Alaska VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 61 This legislation will change the amount a vessel owner may be reimbursed by the Fishermen's Fund. Currently vessel owners may be reimbursed the lower of 50% of their protection and indemnity (P&I) insurance deductible or $5,000 per claim. Under this legislation, vessel owners may be reimbursed the lower of 100% of their P&I insurance deductible or $5,000. The department projects that this will increase liability to the Fishermen's Fund by $16,100 per fiscal year. This projection is based on an average for these types of claims filed between FY14 and FY17 of seven claims per year at an average cost per claim of $2,300. Assuming that $2,300 is 50% of the deductible then the total would be $4,600. Under this scenario, the cost increase to the Fishermen's Fund would be $2,300 per claim for a total of $16,100 per year. There is sufficient revenue in the Fishermen's Fund to cover this increased liability. Effective Date December 12, 2019.

California VIEW STATE →

FEE SCHEDULE NEWS:

• The DWC has published a new file for Medi-Cal rates effective February 15, 2020. The next update is expected March 15, 2020.
• The Division of Workers’ Compensation (DWC) has posted adjustments to the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1. The changes take effect on March 1, 2020. More information and the adjustments to the hospital outpatient departments and ambulatory surgical centers section of the OMFS can be found at https://www.dir.ca.gov/dwc/OMFS9904.htm#6.
• The DWC Posts Adjustments to Official Medical Fee Schedule for Physician Services/Non-Physician Practitioner Services to Implement Second Medicare Correction to the Annual Update. On January 22, 2020, the Centers for Medicare and Medicaid Services (CMS) adopted retroactive corrections to the Geographic Practice Cost Index data. DWC adopted the corrections by an order dated January 27, 2020.  On January 31, 2020, CMS adopted a second retroactive correction to the annual Medicare Physician Fee Schedule update, effective January 1, 2020. The second correction makes changes to the Outpatient Prospective Payment System cap used in determining fees under the Physician Fee Schedule. DWC has posted an order adopting the Medicare corrections to the cap. The Administrative Director update order adopting the adjustments effective January 1, 2020, can be found at the DWC website’s https://www.dir.ca.gov/dwc/OMFS9904.htm#7.

REGULATORY ACTIVITY:

• The Division of Workers’ Compensation (DWC) has launched an electronic filing pilot program for physicians to submit the Form 5021, Doctor’s First Report of Occupational Illness or Injury (DFR), online. The pilot is available on a voluntary basis for physicians who agree to send their reports to DWC electronically rather than filing paper forms. Large volume filers such as hospitals are also invited to participate through electronic data interchange (EDI) submission. Physicians who treat an injured worker are required by the Labor Code to file, within five days after initial examination, a complete report of occupational injury or occupational illness with the employer's insurer or with the employer if self-insured. The forms are currently only available on paper. As this is a pilot, physicians are not required to participate in the electronic filing program. DWC plans to draft regulations to require electronic reporting in the future with the goal of phasing out paper filing. DWC has posted on https://www.dir.ca.gov/dwc/Electronic-Reporting-System-for-DFR/Index.htm more information on the pilot program. To participate in EDI filing, contact dfr_edi@dir.ca.gov.

LEGISLATIVE ACTIONS:

• Assembly Bill 547 Existing law establishes the Division of Labor Standards Enforcement (division) within the Department of Industrial Relations. The division is headed by the Labor Commissioner and the department is headed by the Director of Industrial Relations. Existing law establishes certain protections for janitorial workers, including a requirement that the division establish a biennial in-person sexual violence and harassment prevention training requirement for certain employees and employers. Existing law requires employers of at least one employee and one or more covered workers, as defined, who provide janitorial services, as specified, to register with the commissioner annually and prohibits them from conducting business without a registration. Existing law requires an application for registration to be in a form prescribed by the commissioner and subscribed and sworn to by the employer, as specified. This bill would require the division to issue 2 types of registrations, one for registrants without employees and one for registrants with employees, and prohibit the division from approving a registration, as described above, if the employer does not include, among other things, in their written application the name of any subcontractor or franchise servicing contracts affiliated with branch locations and the name of any subcontractor on franchise servicing the contracts. Existing law requires the director to convene an advisory committee to assist in development of training standards. This bill would require the director to convene a training advisory committee to assist in compiling a list of qualified organizations and peer trainers that employers would be required to use to provide the biennial training described above. The bill would require the department to make the list of qualified training organizations available on its internet website. The bill would require those qualified training organizations to provide specified information to the division for inclusion on its internet website by January 1, 2021. This bill would require the division to require employers subject to the training requirements to use the training content created by the Labor Occupational Health Program. This bill would require employers to use a qualified organization from the list of qualified organizations developed and maintained by the director to provide the required training and would require qualified organizations to provide peer trainers for employers to use in the training, as specified. The bill would require the employer to pay the qualified organization a specified amount per participant, unless an alternative payment has been agreed to pursuant to a collective bargaining agreement. The bill would require the qualified organization to ensure that the peer trainer is paid at least twice the state minimum wage per hour. This bill would require an employer to document and certify compliance with the training to non-supervisors and payment of the qualified organization, as specified, on a form prescribed by, and available to, the division. The bill would require an employer to submit a specified report of training completion to the director. By expanding the scope of the crime of perjury, this bill would impose a state-mandated local program. The bill would require the training advisory committee to approve and recommend the qualified organizations to the director. The bill would authorize a qualified organization to work with a training partner, as defined, to provide the required training. The bill would prescribe certain minimum qualifications for qualified organizations and peer trainers. The bill would require the director to develop, as prescribed a list of qualified organizations and qualified peer trainers, as recommended by the training advisory committee. Existing law provides for specified civil penalties for an employer subject to these provisions who fails to register with the department. This bill would also subject an employer who makes a material misrepresentation on their application to these civil penalties. The bill would make conforming changes. 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, 2020.

