Requirement.  The proposed rule number is 2018-P223. Pursuant to 39-A MRS §209-A (5), every three years the Board must undertake a comprehensive review of the medical fee schedule. The proposed rule incorporates changes deemed prudent after conducting the statutorily required review. The board held a public hearing on Monday, November 26, 2018 at 10:00 a.m., Workers’ Compensation Board, Central Office, 442 Civic Center Drive, Suite 100, Augusta, ME 04330.  Comments on the proposed rule are due by Thursday, December 6, 2018.  This notice can be viewed at http://www.maine.gov/sos/cec/rules/notices/2018/110718.html.   To view the proposed rule, go to  https://www.maine.gov/wcb/Departments/legaldivision/proposed.html.

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

  • Physician – CMS has posted updates to the National Physician Fee Schedule Relative Value File effective January 1, 2019. The next expected update is April 1, 2019.
  • HCPCS – New HCPCS codes have been published by CMS with an effective date of January 1, 2019.  The next expected update is in April 1, 2019.
  • ASP Drugs – New ASP Drugs have been updated by CMS with an effective date of January 1, 2019. The next expected update is in April 1, 2019.
  • Ambulance – CMS released the 2019 ambulance fee schedule with an effective date of January 1, 2019. The next expected update is scheduled for January 1, 2020.
  • CCI, MUE and Add-on Edits – CMS has released the January 1, 2019 changes for the CCI, MUE and Add-on Edits. The next expected update is for April 1, 2019.

Michigan VIEW STATE →

REGULATORY ACTIVITY:

  • Form Submission Reminder: In our continuing efforts to increase efficiency and reduce costs, the Workers' Compensation Agency is in the midst of several modernization and system enhancements. As part of this ongoing effort, we would like to remind you about the Optical Character Recognition (OCR) requirements which were implemented in July 2013. OCR allows us to obtain data from paper and electronically submitted forms. These continued upgrades enable the Agency to better serve our stakeholders through greater efficiency while positioning the agency for future operating system upgrades.  The OCR process requires data to be in very specific locations to prevent processing errors.  Unfortunately, there is very little tolerance for location variation. The Agency requires that all forms 100, 107, 701, 400 and 401 filed must match exactly to those forms found on the Workers' Compensation Agency website, including but not limited to language, block space and positioning, font and dimension.  In addition, when data is input into the various forms, an Arial 10-point font must be used, with each field limited to one line of data. In addition, forms must be submitted either USPS or through the Data Exchange Gateway (DEG). Forms not complying with these requirements will be rejected and returned unprocessed.  Questions regarding these changes should be directed to Caitlin Keene at 517-284-8914.
  • For the eighth consecutive year, Michigan workers and job providers will benefit from the Michigan’s workers’ compensation system as the state’s pure premium advisory rate for workers’ compensation insurance will decrease by 8.3 percent for 2019. Comparatively, the national average change in the rate was a decrease of only 0.7 percent. Michigan has seen a decline in workers’ compensation pure premium rates every year since 2011 and will see an overall cumulative decrease of 49 percent from 2011-2019, saving employers an estimated $492 million in workers compensation premiums. “Employers experience real financial savings from these declining rates,” said Workers’ Compensation Agency (WCA) Director Mark Long. “This allows them to invest more in their business by hiring more employees and increasing salaries. These rate decreases play a pivotal role by continuing to add workers and businesses to the state's economy.” In 2011, Gov. Rick Snyder signed legislation that reformed the state’s workers’ compensation system, including improvements for disability and post-injury earning capacity. These changes helped revamp a 100-year-old system and have played an integral role in reducing costs for employers, stabilizing the state’s system, and ensuring the promise to protect injured workers. Pure premium rates are important in calculating employers’ and job providers’ overall expenses for workers’ compensation. The rates also factor into employer insurance claims that cover costs for work-related injuries. In a recent Workers Compensation Research Institute study Michigan had the lowest overall cost per lost-time claim amongst studied states. The most recent comparison data also shows that Michigan’s cumulative pure premium decrease of 45 percent from 2011-18 is again best in the Midwest and third in the nation. Michigan's injured workers and their employers are governed by the Workers' Disability Compensation Act. The Act was first adopted in 1912 and provides compensation to workers who suffer an injury on the job and protects employers' liability. The mission of the WCA is to efficiently administer the Act and provide prompt, courteous and impartial service to all customers.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

