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Alaska VIEW STATE →

REGULATORY ACTIVITY:

  • Published Bulletin 20-04 Notice of Enforcement Suspensions from March 31, 2020 through May 11, 2020 -Emergency Declaration.  Following the Governor’s COVID-19 Disaster Order of Suspension No. 2, issued March 31, 2020, the Workers’ Compensation Division has made several enforcement adjustments to provide temporary relief for businesses who are struggling due to severe economic impacts related to the public health disaster emergency declaration. This does not eliminate an employer’s responsibility to provide workers’ compensation coverage under the Alaska Workers’ Compensation Act (AS 23.30).  To view the bulletin, go to https://labor.alaska.gov/wc/bulletins.htm.
  • Issued Bulletin Number 20-05 regarding COVID-19 Presumption of Compensability for Emergency Response and Health Care Employees.  To view this bulletin, go to https://labor.alaska.gov/wc/bulletins.htm.

Arizona VIEW STATE →

REGULATORY ACTIVITY:

  • The Governor issued Executive Order 2020-29 regarding increased telemedicine access for workers' compensation.  To view the executive order, go to https://www.azica.gov/news-and-events/public-notices.
  • The Department of Insurance issued Regulatory Bulletin 2020-03 regarding compliance with regulatory requirements during the public health emergency. To view the bulletin, go to  https://insurance.az.gov/regulatory-bulletins.
  • To assist in mitigating the spread of COVID-19, ICA buildings in Phoenix (800 W. Washington St.)  and Tucson (2675 E. Broadway Blvd.) were closed to in-person visitors. Although it appears that mitigation strategies are working, the Arizona Department of Health Services is urging everyone to remain vigilant and continue to follow Federal and State guidelines.  Because there is no greater priority than the health and safety of injured workers, ICA employees, customers, and Arizona senior citizens, the ICA is extending the temporary closure of the ICA buildings in Phoenix and Tucson to in-person visitors and will remain closed until further notice.  The ICA is working closely with Arizona health officials and will resume in-person visits as soon as circumstances warrant.    To view this notice, go to https://www.azica.gov/.

Arkansas VIEW STATE →

REGULATORY ACTIVITY:

  • The Arkansas Workers' Compensation Commission offices continue to be CLOSED TO THE PUBLIC in accordance with state directives concerning limiting COVID-19 exposure. Commission employees are working remotely away from the office. All prehearing conferences, joint petitions, and full hearings are now postponed through May 15, 2020.
  • Issued insurance Bulletin Number 18-2020 regarding compliance with regulatory requirements during the COVID-19 public health emergency. To view the notice, go to https://insurance.arkansas.gov/uploads/resource/documents/18-2020.pdf.

California VIEW STATE →

FEE SCHEDULE NEWS:

  • On May 6, 2020, the DWC posted an additional adjustment to DMEPOS to adopt the Medicare Fee Schedule increase required by the CARES Act. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) mandates that fees for DMEPOS supplied in non-rural areas be increased beginning March 6, 2020 in order to support essential services during the COVID-19 pandemic. The DWC order adopts Medicare’s revised file for DMEPOS items supplied to patients on or after March 6, 2020. Workers’ compensation claims administrators will need to adjust payment systems in light of the retroactive change, set up a process to identify claims which involve DMEPOS dispensed in non-rural areas, and ensure that the increased payments are remitted to the provider. To view the order, go to https://www.dir.ca.gov/dwc/OMFS9904.htm#3.
  • The DWC has published a new file for Medi-Cal rates effective April 15, 2020. The next update is expected May 15, 2020.
  • The Division of Workers’ Compensation (DWC) has posted an order adjusting 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 Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Centers for Medicare & Medicaid Services (CMS) Medicare changes: The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) April 2020 Addendum A quarterly update The CMS Medicare OPPS April 2020 Addendum B quarterly update. The CMS Ambulatory Surgical Center Payment System, April 2020 ASC Approved HCPCS Code and Payment Rates, Column A entitled “HCPCS Code” of “Apr 2020 ASC AA” and Column A entitled “HCPCS Code” of “Apr 2020 ASC EE” Certain sections of the CMS Medicare OPPS April 2020 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V21.1 R1 Apr 2020 quarterly update. CMS April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS), Change Request (CR) 11691 (March 25, 2020), Transmittal R10013CP. The order adopting the OMFS adjustments is effective for services rendered on or after April 1, 2020 and is posted on the DWC website. To view the information https://www.dir.ca.gov/dwc/OMFS9904.htm#6.
  • The Division of Workers’ Compensation (DWC) has posted an order dated April 15, 2020, adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) to conform to additional changes to the 2nd Quarter 2020 Medicare update, as required by Labor Code section 5307.1 to adopt new COVID-19 testing codes and fees. This is the second Administrative Director order for the quarter two update to the Pathology and Clinical Laboratory Fee Schedule. The Centers for Medicare and Medicaid Services (CMS) issued a revised 2020 Clinical Laboratory Fee Schedule dated April 6, 2020. The revised file supersedes the original file. In addition, on April 14, 2020, CMS issued a CMS Ruling adopting two new COVID-19 testing codes for tests that are performed with “high throughput technology,” which employs automated processing of more than two hundred specimens a day. These new test codes provide a higher level of reimbursement than current codes in light of the more intensive training and resources required for high throughput devices. The new codes and fees are expected to streamline billing and payment for the important medical services involved in COVID-19 testing. The Administrative Director’s April 15 update order adopting the OMFS adjustment is effective for services rendered on or after April 1, 2020, except that specified new COVID-19 testing codes, specimen collection codes, and fees are adopted retroactively to the CMS effective dates. The Administrative Director update Order can be found at https://www.dir.ca.gov/dwc/OMFS9904.htm#2.
  • The Division of Workers’ Compensation (DWC) has posted an adjustment to the Inpatient Hospital 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 effective date of the changes is for discharges occurring on or after January 27, 2020. DWC has amended Title 8, California Code of Regulations, section 9789.25, subdivision (b) to conform to changes in the Medicare payment system in light of the increase in DRG weights for COVID-19 related discharges in accordance with Section 3710 of the CARES Act and MLN Matters Special Edition Article SE20015, dated April 15, 2020. To view this notice, go to https://www.dir.ca.gov/dwc/dwc_home_page.htm.  Further information and adjustments to the Inpatient Hospital section of the Official Medical Fee Schedule can be found at https://www.dir.ca.gov/dwc/OMFS9904.htm#4.