Delaware VIEW STATE →

REGULATORY ACTIVITY:

• Published the final adopted rule regarding rule 802 Delaware Workplace Safety Regulation.  The order adopting the final rule was adopted January 15, 2020.  It was published in the state register February 3, 2020.  To view the order and adopted rule, go to http://regulations.delaware.gov/register/february2020/final/23%20DE%20Reg%20676%2002-01-20.htm
• Published the 22nd Annual Report on the Status of Workers' Compensation Management.  To view a copy of the report, go to https://dia.delawareworks.com/workers-comp/

Delaware Auto VIEW STATE →

REGULATORY ACTIVITY:

• Published Auto Bulletin Number 31.  This bulletin reminds automobile insurers, brokers and agents that since June 30, 2008, it has been illegal in Delaware to charge a higher premium for automobile insurance to a member of the armed services or that member's spouse due to a break in coverage that is caused by overseas deployment (the "Patriot penalty").  This protection is codified in the Delaware Insurance Code at 18 Del. C. section 3917.  To view the bulletin, go to https://insurance.delaware.gov/information/bulletins/.

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of a hearing regarding receiving public input for rules 69L-002- 31.014.The Department of Financial Services announces a hearing to which all persons are invited. Date and time: Wednesday, April 8, 2020, 9:00 a.m. – 11:30 a.m. Place: DWC 1st Floor Conference Room, 1579 Summit Lake Drive, Tallahassee, FL 32317; General subject matter to be considered: The hearing is being conducted to receive public input and consider proposed changes to the above-referenced rules. A copy of the agenda may be obtained by contacting: Theresa Pugh, telephone: (850)413-1721, email: Theresa.Pugh@myfloridacfo.com. Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Theresa Pugh, telephone: (850)413-1721, email: Theresa.Pugh@myfloridacfo.com. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice). To view the notice and proposed rules, go to https://www.flrules.org/gateway/View_Notice.asp?id=22927325

Hawaii WC VIEW STATE →

REGULATORY ACTIVITY:

• Department of Labor & Industrial Relations (DLIR) Disability Compensation Division (DCD) is looking to implement a new case management system that incorporates the Workers’ Compensation (WC), Temporary Disability Insurance (TDI), Prepaid Health Care (PHC), and Professional Employer Organization (PEO) programs. External Stakeholders will be able to create an account, login, process claims, petition for a hearing, and receive case updates. For additional information, go to http://labor.hawaii.gov/dcd/dcd-ecms-modernization-project/.

Idaho VIEW STATE →

REGULATORY ACTIVITY:

• Department of Labor & Industrial Relations (DLIR) Disability Compensation Division (DCD) is looking to implement a new case management system that incorporates the Workers’ Compensation (WC), Temporary Disability Insurance (TDI), Prepaid Health Care (PHC), and Professional Employer Organization (PEO) programs. External Stakeholders will be able to create an account, login, process claims, petition for a hearing, and receive case updates. For additional information, go to http://labor.hawaii.gov/dcd/dcd-ecms-modernization-project/.

Illinois VIEW STATE →

REGULATORY ACTIVITY:

• Until further notice, all correspondence related to cases appearing on Arbitrator Nowak’s dockets in Collinsville, Mount Vernon and Herrin should be directed to the attention of Arbitrator Nowak at the Collinsville office address.   This would include settlement contracts, motions, return to call requests and any other case related material. The address is as follows: The Honorable Michael Nowak, IWCC, 1803 Ramada Boulevard, Suite B201, Collinsville, IL 62234

Iowa VIEW STATE →

REGULATORY ACTIVITY:

• Employees who sustain a work injury to a shoulder and are unable to return to gainful employment due to the resulting permanent partial disability, may qualify to participate in vocational training and education under Iowa Code section 85.70(2) and Rule 876 IAC 4.50. For additional information, go to https://www.iowaworkcomp.gov/information-vocational-training-education.
• Published information regarding form number 14-0147 Payment Activity Report.  This form is used to submit a Payment Activity Report to the Iowa Division of Workers' Compensation (DWC). To view additional information regarding the form, go to https://www.iowaworkcomp.gov/form-PAR.