Nevada VIEW STATE →

REGULATORY ACTIVITY:

  • The Board for the Administration of the Subsequent Injury Account for Self-Insured Employers is looking for new members and currently has openings.  Members are appointed by the Governor and hold a 2-year term commencing on July 1 of each odd numbered year.  The members of the Board serve without compensation.  Typically, the Board meets once per month to decide claims for reimbursement according to criteria set out in the statutes and regulations and to discuss other Board related issues.  In order to serve on the Self-Insured Employers Board, one must be employed by an entity who meets the self-insured criteria set forth in NRS 616A.305.  Anyone interested in applying for membership can find the application forms at http://gov.nv.gov/Boards/Boards(1)/.  If appointed, the Governor will send a letter indicating the applicant’s appointment dates. For questions, please email the Boards and Commissions Office at boards@gov.nv.gov.
  • The DIR/WCS has prepared a list of PPD assignments by rotation to each of our rating physicians and chiropractors during fiscal year 2018 (7/1/17-6/30/18). Please be aware there are a number of variables that affect the number of assignments each rater receives including:
      • Degree
      • Specialty
      • Availability (active/inactive)
      • Length of time on the Rating Panel
      • Geographic location(s)

Follow this link to access the list: http://dir.nv.gov/uploadedFiles/dirnvgov/content/WCS/MedicalDocs/FY18%20Rater%20Assgnmts%20Rot%20List.pdfIf you have any questions, please contact me at kgodwin@business.nv.gov

New-Hampshire-Auto VIEW STATE →

REGULATORY ACTIVITY:

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

  • A memo from the Director and Chief Judge Wojtenko regarding COURTS on-line Workers’ Compensation Mandatory Electronic Filing - Initial Pleadings was posted: As of March 15, 2019, the N.J. Division of Workers’ Compensation shall require all licensed New Jersey attorneys and law firms to file the following pleadings electronically through COURTS on-line in accordance with N.J.A.C. 12:235-3.1: Claim Petitions, Answers to Claim Petitions, Dependency Claim Petitions, Answers to Dependency Claim Petitions, Medical Claim Petitions, Answers to Medical Claim Petitions, Applications for Review and Modification of Formal Awards (Re-Openers), Answers to Review and Modification of Formal Awards (Re-Openers), and Amendments to all the pleadings set forth above.  Any such pleading filed on or after March 15, 2019, shall be rejected for filing, with instructions to file the matter electronically through COURTS on-line.  In such instances, the filing date shall be the date the document is received through COURTS on-line.  To view this notice, go to https://www.nj.gov/labor/wc/content/notices.html#efiling_111518.

LEGISLATIVE ACTIONS:

  • Senate Bill 2145

The enacted legislation requires that in cases in which a workers’ compensation petitioner has received compensation from an insurance company prior to any judgment or award, the reasonable allowance for attorney fees will be based upon the sum of the amount of compensation received by the petitioner prior to any judgment, but after the establishment of an attorney-client relationship pursuant to a written agreement, and the amount of the judgment or award in excess of the amount of compensation already received by the petitioner. Currently, in cases in which a petitioner has received compensation prior to a judgment or award, a reasonable attorney fee is based upon only that part of the judgment or award that is in excess of the amount of compensation already received by the petitioner.  Effective Date August 24, 2018.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