REGULATORY ACTIVITY:

  • The Division of Workers’ Compensation (DWC) and the Workers’ Compensation Appeals Board (WCAB) are announcing an update to the modified calendar and filing procedures released on March 16, 2020. This update to the procedures continues to prioritize the health and safety of staff and the public to help prevent the spread of COVID-19.
  • In compliance with ongoing stay-at-home orders, the Division of Workers’ Compensation (DWC) has canceled the meeting of the Pharmacy and Therapeutics (P&T) Committee scheduled for Wednesday, April 22, 2020.  The Pharmacy and Therapeutics Committee was established by Assembly Bill No. 1124 (2015) as an advisory body that will consult with the DWC Administrative Director on updates to the Medical Treatment Utilization Schedule (MTUS) drug formulary. Past and future meeting materials can be accessed through the DWC P&T Committee web page. DWC welcomes comment from the public on the formulary drug list. All correspondence should be directed to Formulary@dir.ca.gov.
  • Insurance Commissioner Ricardo Lara alerted insurance companies that all workers affected by COVID-19 on the job are eligible for workers’ compensation benefits regardless of their immigration status. This includes workers engaged in front-line occupations such as health care, emergency services, food production, sales, and delivery, among others.  “This unprecedented pandemic has sparked questions and concerns among essential workers in the immigrant community who are showing up for work every day, bringing us vital goods and services,” Commissioner Lara said. “Hard-working Californians who are exposed to COVID-19 are entitled to workers’ compensation benefits if they fall ill, regardless of their immigration status.”  Commissioner Lara issued a Notice to remind insurance companies, agents, and employers that California law requires the payment of workers’ compensation benefits to injured workers regardless of their immigration status. His action supports Governor Gavin Newsom’s March 12 executive order stating that workers may be eligible for workers’ compensation benefits if they were exposed to or contracted COVID-19 on the job. In 2015, SB 623, authored by Commissioner Lara when he was a member of the California State Senate, expressly expanded protections for undocumented workers in the event they are injured on the job, to include compensation pursuant to the Uninsured Employers Benefits Trust Fund or the Subsequent Injury Fund, in addition to standard workers’ compensation benefits. "During this pandemic, essential workers face great risk to their health every time they clock in," said California Labor Federation Executive Secretary -Treasurer Art Pulaski. "If they are injured or get sick at work, they should know they can rely on workers’ compensation to provide the health care and benefits they need, regardless of immigration status. We commend Commissioner Lara for standing up for the workers who are among the most vulnerable in this time of crisis."  According to the notice, “Workers’ compensation injuries caused by COVID-19 that arise out of and occur in the course of employment are compensable to the same extent as any other compensable injury or disease. This Notice is a reminder that such claims may not be denied on the basis of the injured worker’s immigration status.” Workers who are not sure whether their employer had insurance on the date they were injured should call the Workers’ Compensation Insurance Rating Bureau at 1-888-229-2472 or visit their website at caworkcompcoverage.com.
  • With restaurants and businesses expanding deliveries to comply with “shelter in place” rules, Insurance Commissioner Ricardo Lara urged insurance companies to extend auto insurance coverage for drivers who are using their personal vehicles to fulfill deliveries for California’s essential businesses during the COVID-19 pandemic. Because personal automobile policies do not typically provide coverage for vehicles used for commercial purposes and some drivers may not be covered under their employer’s commercial automobile policy issued to a California essential business, temporary delivery drivers may be inadvertently uninsured as they carry out their job duties. Today’s action ensures that businesses can continue to provide essential goods to residents and families at their homes and that delivery workers are protected at all times so that they may continue their work critical to public health and safety. “This is an unprecedented time so we must take unprecedented action to help Californians comply with public health ‘shelter in place’ orders,” said Insurance Commissioner Ricardo Lara. “Delivery drivers are performing essential services to help our seniors and families, and this action will protect them while on the roads.” Under this notice, insurance companies should not deny a claim under a personal auto policy solely because the driver was providing delivery service on behalf of a California essential business impacted by the COVID-19 pandemic. The Notice applies to 16 categories of “essential critical infrastructure workers” identified by the U.S. Department of Homeland Security on March 19, including those who deliver food, medication, and other essential goods.  The Department is also requesting insurance companies to extend delivery coverage for motorcycle and bicycle riders and allow essential businesses to retroactively add drivers to their commercial automobile policies beginning on March 19, 2020. “We appreciate Commissioner Lara’s attempt to help our industry in these historically challenging times," said Matt Sutton, Senior Vice President for Government Affairs and Public Policy at the California Restaurant Association. "Any and all help is welcome.”
  • In light of the COVID-19 public health emergency and the Executive Orders issued by Governor Newsom, the Division of Workers’ Compensation (DWC) has posted an order adjusting the Physician Services / Non-Physician Practitioner Services Fee Schedule to adopt changes that will encourage expanded use of telehealth during the COVID-19 public health emergency. The changes are based upon Medicare’s public health emergency Physician Fee Schedule interim revisions, which adopt an expanded list of services that may be provided through telehealth, and which modify the “Place of Service” code for telehealth. Adoption of the Medicare telehealth code list will encourage the expanded use of telehealth by identifying services which may be provided through telehealth where medically appropriate and identified by modifier 95. The adoption of the Place of Service code revision will encourage use of telehealth by equalizing the payment for a service whether provided in a physician’s office or through telehealth using real time audio and video telecommunications. DWC encourages the provision of medical treatment by telehealth in lieu of in-person visits whenever medically appropriate, in order to protect patients and health care providers and to support the crucial effort to slow the community spread of the COVID-19 virus. Increased use of telehealth for workers’ compensation treatment is in alignment with the goals of the Governor’s “stay at home” Executive Order, and Executive Order regarding telehealth services. The DWC order and revised regulation text, effective for services rendered on or after April 15, 2020, can be found at https://www.dir.ca.gov/dwc/OMFS9904.htm#7.
  • On April 6, 2020, the Workers’ Compensation Appeals Board issued an en banc order allowing limited filing of specified documents via email directly to the Appeals Board and to the Division of Workers’ Compensation’s district offices. To assist the workers’ compensation community the Appeals Board and the Division offer the following guidance on emailing documents to the appeals board and the district offices. Documents relating to any matter currently pending before the Appeals Board, including but not limited to cases in which a petition for reconsideration has been granted for further study may be filed by emailing to WCABEmergencyBox@dir.ca.gov. Documents sent by email should include the information required for pleadings by WCAB Rule 10520 and an email address for the sending party. (Cal. Code Regs., title 8, former § 10498, now § 10520 (eff. Jan. 1, 2020).) Documents sent by email should otherwise comply with the WCAB’s Rules. Do not email petitions for reconsideration, removal, or disqualification and answers to the Appeals Board’s emergency email box. Those documents should still be filed electronically in EAMS or JET File or by email with the DWC district office having venue pursuant to WCAB Rule 10940(a). (See Cal. Code Regs., title 8, former § 10840(a), now § 10940(a) (eff. Jan. 1, 2020).)  Email addresses for the 24 district offices may be viewed at https://www.dir.ca.gov/dwc/dir2.htm.
  • The Division of Workers’ Compensation (DWC) issued its Notice of Emergency Regulatory Action to address the ongoing need for medical-legal evaluations and to prevent a backlog of medical-legal evaluations resulting from stay-at-home orders throughout the state. These emergency regulations will help injured workers and employers continue to move their workers’ compensation claims towards a resolution and avoid additional and undue delay. The regulations concern how medical-legal evaluations and payment for those evaluations can occur during this emergency period. Also provided in the regulations are alternative forms of service for required forms related to medical-legal evaluations and reports.  The emergency regulations will be filed with the state’s Office of Administrative Law (OAL) on May 4, 2020 and can be found on the DWC website. OAL has up to 10 days to consider and approve emergency rules. Upon OAL approval and filing with the Secretary of State, such regulations are effective for 180 days. If during this 180-day period the Division determines the need to readopt the emergency regulations, it may do so for an additional 90 days. For information on the OAL emergency regulatory procedures and to learn how you may comment on these emergency regulations, please visit OAL’s website. A notice will be posted on the DWC website when these emergency regulations become effective.  To view this notice, go to https://www.dir.ca.gov/dwc/dwc_home_page.htm.