Kentucky Auto VIEW STATE →

REGULATORY ACTIVITY:

• The Department of Insurance issued Advisory Opinion 2020-01 regarding the depreciation of labor expense in the adjustment of property claims.  To view the opinion, go to http://insurance.ky.gov/PPC/Bulletin.aspx.

Louisiana VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice in the February 2020 State Register of adoption of medical treatment guidelines for pain management. The Louisiana  Workforce  Commission  has  amended certain  portions  of  the  Medical  Guidelines  contained  in  the Louisiana  Administrative  Code,  Title  40,  Labor  and Employment,  Part  I,  Workers’  Compensation Administration, Subpart 2, Medical Guidelines, Chapter 21, regarding chronic pain guidelines. This Rule is promulgated by  the  authority  vested  in  the  director  of  the  Office  of Workers’  Compensation  found  in  S.  23:1291 and R.S. 23:1310.1(C).  This  document  has  been  prepared  by  the  Louisiana Workforce  Commission,  Office  of  Workers'  Compensation (OWCA)  and  should  be  interpreted  within  the  context  of guidelines  for  physicians/providers  treating  individuals qualifying  under  Louisiana  Workers'  Compensation  Act  as injured  workers  with  chronic  pain.  Although  the  primary purpose  of  this  document  is  advisory  and  educational,  the guidelines  are  enforceable  under  the  Louisiana  Workers’ Compensation Act. All medical care, services, and treatment owed  by  the  employer  to  the  employee  in  accordance  with the  Louisiana  Workers'  Compensation Act  shall  mean  care, services, and treatment in accordance with these guidelines. Medical care, services, and treatment that varies from these guidelines  shall  also  be  due  by  the  employer  when  it  is demonstrated  to  the  medical  director  of  the  office  by  a preponderance  of  the  scientific  medical  evidence,  that  a variance from these guidelines is reasonably required to cure or relieve the injured worker from the effects of the injury or occupational  disease  given  the  circumstances.  Therefore, these guidelines are not relevant as evidence of a provider's legal standard of professional care.  To  properly  utilize  this document,  the  reader  should  not  skip  nor  overlook  any sections. To view the February Register, go to https://www.doa.la.gov/Pages/osr/reg/regs2020.aspx.

Maine VIEW STATE →

REGULATORY ACTIVITY:

• Posted a revised version of WCB-90 poster, which is the mandatory workers' compensation poster.  To view this notice and poster, go to https://www.maine.gov/wcb/index.html.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

• On January 9, 2020, the Workers’ Compensation Commission adopted amendments to Regulation .07 under COMAR 14.09.13 Individual Employer Self-Insurer. This action, which was proposed for adoption in 46:24 Md. R. 1115 (November 22, 2019), has been adopted as proposed. Effective Date: February 10, 2020.

Massachusetts VIEW STATE →

REGULATORY ACTIVITY:

• Issued an Advisory Bulletin regarding MGL 152, Section 13 114.3 CMR - Rates for Services under MGL c. 152. Please be advised, the above-captioned regulations promulgated April 1, 2009 remain in effect for professional services under the Workers’ Compensation Act.  This is to include provisions related to therapeutic services as outlined in 114.3 CMR 40.05(13) (g).    As a reminder, 114.3 CMR 40.01(2) in part indicates:  “The payment rates set forth in 114.3 CMR 40.06 are full payment for services provided under M. G. L. c. 152 § 13 including an administrative and overhead costs.   The insurer, employer and healthcare service provider may agree upon a different payment rate for any service set forth in the fee schedule”.

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

• Physicians – CMS has released the new April 2020 Physician database. The next update is expected in July 2020.
• CCI Edits - CMS has released updates to the Outpatient and Physician PTP Edits with an effective date of January 1, 2020.