  • The WCA did NOT host its weekly "Lump Sum Tuesday" on November 20, 2018, because of the short week for the Thanksgiving holiday. Business was resumed on Monday, November 26 at 8 a.m. at all locations.
  • The Advisory Council on Workers’ Compensation and Occupational Disease Disablement exists to review and monitor the workers’ compensation system in New Mexico and to report every year to the Governor and Legislature. The Advisory Council may make recommendations about the law. The Advisory Council holds public meetings, several times a year. Most meetings are in Albuquerque. Anyone may attend. At meetings, the Council learns from the public about issues affecting the workers’ compensation system and discusses policy recommendations.  The Council is interested in different points of view about the workers’ compensation system. Anyone who wishes to speak to the Council may contact the Council’s staff assistant at 505-841-6052. Meetings are planned in advance and the agenda for each meeting depends on the time available. If you are a person with a disability who needs a special accommodation, please notify the staff.  The Council’s role is advisory. The Council or its individual members cannot make rulings or recommendations on individual cases. However, the Council as a whole does have explicit authority to appoint members to the panel of professionals who select Independent Medical Examiners. The Council can also give its endorsement of proposed workers’ compensation legislation.
  • MEETINGS:  The proposed agenda for the meetings will be posted on the WCA website no later than 72 hours prior to the meeting. The website address is: https://workerscomp.nm.gov/Advisory-Council.  For more information, please contact Diana Sandoval-Tapia, 505-841-6052 / Diana.Sandoval@state.nm.us.

New-Mexico-Auto VIEW STATE →

REGULATORY ACTIVITY:

New York VIEW STATE →

REGULATORY ACTIVITY:

  • To allow providers additional time to test and implement required system changes, the Workers’ Compensation Board has postponed the implementation of phase one of the CMS-1500 project until the first quarter of 2019. The following time frames are also expected to change: XML Submission Partner testing is estimated to commence in late January 2019. Implementation of phase two (originally planned on or around July 1, 2019) will be postponed. A definitive date will be announced when the phase two requirements are finalized. In the meantime, the Board encourages medical providers, medical billers, and insurers (including insurance carriers, self-insured employers, and TPAs) to review the information about phase one published on the Board’s website, including: Final XML schema and requirements published. Updated requirements, FAQs, CMS-1500 templates, CMS-1500 crosswalks, and website content published. The Board is also planning to host a series of webinars prior to the implementation of phase one. The webinars will focus on the medical narratives that must accompany the medical bills and will reinforce providers and insurers understanding of the requirements. The webinar schedule and sign-up information will be sent via WCB Notifications and posted to the Board’s website as soon as it is available. If you have any questions, please email: CMS1500@wcb.ny.gov.  To view the XML Schema and requirements, go to: http://www.wcb.ny.gov/content/ebiz/XMLSchemas/XMLschema.jsp.  To view the updated requirements, FAQs, CMS 1500 templates, CMS 1500 Crosswalks, and website content published, go to http://www.wcb.ny.gov/CMS-1500/.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

  • Health care providers must now review the Controlled Substance Reporting System (CSRS) when prescribing a targeted controlled substance to an injured worker with a workers’ compensation claim. The health care provider must also document in the injured worker’s medical record the review and any potential contraindications to prescribing a targeted controlled substance found in the CSRS. North Carolina Industrial Commission Rules 11 NCAC 23M .0201(k), .0202(k), and .0203(k) provide the specific review requirements health care providers must follow.
  • On November 15, 2018, the Rules Review Commission ("RRC") approved amendments to Rules 11 NCAC 23A .0101, .0102, .0103, .0108, .0302, .0411, .0503, .0602, .0603, .0608, .0609A, .0610, and .0611. The RRC also approved the repeal of Rule 11 NCAC 23A .0618. To view this notice, go to http://www.ic.nc.gov/news.html#hot.

North Dakota VIEW STATE →

REGULATORY ACTIVITY:

  • November 2018: Workforce Safety and Insurance (WSI) requires a provider to complete the Advanced Beneficiary Notice of Non-Coverage (ABN) form for each individual date of service.  When recommending a medical service that WSI may not allow, the ABN informs the injured worker of the estimated cost for the service.  This allows the injured worker to decide whether to receive the service and accept financial responsibility if WSI denies payment. To identify a charge accompanied with a signed ABN, a provider should append modifier -GA to each applicable bill line.  A provider should then submit the signed ABN along with the bill and medical documentation to WSI.  WSI will review for the most appropriate payment determination.  If WSI does not reimburse for the service, a provider may then bill an injured worker or other insurance as specified by WSI's remittance advice reason codes. If you have questions about this article, please send an email to wsipr@nd.gov.  To view this notice, go to http://www.workforcesafety.com/news/news-item/advanced-beneficiary-notice-abn-form-to-be-completed-for-each-date-of-service.