Colorado VIEW STATE →

REGULATORY ACTIVITY:

  • Colorado Department of Labor and Employment has adopted two emergency rules, one effective March 24 and the other effective March 31.  Both of the adopted rules amend 7 CCR 1101-3.  To view the rules, go to https://www.colorado.gov/cdle/node/20506.

Colorado Auto VIEW STATE →

REGULATORY ACTIVITY:

Connecticut VIEW STATE →

FEE SCHEDULE NEWS:

  • The Connecticut Workers’ Compensation Commission issues an addendum to 2019 Official Connecticut Practitioner Fee Schedule, which addresses telehealth/telemedicine during the COVID-19 crisis. Published by Optum, the addendum assigns fees to new codes for telemedicine services provided by physical therapists and occupational therapists and gives instruction on the proper codes to use for billing of telemedicine services provided by a physician. There will be no reduction in reimbursement for telemedicine services. They are to be reimbursed at the same fee schedule amount as listed for non-telemedicine services. Information in this addendum will be valid for dates of service beginning March 1, 2020 and continuing through the publication of the 2020 fee schedule on July 15, 2020. The addendum may be obtained from Optum at https://www.optum360coding.com/support/product-updates#2019 under "Product Support." To view this notice, go to  https://wcc.state.ct.us/memos/2020/2020-10.htm.

REGULATORY ACTIVITY:

  • Issued Memorandum Number 2020-09 on April 1, 2020 a policy regarding the use of telemedicine.  To view the memorandum, go to https://wcc.state.ct.us/.
  • WCC update regarding the reimbursement of telemedicine services: Posted Thursday, April 23, 2020. The Workers' Compensation Commission is encouraging the use of telemedicine in response to the COVID-19 pandemic. Providers have been instructed to bill telemedicine visits with the appropriate CMS or CPT identified telemedicine code, utilizing modifier 95 together with place of service 02. Carriers have been advised to reimburse these visits at the fee schedule rate with no reduction (excluding contractual discounts). Until further notice, the Workers' Compensation Commission is instructing that workers' compensation claims billed with place of service 02 shall be reimbursed at the non-facility rate.
  • Issued Bulletin FS-37. The Connecticut Insurance Department (CID) recognizes the severity of COVID-19 and in order to comply with the social distancing policies, many of its employees are working remotely to the greatest extent possible while still accomplishing the essential functions of their jobs. However, the social distancing restrictions and the limitations of personnel in the office will disrupt certain scheduled practices, including the processing and issuance of license renewals for insurance companies, health care centers and fraternal benefit societies as the current procedure requires the presence of numerous personnel in the office to manually process, print, and physically mail out each of the licenses. Connecticut Governor Ned Lamont, in recognition that it may be necessary to extend statutory and regulatory administrative deadlines in order to properly respond to the COVID-19 pandemic, has issued Executive Order No. 7M, dated March 25, 2020, to permit department heads, including the Insurance Commissioner, to extend statutory, regulatory, or other time limitations by up to 90 days.  Therefore, in light of the current COVID-19 situation, the Insurance Commissioner finds that it is in the public interest and consistent with efforts to slow the spread of the virus and minimize serious illness or death for the CID to extend the renewal date for licenses issued to insurance companies, health care centers and fraternal benefit societies as described herein.  To view this bulletin, go to https://portal.ct.gov/CID/Bulletins/Current-List-of-Bulletins.

Delaware VIEW STATE →

REGULATORY ACTIVITY:

Florida WC VIEW STATE →

REGULATORY ACTIVITY:

  • Notice of Development of Rulemaking: DEPARTMENT OF FINANCIAL SERVICES; Division of Workers' Compensation RULE NOS and RULE TITLES: 69L-7.710 Definitions; 69L-7.720 Forms Incorporated by Reference for Medical Billing, Filing and Reporting; 69L-7.730;Health Care Provider Medical Billing and Reporting Responsibilities; 69L-7.740 Insurer Authorization and Medical Bill Review Responsibilities. PURPOSE AND EFFECT: The Department proposes the development of rule amendments to address clarification of medical reimbursement and utilization review requirements. SUBJECT AREA TO BE ADDRESSED: The medical reimbursement and utilization review requirements. RULEMAKING AUTHORITY: 13(7)(e), 440.591, FS. LAW IMPLEMENTED: 440.13(7), (8), (11)(a), (12), 440.134(15), FS. A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW: DATE AND TIME: Wednesday, May 27, 2020; TIMES: 69L-7.710, F.A.C. 9:30 a.m. – 10:30 a.m.; 69L-7.720, F.A.C. 10:30 a.m. – 11:30 a.m.; 69L-7.730, F.A.C. 1:00 p.m. – 2:30 p.m.; 69L-7.740, F.A.C. 2:30 p.m. – 4:00 p.m. PLACE: Room 155, Hilltop Building at Summit East, 1579 Summit Lake Drive, Tallahassee, Florida. 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: Brittany O’Neil, Policy Coordinator, Division of Workers’ Compensation, Department of Financial Services, telephone: (850)413-1927, email: Brittany.Oneil@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). THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Brittany O’Neil, Policy Coordinator, Division of Workers’ Compensation, Department of Financial Services, address: 200 East Gaines Street, Tallahassee, Florida 32399-4228, telephone: (850)413-1927, email: Brittany.Oneil@myfloridacfo.com. THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS NOT AVAILABLE.
  • Issued bulletin OIR-20-05 regarding workers' compensation insurance guidance related to COVID-19.  In response to the Executive Order 20-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, Governor DeSantis’ Executive Order 20-52 declaring a state of emergency in the state of Florida, and Chief Financial Officer Patronis’ Directive 2020-05 providing workers compensation coverage for public servants on the front line of COVID-19, the Florida Office of Insurance Regulation (“OIR”) is issuing an Informational Memorandum to all insurers and entities regulated by OIR (“Regulated Entities”) that are authorized to write workers’ compensation insurance to provide guidance on the treatment of policyholders as part of the state’s ongoing efforts to protect Floridians.  To view the bulletin, go to https://www.floir.com/office/memoranda/index.aspx.
  • Issued bulletin OIR-20-06 regarding telehealth and pharmacy audit guidance for response to COVID-19.  In response to the Executive Order 20-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, and following Governor DeSantis’ Executive Order 20-52 declaring a state of emergency in the state of Florida,  the Florida Office of Insurance Regulation (OIR) is issuing this Informational Memorandum to all health insurers, and other health entities regulated by OIR, and all Pharmacy Benefit Managers registered to do business in Florida to encourage the use of technology to help combat the spread of COVID-19.  To view the bulletin, go to https://www.floir.com/office/memoranda/index.aspx.