Michigan Auto VIEW STATE →

REGULATORY ACTIVITY:

• Bulletin 2020-03-INS was issued regarding choice of bodily injury liability coverage limits form and personal injury protection choice forms. This bulletin supersedes Bulletin 2019-29-INS in order to re-publish the Choice of Bodily Injury Liability Coverage Limits Form and Michigan Selection of Personal Injury Protection (PIP) Medical Coverage Forms.  The Michigan Selection of Personal Injury Protection (PIP) Medical Coverage Form for individual / personal policies has been amended to clarify the amount of coverage available from the Michigan Assigned Claims Plan when a person loses Qualified Health Coverage. The Choice of Bodily Injury Liability Coverage Limits Form (BI Form) has not been amended but has been republished.  The Michigan Selection of Personal Injury Protection (PIP) Medical Coverage Form for commercial policies is unchanged from the version published with Bulletin 2019-24-INS. However, it is being re-published along with the amended form for convenience.  Insurers must include the DIFS BI Form and the appropriate PIP Choice Form(s) in any form filings. To view this bulletin, go to https://www.michigan.gov/difs/0,5269,7-303-12900_12906---,00.html.
• Issued Bulletin 2020-05-INS regarding Medicare and no-fault automobile insurance.  After July 1, 2020, Michigan Medicare enrollees who renew or purchase a new no-fault automobile insurance policy can choose to “opt out” of Personal Protection Insurance (PIP) medical benefits. To do so, the enrollee must demonstrate that they are enrolled in Medicare Parts A and B and that their spouse or any relative of either who resides in the same household has qualified health coverage (QHC) or automobile insurance coverage that includes PIP medical benefits.  Medicare will pay for Medicare-covered services to enrollees who opt out of PIP medical benefits, are injured in an automobile accident, and have no other available coverage. The enrollee will remain financially responsible for coinsurances, copayments, deductibles, and for any services Medicare does not cover, such as transportation to and from medical appointments, vehicle modifications, case management services, residential treatment programs, long-term and custodial care, and replacement services.  Please see Medicare’s booklet titled “Your Guide to Who Pays First” for more information.   To view the bulletin, go to https://www.michigan.gov/difs/0,5269,7-303-12900_12906---,00.html.

Minnesota VIEW STATE →

REGULATORY ACTIVITY:

• The Department of Labor and Industry (DLI) intends to adopt Version 3.1 of the Claims Release Standard published by the International Association of Industrial Accident Boards and Commissions (IAIABC), and the corresponding Minnesota implementation guide, for purposes of reporting workers' compensation claims information to DLI on or after Aug. 31, 2020, and to provide you with an opportunity to comment. The Notice of Intent to Adopt Version 3.1 of the IAIABC Claims Release Standard and the corresponding Minnesota implementation guide was published in the Feb. 18, 2020, edition of the State Register. A copy of the full notice of intent to adopt this electronic data interchange (EDI) standard is available on DLI's website. The notice provides details about how to submit comments and other important information.  A copy of the proposed Minnesota implementation guide is available on DLI's website and provides details about how to electronically submit workers' compensation claims reporting to DLI.  Additional information about EDI is on DLI's website. The comment period ends at 4:30 p.m., Monday, May 18, 2020. More information: If you have questions or would like more information, contact DLI at campus.ediguide.dli@state.mn.us or 651-284-5011.

Missouri VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of amendment to rule 20 CSR 500-6.100 Policy and Endorsement Forms amending sections 1.  This amendment corrects a drafting error present in the rule by removing a reference to an obsolete endorsement form.  To view this rule, go to https://www.sos.mo.gov/default.aspx?PageID=9804.
• Issued Insurance Bulletin 20-01 to inform and educate the reader on the specific issue of rate stability rules. To view the bulletin, go to https://insurance.mo.gov/laws/bulletin/.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

• The Nebraska Workers’ Compensation Court Electronic Data Interchange (EDI) Claims Release 3.1 tables have been updated with changes identified as Version 1.3. For more information, please visit our EDI website (https://nwccedi.info/news).

Nevada VIEW STATE →

REGULATORY ACTIVITY:

• The Administrator of the Division of Industrial Relations has revised the following forms, effective January 24, 2020: C-1 Notice of Injury or Occupational Disease (rev 1/2020); C-3 Employer's Report of Industrial Injury or Occupational Disease (rev 1/2020) and D-2 Brief Description of Your Rights and Benefits if You Are Injured on the Job (rev 1/2020).  Please discontinue the use of the previously revised forms: C-1 Notice of Injury or Occupational Disease  (rev 10/05);  C-3 Employer's Report of Industrial Injury or Occupational Disease (rev 11/05) and D-2 Brief Description of Your Rights and Benefits if You Are Injured on the Job (rev 6/18).  To view the revised forms, go to http://dir.nv.gov/WCS/Workers__Compensation_Forms_and_Worksheets/.