Ohio VIEW STATE →

REGULATORY ACTIVITY:

Oklahoma VIEW STATE →

REGULATORY ACTIVITY:

  • Title 85A sets the maximum compensation benefit rates based on a percentage of the state's average weekly wage reported to the Commission by the Oklahoma Employment Security Commission. After review of the definition of “state average weekly wage” in 85A O.S. §2, the Commission has determined that the Administrative Workers’ Compensation Act requires the new average weekly wage to become effective January 1, 2019, rather than November 1, 2018.  Accordingly, the new state average weekly wage and associated rates for temporary total disability, permanent total disability, and death benefits will become effective for injuries or illnesses arising during the period beginning January 1, 2019 and ending December 31, 2019. Due to an INCREASE in the state average weekly wage, the maximum compensation benefit rate for injury, illness or death will change as follows:
    • For temporary total disability, the maximum rate is $607.40 per week for injuries and illnesses arising during the period beginning January 1, 2019 and ending December 31, 2019. 85A O.S. Supp. 2013, §45(A).
    • For Permanent Total Disability (PTD) and Death, the maximum rate is $867.71 per week for work-related injury, illness or death occurring during the period beginning January 1, 2019 and ending December 31, 2019.  85A O.S. Supp. 2013, §45(D) regarding PTD, and 85A O.S. Supp. 2013, §47 regarding death.
    • For Permanent Partial Disability (PPD), the maximum compensation benefit rate remains unchanged at $323 per week for work-related injury and illness occurring on or after February 1, 2014.  See, 85A O.S. Supp. 2013, §45(C).

Look for revised benefit charts on the Commission’s website https://www.ok.gov/wcc/Legal/Benefit_Charts/index.html or contact the Workers’ Compensation Commission’s Counselor/Ombudsman Program for more information at 855-2913612 (in-state toll free) • 405-522-5308 (OKC) • Counselors@wcc.ok.gov (electronic mail). To view the notice, go to https://www.ok.gov/wcc/Legal/Alerts/index.html.

  • The Workers' Compensation Commission is considering the revision of several forms, including the CC-Form 36A Affidavit of Exempt Status, Certificate to Joint Petition, Copier Charge Account Maintenance Form, and the Online Attorney Leave Request Form. The Commission is also considering the adoption of a new Online Attorney Mailing and Email Address Change Form. A copy of the proposed forms are available on the Commission's website at https://ok.gov/wcc/Legal/Governing_Documents_/index.html. If you would like to submit comments to the commission regarding the proposed rules, you may email them to rules@wcc.ok.gov through December 7, 2018. A public hearing will be held at 2:00 p.m., Friday, December 7, 2018, in Commission Chambers on the 2nd floor of the Denver Davison Building, Oklahoma City, OK. Interested parties must sign in at the door.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