Georgia VIEW STATE →

FEE SCHEDULE NEWS:

  • A new Medical and Hospital fee schedule effective April 1, 2020 has been adopted. The state has also posted changes to the 2020 Dental Fee Schedule. The next expected update is in April 2021.

REGULATORY ACTIVITY:

  • Added Telemedicine services to the Georgia Medical Fee Schedule due to CONVID-19. To view this information, go to https://sbwc.georgia.gov/.
  • The Administrative Law Judges in the Hearing Division will hold virtual hearings with the consent of the parties.  The judges will also consider issues in claims that the parties agree can be submitted on stipulated facts, along with each party’s supporting documentary evidence.  If you and opposing counsel would like to have a virtual hearing in your claim or submit issues on the record in lieu of a hearing, please call the office of the assigned judge to discuss these options further.

Hawaii WC VIEW STATE →

REGULATORY ACTIVITY:

Idaho VIEW STATE →

REGULATORY ACTIVITY:

  • Published a telehealth policy memo.  To view the memo, go to https://iic.idaho.gov/.
  • Published in the State Administrative Bulletin temporary rules regarding rule 17.01.01 Administrative Rules under the Workers' Compensation Law. These temporary rules are necessary to protect the public health, safety, and welfare of the citizens of Idaho and confer a benefit on its citizens. These temporary rules implement the duly enacted laws of the state of Idaho, provide citizens with the detailed rules and standards for complying with those laws, and assist in the orderly execution and enforcement of those laws. The expiration of these rules without due consideration and processes would undermine the public health, safety, and welfare of the citizens of Idaho and deprive them of the benefit intended by these rules. To view these rules, go to https://adminrules.idaho.gov/bulletin/index.html.

Illinois VIEW STATE →

FEE SCHEDULE NEWS:

  • Issued an update to the medical fee schedule to adopt new procedures for COVID-19. The update is retroactive to January 1, 2020.

REGULATORY ACTIVITY:

  • The rapid spread of COVID-19 and uncertainty created within regulated industry has necessitated the modification of evidentiary rules regarding practice before the Commission to ensure first responders and essential front-line workers, who are most susceptible to exposure to COVID-19, are afforded the full protections of the Workers’ Compensation Act in the event they are exposed to or contract the virus. Illinois issued an emergency amendment containing modifications of evidentiary rules.   To view the notice, go to https://www2.illinois.gov/sites/iwcc/Pages/default.aspx.
  • MAY 2020 SPECIAL CIRCUMSTANCE ARBITRATION PROCEDURES: ​Based upon the continuing National Emergency and Worldwide Pandemic created by the COVID-19 virus, Arbitrators will conduct May 2020 Arbitration Calls telephonically.

Indiana VIEW STATE →

REGULATORY ACTIVITY:

  • The agency has received numerous questions regarding workers’ compensation coverage for employees who contract Covid-19, particularly those on the front lines.  In Indiana, workers’ compensation benefits are paid by employers, not the State.  Under our laws, the State cannot tell employers they must automatically cover employees who contract Covid-19.  Whether an individual contracts the virus in the course and scope of their employment is a determination that must initially be made by the employer. This decision is routinely made at the time the employee notifies the employer of the injury, or in this case, contraction of the virus.  It is well accepted that first responders, as defined in P.L.113-2020, and health care providers, as defined at IC 16-18-2-163, as well as others directly involved in the provision of services to those exhibiting symptoms of Covid-19 are more susceptible to contraction of the disease as a direct result of their work duties.   Others whose jobs necessarily entail close interaction with many people in a public setting are also more vulnerable to exposure and possible infection than those working remotely or in a limited office setting.  Employers are urged to consider making a prospective decision as to whether any vulnerable segment of their workforce will be presumptively covered under the provisions of the Indiana Workers’ Compensation Act should they:
    • Be quarantined at the direction of the employer due to a confirmed or suspected Covid-19 exposure,
    • Receive a Covid-19 diagnosis from a physician without a test,
    • Receive a presumptive positive Covid-19 test, or
    • Receive a laboratory-confirmed Covid-19 diagnosis.

Employers are encouraged to relay such decisions to their workforce and workers’ compensation insurance carrier/third party administrator as soon as possible in order to allay fears and expedite the claims process.  Plans of action upon any occurrence listed above should also be communicated. Questions may be directed to lhamilton@wcb.in.gov.

  • Issued insurance bulletin 253 to provide guidance relating to Governor Eric J. Holcomb's executive order 20-13 as well as providing additional information about coverage for COVID-19 testing services.  To view the bulletin, go to https://www.in.gov/idoi/2591.htm.

Iowa VIEW STATE →

REGULATORY ACTIVITY:

Kansas VIEW STATE →

REGULATORY ACTIVITY:

  • Issued bulletin 2020-01 to all interested parties including insurers, agents, consumers and all others having business before the Kansas Insurance Department.   To meet the inherent dangers of disasters to which the State and its citizens have been exposed due to novel coronavirus (COVID-19), Governor Laura Kelly issued a State of Disaster Emergency Proclamation on March 12, 2020. In that proclamation, the Governor suspended the provisions of any regulatory statute prescribing the procedures for conduct of state business, or the order of rules and regulations of any state agency which implements such statute, if strict compliance with the provisions of such statutes, order or rule and regulation would prevent, hinder, or delay in any way necessary action in coping with the disaster as set forth in K.S.A. 48-925(c) (1).  To view this bulletin, go to https://insurance.ks.gov/department/LegalIssues/bulletins.php

Kentucky VIEW STATE →

REGULATORY ACTIVITY:

  • As of March 12, 2020, the Department of Workers’ Claims (DWC) cancelled all in-person benefit review conferences and formal hearings in response to the Coronavirus emergency in the Commonwealth of Kentucky. Initially (optimistically), the cancellation was to run only through April 20, but that has now been extended through May 17, 2020. The prohibition against in-person proceedings required the cancellation of formal hearings on the March docket; and will impact benefit review conferences set for April and May, and the ability to set hearings from those dockets, and perhaps beyond.   Issued a memorandum regarding videoconference proceedings. The memorandum is dated April 9, 2020.  To promptly  address the claims with cancelled hearings, and to prevent a backlog of claims presently unable to be scheduled for hearing, the DWC is temporarily permitting videoconference proceedings and is working with the Commonwealth Office of Technology to determine and implement secure methods for conducting those proceedings. Once an ALJ has videoconference capacity, the DWC will make an announcement to that effect. At that point, counsel wishing to participate in videoconference proceedings for a hearing that has been cancelled should contact the assigned ALJ for scheduling and instruction regarding the videoconference process. Going forward, the scheduling of videoconference hearings will be handled at the benefit review conference.  The DWC continues to examine and establish procedures for videoconference proceedings to make them as secure and productive as possible. Technical issues will be addressed as well, such as the process by which exhibits are introduced at hearings and placed in the record. Challenges notwithstanding, the DWC remains committed to developing a system that will best serve its stakeholders, not just under the present circumstances, but into the future as well. As always, the DWC invites input and suggestion from all. To view this memorandum, go to https://labor.ky.gov/comp/Pages/default.aspx.
  • The Department of Workers' Compensation issued administrative order 2020-001 regarding electronic signatures and notarization. To view the administrative order, go to https://labor.ky.gov/comp/Pages/default.aspx.
  • Issued an Executive order 2020-277 to advise the reader of the current position of the Department of Workers’ Claims (the “Department”) on the specified issue on COVID-19. To view the memo, go to https://labor.ky.gov/comp/Pages/default.aspx.
  • Issued a memorandum on April 16, 2020 regarding video conferencing. The Department of Workers’ claims is pleased to announce that all administrative law judges now have the capacity to conduct videoconference proceedings through the Zoom platform. Parties wishing to schedule a videoconference proceeding should contact the assigned ALJ for further details and instruction. Videoconferences will only be scheduled if all parties agree to participate. The Department is committed to promoting videoconference proceedings in light of the on-going prohibition of in-person proceedings and in order to facilitate the timely resolution of claims. For additional information, please contact Chief Administrative Law Judge Douglas W. Gott at douglas.gott@ky.gov or Commissioner Robert L. Swisher at robert.swisher@ky.gov.  To view the announcements, go to https://labor.ky.gov/comp/Pages/default.aspx.

Louisiana VIEW STATE →

FEE SCHEDULE NEWS:

  • The Office of Workers’ Compensation issued an emergency rule to be effective April 3, 2020 to adopt rules and new temporary codes for telehealth/telemedicine methods.

REGULATORY ACTIVITY:

  • Emergency Rule 40, originally issued on March 26, 2020, is hereby amended to provide further clarification of the rating plans that all insurers are to utilize in pricing their products, to provide for changes caused by the federal Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), other matters related to the protections afforded to insureds, and how all insurers are to operate during Emergency Rule 40. The purpose of Emergency Rule 40 is to impose a moratorium on policy cancellations and non-renewals for policyholders in Louisiana during the outbreak of the coronavirus disease (COVID-19). Emergency Rule 40 is effective during the period of time from March 12 thru May 12. Cancellations for fraud and material misrepresentations or upon written request by the consumer continue to be permitted during this period. Insureds remain obligated to pay all premiums. Emergency Rule 40 does not apply to new policies issued after the effective date therein.
  • Adopted emergency rule 43. The purpose of Emergency Rule 43 is to provide the procedure to implement the protocol necessitated for the temporary licensing of adjuster applicants who have been negatively impacted by closure of insurance testing sites following issuance of Proclamation No. 33 JBE 2020, issued on March 22, 2020, by Governor John Bel Edwards declaring a stay at home order and closure of nonessential businesses until April 13, 2020 unless extended or terminated sooner, and Proclamation No. JBE 2020-41 issued on April 2, 2020, extending the stay at home order and closure of nonessential businesses until April 30, 2020 unless terminated sooner.
  • Has reissued Emergency Rules 36, 37, and 39 extending the effective date to May 12, 2020.
  • Posted notice of adoption of emergency rule regarding extension of renewal dates. Emergency  Rule  44  provides  for  the  extension  of renewal  dates  for  licenses  of  insurance  producers  and adjusters  held  by  individuals  who  have  been  negatively impacted  by  the  related  commercial  and  economic  impacts of  COVID-19,  in  accordance  with  Proclamation  No.  JBE 2020-33,  issued  on  March  22,  2020,  by  Governor  John  Bel Edwards  declaring  a  stay  at  home  order  and  closure  of nonessential  businesses  until  April  13,  2020  unless terminated sooner and Proclamation No. JBE 2020-41 issued on April 2, 2020, declaring a stay at home order and closure of nonessential businesses until April 30, 2020 unless terminated sooner.  To view this rule, go to https://www.ldi.la.gov/onlineservices/documentsearch/.
  • Adopted Regulation 114 - Claims Adjuster Pre-Licensing Education Program.
  • Adopted regulation Chapter 27 Utilization Review Procedures Section 2715 Medical Treatment Schedule Authorization and Dispute Resolution.  To view the notice of adoption and the adopted rule, go to https://www.doa.la.gov/Pages/osr/reg/regs2020.aspx.
  • Adopted regulation Subpart 2 Medical Guidelines Chapter 51 Medical Reimbursement Schedule regarding telemedicine.  To view the notice of adoption and adopted rule, go to https://www.doa.la.gov/Pages/osr/reg/regs2020.aspx.

Maine VIEW STATE →

REGULATORY ACTIVITY:

  • In response to concerns regarding COVID-19, the Board is working to strike an appropriate balance between conducting business and supporting social distancing. Please be aware that effective immediately:
    • Troubleshooting is being conducted only by phone.
    • Mediations are being conducted only by phone.
    • Hearings are being conducted only by phone or other form of remote technology for the month of April.

Prior to the end of April, the Board will make a determination with respect to hearings scheduled for May. With respect to other forms of remote technology, CourtCall is available.  The Board is continuing to look into other methods such as Zoom and Skype.  The Central, Regional and Advocate offices are closed to the public. Limited staff is available to receive mail, deliveries, and Board filings. If you have any questions, please check our COVID-19 FAQ or contact us. Finally, we encourage everyone to stay informed. You can access the Maine CDC website at: https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/coronavirus.shtml.

  • Issued bulletin 443 regarding coronavirus pandemic, property and casualty coverage. The Superintendent directs this bulletin to the attention of property casualty insurers, producers with property or casualty authority, surplus lines insurers, and surplus lines brokers. On March 12, 2020, Governor Mills declared a state of insurance emergency in Maine because of the coronavirus pandemic, known as COVID-19, and authorized the Superintendent “to make, amend, or rescind such rules and regulations governing the business of health insurance carriers as the Superintendent deems expedient in order to adopt and maintain sound methods of protecting the interests of such insurers, insureds, beneficiaries and the public” during the emergency.  That day, the Superintendent issued Bulletin 442, “Emergency Measures Responding to the Coronavirus Pandemic.”  Bulletin 442 pointed out that the pandemic will affect various types of insurance in addition to health coverage. To view the bulletin, go to https://www1.maine.gov/pfr/insurance/legal/bulletins/index_by_number.html.
  • Issued Bulletin 444 regarding coronavirus pandemic and property and casualty premium refunds.  To view the bulletin, go to https://www1.maine.gov/pfr/insurance/legal/bulletins/index_by_number.html.
  • Due to COVID-19 precautions, oral arguments for the May Appellate session have been cancelled. Cases will be decided on briefs.