New Hampshire VIEW STATE →

REGULATORY ACTIVITY:

• Registration is now open for the 2020 Labor Law Training Seminar sessions. Please note: This year’s seminars are starting at 8:30am and ending at 12:00pm in an attempt to give the presenters and the audience more time for Q & A. For the full list of seminars and to register, go to https://www.nh.gov/labor/news-events/events/index.htm.
• The Department of Insurance issued Bulletin Docket No: INS 20-008-AB. On December 19, 2019, the New Hampshire Insurance Department (Department) issued Bulletin INS 19-028-AB ("Registration of all Pharmacy Benefits Managers") detailing new requirements established by RSA 402-N.   The prior bulletin provided a link to the pharmacy benefits manager registration application.   The Department has since amended the registration application to remove the requirement that a copy of the contract between the pharmacy benefits manager and health carrier be attached to the application. The pharmacy benefits manager is still required to fill out page 2 of the application for each contract it holds with a health carrier.  The Department intends to amend the Ins 2704 Pharmacy Benefits Manager proposed rules to reflect this change.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

• New Mexico's Annual Expenditure Report Filing was due between January 1 through February 15, 2020.  New Mexico State Law (NMSA Section 52-1-58) requires every workers' compensation insurance carrier and self-insured employer to report their annual expenditures to the New Mexico Workers' Compensation Administration. If you need a login/password or have any questions about the submission process, please contact the WCA at (505) 841-6044. In the meantime, you can use the link below to download detailed instructions about completing your AER submission. For additional information, go to https://workerscomp.nm.gov/WCA-eServices.
• Published the New Mexico Medical Report for 2019 and the New Mexico Opioid Supplemental 2019.  To view the reports, go to https://workerscomp.nm.gov/Communications.

New York VIEW STATE →

REGULATORY ACTIVITY:

• Published an important notice regarding important information for authorized medical providers. As of January 1, 2020, licensed clinical social workers, nurse practitioners and acupuncturists, as well as physician assistants, occupational therapists and physical therapists can be authorized to treat injured workers in New York State. Going forward, only those providers who are Board authorized may treat workers’ compensation patients. To see additional information regarding this notice, go to http://www.wcb.ny.gov/content/main/hcpp/hcpp.jsp.
• The Notice and Proof of Claim for Disability Benefits (Form DB-450) has been updated to include a question on collection of other unemployment insurance benefits during the period for which disability benefits are being claimed. The Chair-prescribed claim form includes Part A, which must be completed by the claimant, and Part B, which must be completed by the claimant’s medical provider. No Part C or other modification of the form is permitted. The insurance carrier has 18 days from receipt of a completed Form DB-450 to make payment to the claimant. Alternatively, the insurance carrier may request additional information for cause. Unless there is suspicion of fraud, if Form DB-450 is complete and information provided by the medical provider, who is licensed as required, and Part B supports the periods claimed in Part A, then no additional information may be required by the insurance carrier. If further information is needed for cause, the insurance carrier must pay within 18 days and/or partially deny within 45 days. The claimant may request Board review of any denial or partial denial. In addition, if the insurance carrier does not timely respond to a Form DB-450with payment, denial or partial denial, the claimant may file a request for Board action on the claim. Failure to properly respond to Form DB-450 will subject the insurance carrier to penalties, including late payment penalties if the claim is accepted. Claimants may obtain Form DB-450 on the WCB website or contact their employer or payer to obtain a copy. Use of version 1/20 of the form will be effective March 1, 2020.
• The Chair has adopted the amendments to 12 NYCRR 441.2 to make various updates to the New York Workers’ Compensation Formulary. A Notice of Proposed Rule Making was published in the August 7, 2019 edition of the State Register. A Notice of Emergency Adoption and Proposed Rulemaking was published in the November 20, 2019 edition of the State Register.  A Notice of Adoption was published in the February 12, 2020 and February 19, 2020 editions of the State Register. These amendments are now effective.

New York No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Posted notice of emergency adoption and proposed rulemaking for Ninth Amendment to Ins Reg 35-D (11 NYCRR 60-2) regarding supplementary uninsured and underinsured motorist coverage. To view the rule, go to https://www.dfs.ny.gov/industry_guidance/regulations/proposed_insurance.
• Posted notice of emergency and proposed 35th amendment to regulation 83 (NYCRR 68) regarding charges for professional health services. To view the posted notice, go to https://www.dfs.ny.gov/industry_guidance/regulations/proposed_insurance.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

• The Commission held the Public Hearing on the proposed adoption of 11 NCAC 23B .0106 and proposed amendments to 11 NCAC 23A.0104, .0408, .0409, 0501, .0903, 11 NCAC 23E .0104, and 11 NCAC 23L .0103 on January 30, 2020. To view this notice, go to http://www.ic.nc.gov/news.html#hot.
• The Form 33 Request for Hearing has been updated to allow a party to indicate that a claim for extended compensation is being filed pursuant to G.S. 97-29(c). In addition, a new document type, “Form 33- Request for Extended Compensation,” has been added to the EDFP menu. Claimants seeking a determination of entitlement to extended compensation prior to reaching the 500-week limitation should timely file a claim when eligible pursuant to G.S. 97-29(c). Given the statutory period between eligibility to file a claim for extended compensation and the 500-week limitation, parties will not be ordered into mediation when a claim for extended compensation is filed, and the claim will proceed to a hearing. However, parties are encouraged to mediate either before or after the hearing if the parties believe mediation may be fruitful in resolving the claim.   To view this notice, go to http://www.ic.nc.gov/news.html#hot.  To view the new form, go to http://www.ic.nc.gov/forms.html#claims.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