  • Lou Savage, the Administrator of the Workers' Compensation, has approved the recommendation of the Medical Advisory Committee to keep platelet rich plasma injections a non-compensable service in Oregon workers' compensation system. The committee recommendation is attached to this notice and also posted on the committee website. The next step is to get public testimony on the recommendation. Comments can be submitted in writing to Juerg Kunz (juerg.kunz@oregon.gov) or provided to the committee at their February 15, 2019 meeting. If you have questions, please contact Cara Filsinger, 503-947-7582.
  • The Oregon Workers' Compensation Division has updated the permanent total disability (PTD) calculator that is posted to the division's website: https://www4.cbs.state.or.us/exs/wcd/ptd/ . The web calculator has two versions available: 1. The "web" version is used with an active internet connection and updates automatically. The web calculator is the preferred version if you have an internet connection. 2. The "stand-alone" version of the web calculator is for offline use (no active internet connection). The stand-alone version will automatically update when an internet connection is established. To update, you must have an active internet link, then start the stand-alone calculator and allow it to update. The web version is kept up to date and should be used as the primary calculation tool. It has been tested with the major web browsers and should work on any operating system. Because this calculator is always kept current, we do not plan to issue this notice in the future. If you have any questions, contact fred.h.bruyns@oregon.gov.
  • The Workers’ Compensation Division has posted an update to OAR 436-070-0003: https://wcd.oregon.gov/laws/Documents/New_rules/70-18063-short.pdf.  The effective date in Rule 0003, applicable for all rules in OAR 436-070, “Workers’ Benefit Fund (WBF) Assessment,” has been revised from Jan. 1, 2017 to Jan. 1, 2019. The division previously adopted a reduced WBF assessment rate, also effective Jan. 1, 2019. To view the new rule, go to https://wcd.oregon.gov/laws/Pages/new-rules.aspx.  Both rules become effective January 1, 2019.
  • Posted notice of a board meeting to be held 10 a.m. on Tuesday, December 11, 2018, at 2601 25th St. SE, Suite 150, Salem, OR. To view the notice, go to  https://www.oregon.gov/wcb/Pages/meetings-minutes.aspx.
  • Posted notice of four rules that become effective on January 1, 2019.  The four rules becoming effective on January 1, 2019 are OAR 436-050 Employer/Insurer Coverage Responsibility, OAR 436-080 Noncomplying Employers, OAR 436-070-003 Workers' Benefit Fund Applicability Date and OAR 436-070-0010 Workers' Benefit Fund Assessment Rate.  To view the new rules, go to  https://wcd.oregon.gov/laws/Pages/new-rules.aspx.
  • The October Edition of Board News and Case Note has been published.  To view the latest edition, go to https://www.oregon.gov/wcb/Pages/news-notes.aspx.

Pennsylvania WC VIEW STATE →

REGULATORY ACTIVITY:

  • Announced the 18th Annual Pennsylvania Workers’ Compensation Conference, June 3-4, 2019, at the Hershey Lodge & Convention Center, Hershey, Pennsylvania. Nearly 1,400 people registered to attend the 2018 conference, representing employers, case managers, third-party administrators, defense/claimant counsel, labor and others. Attendance at this event promises a sharing of practical, useful and timely information and provides attendees with the unique opportunity to network with other workers’ compensation professionals while renewing valuable contacts. Attendees will also have the opportunity to visit with 125 vendors and learn about their workers’ compensation-related goods and services. Conference registration will not be open until at least the end of January, but you may wish to book your hotel reservations in the meantime. Reservations for overnight accommodations at the Hershey Lodge must be made by contacting the Hershey Lodge on or before Thursday, May 2, 2019, at 855-729-3108 or visit: https://book.passkey.com/go/BWCC2019. When making your reservations, advise the lodge that you are attending the “Bureau of Workers’ Compensation Conference, June 3-4, 2019” to get the conference room rate of $205 per room/per night, plus 11 percent taxes.  To view the notice, go to  https://www.dli.pa.gov/Businesses/Compensation/WC/conferences/Pages/default.aspx.

Rhode Island Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued insurance bulletin 2018-15 regarding Rhode Island Insurance Verification System change to reporting frequency and letter issuance.   The RI Insurance Division in conjunction with the RI Division of Motor Vehicles (DMV), issues this Bulletin to notify Insurance Company Representatives of new requirements under Public Law 2018, Chapters 160 and 245, Relating to Motor and Other Vehicles -  Uninsured Motorist Identification Database Procedure, which amends RI Gen. Laws § 31-47.4. This Bulletin supersedes Insurance Bulletin 2015-1.  To view the bulletin, go to http://www.dbr.ri.gov/news/insurance.php.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

  • Issue Bulletin 2018-12 regarding Information Security Program Exemptions South Carolina Insurance Data Security Act, 2018 S.C. Act No. 17. This is the third in a series of bulletins addressing the implementation of the South Carolina Insurance Data Security Act (2018 S.C. Act No. 171 ("Act")).  The Act is codified as Chapter 99 of Title 38 of the South Carolina Code of Laws.   This Bulletin specifically addresses exemptions  from the information  security program requirements.  To view the bulletin, go to http://www.doi.sc.gov/432/Property-Casualty#bulletins.