Maryland VIEW STATE →

REGULATORY ACTIVITY:

  • Issued Bulletin 20-20 regarding Commercial Insurance/COVID-19.  To view the bulletin, go to https://insurance.maryland.gov/Pages/newscenter/PropertyCasualtyBulletins.aspx.
  • Due to the outbreak of COVID-19 and following Chief Judge Barbera’s lead, the Commission is extending the postponement of all in-person hearings through June 5, 2020.We are in the final stages of establishing the availability of video hearings which will utilize Microsoft Teams. Commissioner and staff training is underway and specific instructions on how to request such a hearing will be posted here next week. At least initially, while we adjust to this new process, these hearings will proceed only with the agreement of both/all parties. We understand the hardship that these postponements impose on the community and appreciate your continued patience as we follow the Governor’s executive orders and the guidance issued by the Centers for Disease Control.
  • Pursuant to the authority granted by COMAR 14.09.17, on 4/17/20, Chairman Aumann issued an Administrative Order regarding hearings. To view the order, go to http://www.wcc.state.md.us/.
  • Practitioners: Effective immediately, parties may begin the process of requesting, by agreement of the parties, a Video Remote Hearing (VRH). If your request is approved, the Commission will generate an Emergency Hearing approval notice and a VRH will be scheduled. Once scheduled, the Commission will send out email invites via Microsoft Teams to participants to join the hearing. If there are questions after reading the instructions, please email TCornish@wcc.state.md.us. To view this notice, go to https://www.wcc.state.md.us/Adjud_Claims/Notices_and_Announcements/April_2020_Notices.html.
  • Issued bulletin number 20-21 to all insurance carriers regarding COVID-19 Workers' Compensation Insurance.  To view the bulletin, go to https://insurance.maryland.gov/Pages/newscenter/PropertyCasualtyBulletins.aspx.

Massachusetts VIEW STATE →

FEE SCHEDULE NEWS:

REGULATORY ACTIVITY:

Medicare VIEW STATE →

FEE SCHEDULE NEWS:

  • Physicians - CMS has updated the list of approved telemedicine procedures and reposted the Physician Fee Schedule with an effective date of April 1, 2020.
  • Clinical Lab – CMS has reposted the Clinical Lab file effective April 1, 2020.
  • CCI and MUE Edits – CMS has reposted the CCI and MUE edits effective April 1, 2020.
  • ASP Drugs – CMS has reposted the ASP Drug file effective April 1, 2020.
  • DMEPOS – CMS has updated the DMEPOS as a result of the CARES Act. This update increases the non-rural rates for many codes and is effective retroactive to March 6, 2020.
  • ASC – CMS has reposted ASC Addendum BB effective April 1, 2020.
  • Outpatient Hospital – CMS has reposted OPPS Addendum B effective April 1, 2020.

Michigan VIEW STATE →

FEE SCHEDULE NEWS:

  • The Division of Workers’ Compensation has adopted new COVID-19 and Telemedicine regulations with an effective date of March 31, 2020. To view the memorandum, go to https://www.michigan.gov/documents/leo/COVID_General_Updates_688926_7.pdf.
  • A new revision to the Hospital fee schedule was published retroactive to August 8, 2019. There were no actual rates changed; only two facilities had tax ID revisions.

REGULATORY ACTIVITY:

  • The Workers’ Disability Compensation Agency has updated the WC-701 filing instructions to include the new COVID-19 injury code (083).  To view the filing instructions, go to https://www.michigan.gov/leo/0,5863,7-336-78421_95508_26917---,00.html
  • Reminder:  issued emergency rules related to COVID-19 and first response employees.  To view the emergency rule, go to https://www.michigan.gov/leo/0,5863,7-336-78421_95508---,00.html.
  • Pursuant to the Governor's extended Executive Order, the Workers' Disability Compensation Agency Board of Magistrates have rescheduled their hearings.
  • Pursuant to EO 2020-45, the Workers’ Disability Compensation Agency and the Workers’ Compensation Board of Magistrates are suspending in-person hearings until May 12, 2020.  The local agency where the case is pending should be contacted for all scheduling of redemptions, motions, and facilitations to be held telephonically.

Michigan Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued bulletin 2020-18-INS.  This bulletin applies to automobile insurers that plan to issue refunds or premium waivers to their customers as a result of the COVID-19 pandemic and advises them of the filing requirements for these plans. In light of the COVID-19 emergency, DIFS will expedite its review and urges insurers to submit the following information as soon as possible.

Minnesota VIEW STATE →

REGULATORY ACTIVITY:

  • A new Minnesota law expands workers' compensation eligibility for first responders and certain health care and childcare workers who contract COVID-19. The law, a summary of the law and FAQs have been posted on the Department of Labor and Industry'.  To view information regarding the legislation, go to http://www.dli.mn.gov/updates?utm_medium=email&utm_source=govdelivery.
  • The Minnesota Department of Labor and Industry has created a new email address for submission of certain workers' compensation forms, documents, medical records and other correspondence to facilitate compliance with Gov. Tim Walz’s Stay at Home executive orders. Submission via this email address is meant to help stakeholders continue to submit necessary filings and documents related to reportable workers' compensation claims while working from home offices and without ready access to their usual mail or fax submission methods. If you are able to mail or fax documents, continue to do so, to ensure this email inbox will be available for remote workers who do not currently have access to those methods. To view this notice, go to http://www.dli.mn.gov/business/workers-compensation-businesses.

Missouri VIEW STATE →

REGULATORY ACTIVITY:

  • Issued an updated notice of operations during the CONVID-19 Pandemic.  To view the notice, go to https://labor.mo.gov/DWC.
  • On April 7, 2020, the Department of Labor and Industrial Relations with its Division of Workers’ Compensation filed an emergency rule under the workers’ compensation statue to provide a presumption that first responders contracting COVID-19 were infected in the course of their employment. The Labor and Industrial Relations Commission voted unanimously to approve the emergency rule. On April 8, 2020, upon receipt of the signed approval of the Commission, the Department of Labor Director, Division of Workers’ Compensation Director and Department General Counsel signed a letter conveying the emergency rule to the Secretary of State and the Joint Commission on Administrative Rules. After ten business days from date of receipt by the Secretary of State and barring any substantive revisions, the emergency rule will be effective on April 22, 2020. The emergency rule allows for retroactive application of the presumption for instances which occurred prior to its effective date. 8 CSR 50-5.005 Presumption of Occupational Disease for First Responders.  To view this notice, go to https://labor.mo.gov/DWC.
  • Issued a notice regarding docket changes.  To view the memo, go to  https://labor.mo.gov/DWC .