• Published revised Bulletin 151 regarding list of registered vocational assistance providers.  To view the undated list of registered vocational assistance providers, go to http://www4.cbs.state.or.us/ex/imd/reports/rpt/index.cfm?ProgID=CE8059.  To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• Published revised bulletin 342 regarding determination of gainful occupation for permanent total disability.  This bulletin provides examples of “gainful occupation” to be used to determine eligibility for PTD benefits under ORS 656.206 and updates the annual percentage of change in the federal poverty guidelines for a family of three that apply to Oregon residents.  This bulletin was published February 4, 2020. This bulletin replaces Bulletin No. 342 dated Jan. 24, 2019. To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
• Oregon Announces A Modernization Program: Creating a world-class workers’ compensation system: It is time to modernize business processes and technology at the Workers’ Compensation Division (WCD). Modernization is important to our regulatory functions and continued innovation. The need: Stakeholders have asked for updated services and processes, such as online self-service options and mobile technology. Our partners want to report data and share documents electronically; get secure access to real-time claims information; and see data reporting statistics using modern and flexible technologies. The process: The Modernization Program will work to create a detailed plan that will bring multiple technologies together for an overall solution. This program has a long-range vision, so you may not see an immediate change in the way the division operates. However, we do expect changes during the next few years that will improve our services, responses, and accessibility to customers.  How you can help: Tell us about your experiences with WCD. How can we improve processes and technology? Fill out this survey and help us serve you better.  Contact: Cecily Warren, 503-947-7595, Fax: 503-947-7725. Modernization@oregon.gov For additional information on the program, go to https://wcd.oregon.gov/Pages/modernization-program.aspx.
• Posted notice of adoption of two amended workers' compensation rules: OAR 436-030, Claim Closure and Reconsideration; and OAR 436-035, Disability Rating Standards. The rules become effective March 1, 2020.  A copy of the adopted rules can be viewed at https://wcd.oregon.gov/laws/Pages/new-rules.aspx.  A copy of the transcript of the hearing regarding these rules can be viewed at https://wcd.oregon.gov/laws/Pages/proposed-rules.aspx.
• Two members of the Oregon Workers' Compensation Board have proposed amendment to proposed rules that will be considered at the April 20, 2020 public meeting of the board.  To view the amendments, go to https://www.oregon.gov/wcb/Pages/meetings-minutes.aspx.

Oregon-Auto VIEW STATE →

REGULATORY ACTIVITY:

• The Division of Financial Regulation (DFR) has issued a proposed bulletin that provides guidance to auto insurers on the use of step-down limits in auto policies and outlines disclosures necessary to inform consumers of the nature and extent of coverage. The public comment deadline is Thursday, March 19. Public comments may be submitted to DFR. Bulletin@oregon.gov.
• Published Bulletin Number DFR 2020-4.  The purpose of this bulletin is to provide guidance to auto insurers that use virtual claim adjustment systems on how to avoid unfair claim settlement practices. The bulletin also clarifies when an insurer may require the use of a mobile application to submit a claim.  To view the bulletin, go to https://dfr.oregon.gov/laws-rules/Pages/bulletins.aspx.

Pennsylvania No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Published a notice 2020-01 regarding increase in the accident surcharge dollar threshold to $1,800.  To view the notice, go to http://www.pacodeandbulletin.gov/Display/pabull?file=/secure/pabulletin/data/vol50/50-1/24.html. 

Pennsylvania WC VIEW STATE →

REGULATORY ACTIVITY:

• The state has updated its 2020 fee schedule page.  To view the updated page, go to https://www.dli.pa.gov/Businesses/Compensation/WC/HCSR/MedFeeReview/Fee%20Schedule/Pages/default.aspx.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

• Published a copy of the agenda of the commission's business meeting held February 10, 2020.   A copy of the agenda including a copy of the materials that were considered at the meeting can be viewed at https://wcc.sc.gov/news/2020-02/full-commission-business-meeting-agenda-february-10-2020.
• The SC Workers’ Compensation Commission is temporarily suspending work on the IT Legacy System Modernization Project (KERMIT) due to unforeseen circumstances. For carriers, trading partners and vendors, implementation of EDI 3.1 originally scheduled for March 15 will be postponed until further notice. For attorneys, all claims related transactions will continue to be submitted according to the current business practices using eCase, emailing documents and the US Postal Service.  KERMIT will be deactivated for user and organization registration, EDI 3.1 testing and claims view. 
• Workers' Compensation Loss Cost Adoption Filings (Reminder): The National Council on Compensation Insurance (NCCI) is the workers’ compensation insurance rating organization in South Carolina.  As such, they file prospective loss costs with the South Carolina Department of Insurance (Department) for approval.  Once approved by the Department, insurers writing workers’ compensation insurance must adopt these loss costs. The Department approved NCCI’s most recent loss cost filing on January 9, 2020 with an effective date of April 1, 2020.  Workers’ compensation insurers are required to make a filing to adopt the new loss costs on or before March 9, 2020 (60 days after the approval date of those loss costs).  The effective date of this adoption must be no later than July 30, 2020 (120 days after the effective date of the approved loss costs).  Any such filing is considered to be informational.