Tennessee VIEW STATE →

REGULATORY ACTIVITY:

  • The renewal process for Nurse Case Managers will soon open. Information about the renewal process can be found at https://www.tn.gov/content/dam/tn/workforce/documents/injuries/CaseManagerRenewalNotice.pdf.
  • The Bureau of Workers’ Compensation will once again offer its highly successful Adjuster Certification Training in each Grand Division of the State in 2019. Due to the overwhelming response to the 2018 sessions, the number of offerings will increase by 50%.  The tentative dates and locales for the 2-day training events being offered in 2019 are as follows:
      • Nashville: • February 26th and 27th • April 30th and May 1st • August 20th and 21st
      • Sevierville: • June 4th and 5th • October 8th and 9th
      • Memphis: • November 5th and 6th

 Registration for the individual training sessions will open approximately 45-60 days before each session.  Those interested in attending are encouraged to register promptly, as 2018 sessions filled within 24 hours of their opening. Specific locations within these cities will be announced when registration opens.   Information about Tennessee’s Adjuster Certification Program, including the Rules that govern the program and the Registry of Certified Adjusters, is available on the Bureau’s website.  For additional information, please contact Bureau Assistant Administrator, Jeff Francis, at b.jeff.francis@tn.gov or 615-253-6269.

Texas VIEW STATE →

FEE SCHEDULE NEWS:

  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has released the new conversion factors for the medical fee schedule effective January 1, 2019. The next update is expected in January 2020.

REGULATORY ACTIVITY:

  • The Texas Department of Insurance, Division of Workers' Compensation (DWC) is withdrawing the prior amendments to 28 Texas Administrative Code (TAC) §180.26 and §180.8 published on May 18, 2018 (43 TexReg 3226) and, in response to the comments received, proposes new amendments to those rules for public comment. DWC will hold a public hearing on these amendments on November 16, 2018, at 10 a.m. in the Tippy Foster Room at the DWC Central Office located at 7551 Metro Center Drive, Suite 100, in Austin.  Written comments and public testimony presented at the hearing will be considered. The proposal was published in the November 2, 2018 issue of the Texas Register and is available at sos.state.tx.us/texreg/index.shtml once published. A courtesy copy is also available on the TDI website at www.tdi.texas.gov/wc/rules/2018rules.html.  DWC proposes these amendments 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 (EDI). SB 1895 also added Texas Labor Code § 415.021(c-1) which requires the commissioner to adopt rules to communicate to the person 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 provide for the communication required by SB 1895 when assessing an administrative penalty.  To view the notice, go to  https://www.tdi.texas.gov/alert/whatsnew/index.html.  
  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is proposing five new forms to help insurance carriers submit requests for reimbursement from the Subsequent Injury Fund (SIF). Use of these forms will be voluntary.  The forms are designed to help meet filing requirements under 28 Texas Administrative Code §116.11 and are expected to help expedite an insurance carrier’s request for reimbursement by reducing requests from DWC for additional information.
    • DWC Form-095 can be used to file for reimbursement of unrecoupable overpayments due to the decision of a hearing officer, the appeals panel, or an interlocutory order that is reversed or modified by final arbitration, order, or decision.
    • DWC Form-096 can be used to file for reimbursement of death benefits paid to the SIF prior to identifying a legal beneficiary entitled to receive death benefits.
    • DWC Form-097 can be used to file for reimbursement of income benefits paid as a result of an injured employee’s multiple employment.
    • DWC Form-098 can be used to file for reimbursement of unrecoupable overpayments due to a designated doctor opinion that is reversed or modified by a final arbitration award, a final order, or a commissioner or court decision.
    • DWC Form-099 can be used to file for reimbursement of payments resulting from initial pharmaceutical coverage after a determination that the injury is not compensable.