Montana VIEW STATE →

REGULATORY ACTIVITY:

  • Posted notice of the proposed medical fee schedule to become effective July 1, 2020.  To view the proposed fee schedules, go to http://erd.dli.mt.gov/work-comp-claims/medical-regulations/montana-facility-fee-schedule.
  • Issued and informational bulletin on April 9, 2020.  The department has been communicating with numerous Property and Casualty insurance companies regarding industry-related impacts due to COVID-19.  Several companies have proposed a premium refund, discount or credit to their policyholders during this unforeseen dramatic downturn in the economy as a result of the COVID-19 virus. We commend these companies for helping consumers during a time of great financial need. The purpose of this Bulletin is to provide guidance regarding compliance with regulatory requirements with respect to issuance of refunds, discounts or credits. Insurance companies who desire to issue such refunds, discounts or credits must comply with the attached rate and form filing requirements.  To view this information, go to https://csimt.gov/laws-rules/advisory-memos/.

Nebraska VIEW STATE →

REGULATORY ACTIVITY:

  • The Nebraska Workers’ Compensation Court has issued an Order stating that all trials and evidentiary hearings scheduled in May 2020 will be conducted by video teleconference or by telephone. However, the parties to the trials and hearings scheduled for May 18 and after may file a motion requesting that these be held in person, either in Douglas or Lancaster County. To view the notice, go to https://www.wcc.ne.gov/home/court-news.
  • The Nebraska Supreme Court has issued a new administrative order regarding novel coronavirus and COVID-19 disease. During this time, please eFile with the Nebraska Workers’ Compensation Court as much as possible. Please contact us for assistance in setting up eFiling at 402-471-6468 or 800-599-5155 (toll free). The Clerk's Office is willing to provide training or other assistance to anyone who needs it.  To view this notice, go to https://www.wcc.ne.gov/home/court-news.

Nevada VIEW STATE →

REGULATORY ACTIVITY:

  • On April 1, 2020, Governor Sisolak issued Declaration of Emergency Directive 009 (Revised) concerning the renewal of governmental licenses and permits and the timelines and requirements for legal actions and proceedings during the current State of Emergency declared on March 12, 2020. In general terms, all licenses and permits issued by the Division of Industrial Relations that expire or are set to expire during the period of the Emergency Declaration are extended for a period of 90 days from the current expiration or 90 days after the state of emergency is terminated, whichever is later. Additionally, all specific time limits in legal proceedings will be extended from April 1, 2020 until 30 days from the date the state of emergency is terminated. For the Workers' Compensation Section of this Division, this Directive means that Professional Employer Organization (PEO) licenses expiring between April 1, 2020 and the termination of this state of emergency will be extended for a period of 90 days from the current expiration or until 90 days after the end of the emergency. For workers' compensation claims, the time limits set forth by statute or regulation for appeals in the Department of Administration, Hearings Division will be extended from April 1, 2020 until 30 days from the date the state of emergency is terminated. Please note this Directive does not, pursuant to NRS 414.110 (1), extend, delay or toll the delivery of services or payment of benefits to injured workers who are otherwise be entitled under NRS Chapters 616A-616D and NRS Chapter 617.  This document is intended solely as notice of the Governor's April 1, 2020 Directive 009 (Revised). It does not include every specific application of this Directive to all of the processes of this Division or all of its Sections. This Notice is not legal advice regarding any specific license, permit, or legal proceeding. Please consult an attorney to obtain a legal opinion regarding any specific issue or the effects, in any; this Directive has on any issue.

New Hampshire VIEW STATE →

REGULATORY ACTIVITY:

New Jersey WC VIEW STATE →

REGULATORY ACTIVITY:

  • In accordance with Governor Murphy’s Executive Orders to slow the spread of the virus, all N.J. workers’ compensation courts shall continue to be closed to the public and to non-essential court personnel until May 11, 2020. All Administrative Supervisory Judges and Supervising Judges shall continue to be designated by the N.J. Department of Labor and Workforce Development and the N.J. Division of Workers’ Compensation as essential personnel and shall hear as many Workers’ Compensation matters as possible in their home vicinage by telephonic conferencing, and if possible by video conferencing, including all emergent matters and the following non-emergent matters, pre-trial conferences, general motions for medical and temporary benefits, and settlements by affidavit.  To view the notice, go to https://www.nj.gov/labor/wc/wc_index.html.

New Mexico VIEW STATE →

REGULATORY ACTIVITY:

  • The New Mexico Workers' Compensation Administration (WCA) has completed changes to the IAIABC EDI Edit program and tables to accept the new Pandemic and COVID-19 codes for Cause and Nature. The changes are in production as of Wednesday, April 1, 2020. If you have technical questions, please contact the following MIS Bureau staff: Gary Chavez (GaryD.Chavez@state.nm.us) and Gayle Osburn (Gayle.Osburn@state.nm.us), who will continue to monitor the smooth running of the EDI system until May 31, 2020. After May 31, send all technical questions through the WCA Helpdesk email: WCA.Helpdesk@state.nm.us. If you have administrative questions, email WCA Helpdesk at: Helpdesk@state.nm.us.
  • In a further effort to assure the continuation of medical services to injured workers during this time of "social distancing" efforts to slow the spread of the novel coronavirus, WCA Director Loretta Lopez has issued a Director's Order regarding the use of telemedicine in workers' compensation medical cases. This order becomes effective immediately and will remain in place until the restrictions surrounding the virus are lifted, or until implementation of the 2021 Health Care Providers' Fee Schedule, whichever comes first.  To view this notice, go to https://workerscomp.nm.gov/Communications.
  • Effective April 17, 2020, and each Friday thereafter, jointly requested lump-sum settlements will be heard on Fridays. The hearings will be set telephonically at a designated time and will not be heard on a first-come, first-served basis. Our staff will work to get these matters resolved as quickly as possible. Our goal is to provide our constituents with essential services to the best of our capabilities. We anticipate there will be some modifications, and we will provide more information in the weeks to come.  To view this notice, go to https://workerscomp.nm.gov/Attorneys.
  • The New Mexico Workers' Compensation Administration (WCA), in keeping with the latest directives issued by Governor Michelle Lujan Grisham to further reduce community spread of the novel coronavirus (COVID-19), will continue to operate telephonically for mediations and hearings, and for much of the agency's daily operations through at least Friday, May 15, 2020.

New York VIEW STATE →

FEE SCHEDULE NEWS:

  • A new EAPG data set was released with an effective date of April 1, 2020. The next update is expected in July 2020.
  • The Workers’ Compensation Board has adopted new rules related to COVID-19 and telemedicine services with an effective date of March 16, 2020. To view the new rules, go to http://www.wcb.ny.gov/content/main/wclaws/Covid-19/3-16-20/text.pdf.