Texas VIEW STATE →

REGULATORY ACTIVITY:

• Since 1991, the Texas Department of Insurance, Division of Workers’ Compensation (DWC) has prescribed standard form interrogatories under Texas Labor Code §410.159. The form interrogatories have been adopted by reference under 28 Texas Administrative Code §142.19. The form interrogatories are formal sets of questions that are used during discovery prior to a hearing to obtain written responses from an opposing party. There are two sets of interrogatories: Claimant’s Interrogatories to Carrier; Carrier’s Interrogatories to Claimants.  DWC has initiated a review of the utility and sufficiency of the current interrogatory forms and is requesting comments and suggestions from stakeholders regarding updates or revisions. DWC will host a stakeholder meeting to discuss the interrogatories on Tuesday, March 31, 2020, at 10 a.m. in DWC’s Tippy Foster Room at 7551 Metro Center Drive, Suite 100, in Austin.  DWC provides reasonable accommodations for persons attending meetings, hearings, or educational events as required by the Americans with Disabilities Act. If you need accommodations, please contact Cynthia Guillen at 512-804-4275 or at RuleComments@tdi.texas.gov before 12 p.m., Central time, on Thursday, March 26, 2020. Written comments may be submitted to RuleComments@tdi.texas.gov, or by mail to Cynthia Guillen Legal Services, MS-4D Texas Department of Insurance, and Division of Workers' Compensation 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1645. To view this notice, go to https://www.tdi.texas.gov/wc/index.html.
• The  Texas  Department  of  Insurance  proposes  to  amend  28  TAC §5.9332,  relating  to  workers'  compensation  classification  relativities.  The  amendment  is necessary because Senate Bill 1336, 86th Legislature, Regular Session (2019), eliminated the department's statutory requirement to develop workers' compensation classification relativities, which made paragraph (7)(B) of 28 TAC §5.9332 obsolete.
• The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has adopted amendments to 28 Texas Administrative Code §129.5 (concerning Work Status Reports) to implement House Bill (HB) 387, 86th Legislature. These amendments conform to the amended statute, allowing a treating doctor to delegate authority to complete and sign a work status report to a licensed advanced practice registered nurse. The amendments are adopted without changes. The adopted rules will be published in the February 28, 2020, issue of the Texas Register and will be available at sos.state.tx.us/texreg/index.shtml once published. A courtesy copy is on the TDI website. DWC previously approved revisions to the DWC Form-073, Work Status Report, as the changes made by HB 387 went into effect on September 1, 2019. Advanced practice registered nurses have been authorized to sign work status reports since that date. The amended rule is effective March 1, 2020.
• The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is accepting public comment on a proposed new form: DWC Form-121, Claim Administration Contact Information. Insurance carriers, including certified self-insurers, certified self-insurer groups, and governmental entities will be required to use DWC Form-121 to provide new or updated claim administration contact information through their Austin representative. Insurance carriers must update this information within 10 working days after making a change. Texas Administrative Code, Title 28, Section 124.2(r) (1) requires insurance carriers to provide contact information for:
  • coverage verification (policy issuance and effective dates of policy);
  • claims adjustment;
  • medical billing;
  • pharmacy billing (if different from medical billing); and
  • pre-authorization

The proposed form is available on the TDI website. You may submit written comments on the form to RuleComments@tdi.texas.gov, or mail your comments to Cynthia Guillen Legal Services, MS - 4D Texas Department of Insurance, Division of Workers’ Compensation 7551 Metro Center Drive, Suite 100 Austin, Texas 78744-1645.  The deadline to submit comments is 5 p.m., Central time, Thursday, February 27, 2020. To view the memo and draft form, go to https://www.tdi.texas.gov/wc/rules/drafts.html.

• The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has updated its English and Spanish plain language notices (PLNs) to show all text in 12-point font or larger. The instructions have also been changed to reflect recent DWC rule changes that require all PLNs sent by insurance carriers be in plain language and in no less than 12-point font as required by 28 Texas Administrative Code §124.2(s).     The new font size requirement is for PLNs sent on or after April 1, 2020.  The updated PLNs can be found on the DWC website at https://www.tdi.texas.gov/forms/form20plain.html.