These forms are available for review on the TDI website at www.tdi.texas.gov/wc/rules/drafts.html.

  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is accepting public comments on proposed amendments to the above-identified rules and proposed new 28 Texas Administrative Code (TAC) §140.9. The purpose of the proposal is to:
    • Harmonize DWC rules with legislative changes made in House Bill 2111 (85th Legislature, Regular Session) by replacing “hearing officer” and “hearings officer” with “administrative law judge.”
    • Delete obsolete rule text, replace “commission” with “division,” correct typographical errors, designate several new abbreviations, and clarify that a request for a hearing subpoena must be delivered to the parties, including any potential legal beneficiaries.
    • Create new 28 TAC §140.9, which requires carriers, carrier representatives, claimants represented by an attorney, and claimants assisted by the Office of Injured Employee Counsel (OIEC) to include with any requests to a presiding officer a signed statement that the requesting party made reasonable efforts to confer with other parties about the request.  Section 140.9 also establishes timeframes for responding to requests but provides presiding officers with latitude to consider requests or responses that are not timely filed.  Claimants neither represented by an attorney nor assisted by OIEC may request to continue a proceeding by contacting DWC in any manner.
    • Amend 28 TAC §141.2 to clarify that there is only one “first request” to reschedule a benefit review conference (BRC) that need not demonstrate good cause. The clarification is necessary to give notice that both parties do not have a “first request.”  The rule also provides that requests to cancel or reschedule a BRC must be sent to DWC and opposing parties no later than five days before the scheduled BRC. Parties opposing such requests must file written opposition with DWC within three days of receiving the cancellation or rescheduling request. Claimants neither represented by an attorney nor assisted by OIEC may request to cancel or reschedule a BRC by contacting DWC in any manner.
    • Amend 28 TAC §142.10 to require parties to comply with new §140.9 and state that claimants neither represented by an attorney nor assisted by OIEC may request to continue a hearing by contacting DWC in any manner.
    • Amend 28 TAC §142.11 to require administrative law judges (ALJs) to send notice to a party that fails to attend a scheduled contested case hearing that the non-attending party, within 10 days of receipt of the notice, must show good cause for failing to attend. Replies to the non-attending party’s response are due within three days of receipt of the response. If the ALJ does not find good cause, or the non-attending party does not respond to the notice, the ALJ shall issue a decision based on the evidence presented at the hearing and may recommend the issuance of an administrative violation.
    • Amend 28 TAC §§5, 142.7, and 142.12 to be consistent with proposed new §140.9 on the treatment of claimants neither represented by an attorney nor assisted by OIEC.
    • Amend 28 TAC §142.4 to be consistent with proposed new §140.9 as regards the delivery of copies of documents to other parties to a proceeding.

 In addition, until 5 p.m. central time on December 3, 2018, the DWC is accepting public comment on revisions to DWC Form-045, Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC), or to Proceed Directly to Contested Case Hearing (CCH) and DWC Form-045M, Request to Schedule, Reschedule, or Cancel a Benefit Review Conference to Appeal a Medical Fee Dispute Decision (BRC-MFD). The proposed revisions to DWC Form-045 and DWC Form-045M will make the form consistent with the proposed amendments to chapters 140 and 141, updates contact information, and conforms to current agency style. If a hearing is held, DWC will consider written comments and public testimony presented at the hearing.

  • On October 23, 2018, Commissioner of Workers' Compensation Cassie Brown proposed amendments to 28 Texas Administrative Code (TAC) §148.17, Special Provisions for Sanctions. The proposed amendments were filed with the Office of the Secretary of State on October 23, 2018, and were to be published in the November 9, 2018, issue of the Texas Register. When published, the adopted amendments may be viewed on the Secretary of State’s website at www.sos.state.tx.us/texreg/index.shtml. A courtesy copy of the adoption is available on the Texas Department of Insurance website at tdi.texas.gov/wc/rules/2018rules.html.  The amendments to 28 TAC §148.17 would:
    • Retitle and amend the rule to apply to all administrative sanctions, including monetary penalties.
    • Delete the requirement for paying the penalty or posting a bond in order to seek judicial review.
    • Provide for other forms of payment, as approved by DWC.

To view the notice, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.

  • Published the Texas Workplace Injury, Illness Rate Reported for 2017.  To view the report, go to https://www.tdi.texas.gov/wc/safety/sis/nonfatalhomepag.html#Y2017.
  • New changes to the Medical Fee Guideline conversion factors established by 28 Texas Administrative Code §134.203 have been published. Under Labor Code §413.011(a), fee guidelines adopted by the Division of Workers’ Compensation (DWC) for non-network services and approved out-of-network services are based on the most current reimbursement methodologies, models, and values or weights used by the federal Centers for Medicare and Medicaid Services. DWC established a conversion factor and an annual update to provide predictability and reflect changes in medical service delivery costs to system participants. The annual update is based on the Medicare Economic Index (MEI), which is a weighted average of price changes for goods and services used to deliver physician services. The MEI for 2019 reflects an increase of 1.5 percent. For services provided in calendar year 2019, the new Medical Fee Guideline conversion factors are $59.19 and $74.29. The conversion factor of $59.19 applies to service categories of evaluation and management, general medicine, physical medicine and rehabilitation, radiology, pathology, anesthesia, and surgery when performed in an office setting. The conversion factor of $74.29 applies to surgery when performed in a facility setting. If there are any questions about the information in this bulletin, call Comp Connection for Health Care Providers at 1-800-372-7713.  To view the bulletin, go to https://www.tdi.texas.gov/bulletins/index.html.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

  • Posted notice of proposed rule regarding medical care in the November 15, 2018 Bulletin. The purpose of this amendment is to adopt, with modifications, the   Optum   2018   Essential   Resource-Based Relative Value Schedule (RBRVS), 2018 1st Quarter Update and to adjust the conversion factors regarding certain medical specialties.  These amendments incorporate by reference current versions of the Resource-Based Relative Value Scale (RBRVS) and adjust certain   conversion   factors   related   to   the   evaluation   and management   from   $50   to   $56 (codes   99203-99204   and 99213-99214)   and   the   remaining   evaluation   and management codes from $50 to $52 per unit.  To view the proposed rule, go to https://rules.utah.gov/publications/utah-state-bull/.

Vermont VIEW STATE →

REGULATORY ACTIVITY:

  • After the aborted Legislative Committee on Administrative Rules (LCAR) hearing on October 18, the Department of Labor met with opponents of the proposed rule to discuss their concerns. Unfortunately, we were unable to come to agreement on the rules, although there was some agreement that statutory changes may be necessary. The Department has decided to withdraw the proposed rule and leave the existing rule in place. Therefore, it was not necessary for LCAR to consider the rule at its November 15th To view a copy of rule withdrawn, go to http://labor.vermont.gov/legal-information/proposed-rules/.

 

Vermont Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued insurance bulletin No. 206 regarding interest on insurance claim payments. The purpose of this bulletin is to clarify the effect of the passage of Act 134 of the 201 7-18 legislative session on 8 V.S.A.  § 3665.  ("Timely payment of claims; interest; damages").  To view the bulletin, go to http://www.dfr.vermont.gov/view/regbul?tid=3&field_rb_type_value=Bulletin.

Virginia Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Has issued administrative order 12069 and 12070. AO 12069 Effective January 1, 2019 (new business) and February 1, 2019 (renewal business) - AIPSO Filing No. VA 18-07 Commercial Auto Rate Filing - This filing includes a rate increase of 0.8% overall. AO 12070 Effective January 1, 2019 (new business) and (renewal business) - AIPSO Filing No. VA 18-08 Section 2 of the Plan Manual for Personal Lines Auto amended to introduce language that would limit the eligibility for physical damage coverage to vehicles with an original cost new of $75,000 or less.  To view the orders, go to https://www.scc.virginia.gov/boi/adminords/2018.aspx.

Washington-Auto VIEW STATE →

REGULATORY ACTIVITY:



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