Utah No-Fault VIEW STATE →

REGULATORY ACTIVITY:

• Proposed an amendment to rule R590-277-4 regarding prohibited policy provisions.  The rule is being amended to allow an insurer to exclude from coverage losses that come as a direct result of an insured driving under the influence.  The subsection sets forth the parameters for such exclusions. The earliest possible effective date is April 21, 2020. To view the proposed rule, go to https://insurance.utah.gov/consumer/legal-resources/rules.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

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

Vermont VIEW STATE →

LEGISLATIVE ACTIONS:

• Senate Bill 108 This bill permits the Attorney General to enforce complaints of employee misclassification under the workers’ compensation and unemployment laws. Effective Dates: Sec. 8 of this act shall take effect on passage, and the memoranda of understanding required pursuant to that section shall be executed not more than 90 days after the date of passage. Secs. 11, 12, 13, and 14 of this act shall take effect on July 1, 2026. Sec. 18 of this act shall take effect on January 1, 2021 and shall apply to injuries incurred on or after that date. This section and the remaining sections of this act shall take effect on passage.

Vermont Auto VIEW STATE →

REGULATORY ACTIVITY:

• Issued Insurance Bulletin #206 regarding virtual adjustment of vehicle partial and total loss claims.  The Vermont Insurance Division has recently seen an increase in the use of “virtual claims adjustment systems” that require the insured or the insured’s body shop to submit photographs or videos to the insurer in lieu of having a claims adjuster assess the damage to an automobile in person.  At the same time, the Division has seen a rise in consumer complaints alleging that the virtual adjustment process has unreasonably delayed the settlement of vehicle damage claims or resulted in inadequate settlement offers. The purpose of this Bulletin is to clarify the Division’s position regarding the use of virtual adjusting in the settlement of motor vehicle partial and total loss claims.  To view the bulletin, go to https://dfr.vermont.gov/view/regbul?field_rb_type_value=Bulletin&term_node_tid_depth=All.

Virginia VIEW STATE →

REGULATORY ACTIVITY:

• The Commission is aware of two issues that may prevent the submission of webforms through WebFile. The “Claim Form” and the “Employer’s Application for Hearing” webform options under the “Submit Web Forms” tab are affected. The IS Team is working to deploy a solution to these issues as soon as possible.

Claim Form Webform

• Issue #1: The “Secondary Street Address” fields of the "Claim Form" webform are limited to 15 characters. When data from an existing JCN is pre-populated into these fields the system allows more than 15 characters to appear without displaying an error or warning and the user is unable to click the “Next” button to proceed with submitting the form. Solution: Reduce the characters in the “Secondary Street Address” fields to 15 characters or less by moving some or all of the address to the “Primary Street Address” fields. The Claim Form can also be filed by fax to 804-823-6957 or by mail to 333 E. Franklin St., Richmond, VA 23219.
• Issue #2: The “Phone (Home)” field under the "Injured Worker's Phone" heading on the "Claim Form" webform is limited to 10 characters. When data from an existing JCN is pre-populated into this field the system allows more than 10 characters to appear without displaying an error or warning and the user is unable to click the “Next” button to proceed with submitting the form. Solution: Reduce the characters in the “Phone (Home)” field to 10 characters or less. This can usually be done by deleting any dashes or parentheses. The Claim Form can also be filed by fax to 804-823-6957 or by mail to 333 E. Franklin St., Richmond, VA 23219.

Washington VIEW STATE →

REGULATORY ACTIVITY:

• The office of Insurance Commissioner posted notice that the office is considering amending WAC 284-33-030 to increase the allowable amount for risk reduction goods and services. The Commissioner is considering raising the allowable amount an insurer can provide its insured over a 12-month aggregate period for risk mitigation goods and services to further encourage insurance companies assist their insureds in reducing claim frequency and severity.  Comments must be submitted by March 6, 2020.  To view the notice, go to https://www.insurance.wa.gov/increasing-allowable-amount-risk-reduction-goods-and-services-r-2020-01?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=.

Wisconsin VIEW STATE →

FEE SCHEDULE NEWS:

• Published the Radiology Data Base effective January 2020.  To view the 2020 Data Base, go to https://dwd.wisconsin.gov/wc/insurance/radiology/radiology_data.htm. The next update is expected July 2020.

Wyoming VIEW STATE →

REGULATORY ACTIVITY:

• Director Robin Sessions Cooley, J.D., has named Elizabeth Gagen, J.D., to the position of Deputy Director of the Wyoming Department of Workforce Services (DWS). Deputy Director Gagen has worked for the State of Wyoming for more than 24 years, including two years at the State District Court and more than 20 years at the Attorney General's Office. She served seven of those years as the Chief Deputy Attorney General. "Liz brings a wealth of knowledge and experience to DWS, and she will be a great asset to the department," Director Cooley said. "We look forward to adding her expertise to our talented DWS team." Deputy Director Gagen fills a position that has been open since the former deputy director, John Ysebaert, retired.