     

REGULATORY ACTIVITY:

  • The Chair has adopted on an emergency basis an amendment to clarify that employees may take family leave to care for a family member diagnosed with the COVID-19 virus. The amendment is to section 355.9 of Title 12 NYCRR. A Notice of Emergency Adoption was published in the April 15, 2020 edition of the State Register. This emergency rulemaking is effective for 90 days upon filing March 27, 2020. To view this notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1286.jsp.
  • In response to staffing and other changes put in place related to the COVID-19 pandemic, the Workers’ Compensation Board is updating some processes to ensure timely continuity of programs within the workers’ compensation system. Health care providers have been instructed to submit prior authorization requests for medical procedures to their insurance carrier’s designated email contact (if present) as posted on the Board’s website, rather than a fax number. Fax submissions may not be able to be reviewed in a timely manner because many insurer staff members are working remotely. Prior authorization requests for non-formulary medications should continue to be submitted through the medical portal. However, all insurance carriers, self-insured employers, and third-party administrators should forward their fax number to their designated email contact to ensure that these non-formulary prior authorization requests are received and acted upon accordingly. The Board will continue to issue Orders of the Chair for non-formulary prior authorization requests that are not responded to in a timely manner. These instructions pertain to the following forms:
    • Attending Doctor’s Request for Optional Prior Approval and Carrier's/Employer's Response (Form MG-1);
    • Attending Doctor's Request for Approval of Variance and Carrier's Response (Form MG-2);
    • Attending Doctor's Request for Authorization and Carrier's Response (Form C-4 AUTH).

The NY Workers’ Compensation Drug Formulary Prior Authorization process will continue to be used for prescriptions that require prior authorization. We also ask that your Medical Treatment Guidelines administrator verify your designated email contact and update it if necessary. Thank you for your cooperation. Please contact the Board at WCBMedicalDirectorsOffice@wcb.ny.gov if you have any questions.

  • Pursuant to Executive Order 202.13, and effective March 30, 2020, all Workers’ Compensation and Disability and Paid Family Leave benefits insurance carriers are directed to cease cancelling, non-renewing, or conditionally renewing any insurance policy issued to an individual or small business, or, in the case of a group insurance policy, insuring certificate holders that are individuals or small businesses, for a period of 60 days, for any policyholder, or in the case of a group insurance policy, group policyholder or certificate holder where such policy holder and or certificate holder is facing financial hardship as a result of the COVID-19 pandemic. For purposes of the Executive Order, a small business means any business that is resident in this State, is independently owned and operated, and employs one hundred or fewer individuals. Pursuant to Department of Financial Services (DFS) regulation, an employer may establish that it is facing financial hardship as a result of the COVID-19 pandemic by filing an attestation to that effect with its workers’ compensation and/or disability and paid family leave benefits insurance carrier. See 11 NYCRR 229.5(c). All Workers’ Compensation, Disability Benefits and Paid Family Leave carriers are now on notice of the Executive Order. Given the nature of the Executive Order, and the likelihood that there will be a significant number of voluntary cancellations by small businesses that have either been directed to temporarily close or temporarily have no employees due to the COVID-19 pandemic, the Board will not implement a system hard coding to prevent the submission of all coverage cancellation transactions filed by your organization for small businesses in New York (as defined above). Rather, the Board expects all carriers to comply with the Executive Order voluntarily and not file such transactions where the small business has filed the appropriate attestation of financial hardship with the carrier as indicated above.  However, as carriers have now been specifically placed on notice of this 60-day moratorium, in the event that a carrier files a prohibited coverage transaction, and the Board in turn undertakes activity vis a vis an affected small business, the Board will impose sanctions.  Specifically, the Board will consider such activity to have been necessitated by carrier action without reasonable grounds, warranting an assessment of costs against the carrier pursuant to WCL § 114-a (3) (i). Finally, to the extent that there are any pending transactions that would violate the Executive Order, carriers are directed to immediately file reinstatement transactions (or other transactions as circumstances warrant) to negate the pending cancellations.
  • Many insurance carriers, self-insured employers and third-party administrators are having their staff work from home during the Novel Coronavirus (COVID-19) health emergency. To accommodate this situation, the Board has changed its guidance on submitting medical bills and attached reports. For payers submitting these documents to the Board, we ask that you please follow these guidelines: If the medical bill is already in the case folder, the submitter should complete the form and note the Document ID for the medical bill. A copy should not be attached. If the medical bill is not already in the case folder, and the submitter cannot attach it to the Notice of Treatment Issue(s)/Disputed Bill Issue(s) (Form C-8.1B), then the medical bill can be submitted separately, if the medical bill is submitted on the same day as the Form C-8.1B.  A notation on the form of a same day medical bill submission is also acceptable proof. A photo or image of the medical bill is an acceptable submission in lieu of a scanned copy; however, our scanning vendor has advised us that photos taken on a mobile device produce large files that are not amenable to scanning. The vendor recommends downloading the Genius Scan app onto a mobile device for scanning medical bills. Genius Scan is a free download and produces image files that are smaller in size and can be downloaded for an Apple iOS or Android device. Forms should be submitted by email to wcbclaimsfiling@wcb.ny.gov. The medical bill should not also submitted by paper mail (this would create a duplicate in the case folder).
  • The Chairman of the Workers' Compensation Board issued a letter to workers' compensation insurers and payers regarding workplace occupational disease COVID-19.  To view the letter, go to http://www.wcb.ny.gov/content/main/TheBoard/Letter-from-Chair-Rodriguez-to-payers.jsp.
  • Over the past month, the New York State Workers’ Compensation Board (Board) has issued important guidance regarding process and other changes related to the novel coronavirus (COVID-19) outbreak. These actions have been taken to keep both the public and Board staff safe, and to address some of the challenges Board stakeholders may currently be facing. As the situation continues to evolve in the coming weeks, please watch the Board’s website for updates. You can also sign up to receive notifications right to your inbox or phone.  To view the summary, go to   http://www.wcb.ny.gov/ .
  • The Chair has adopted on an emergency basis amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 to expand the telemedicine options for social distancing purposes due to outbreak of COVID-19 and to supersede the previous emergency telemedicine adoption filed on March 16, 2020. A Notice of Emergency Adoption will be published in the May 6, 2020, edition of the State Register. The text of the Emergency Adoption has been published to the Board's website. This emergency rulemaking is effective for 90 days upon filing April 20, 2020. To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1292.jsp.

New York No-Fault VIEW STATE →

FEE SCHEDULE NEWS:

  • A new EAPG data set was released with an effective date of April 1, 2020. The next update is expected in July 2020.

REGULATORY ACTIVITY:

  • Amendments to rule 11 NYCRRR 60-2 (insurance regulation 35-D) regarding supplementary uninsured/underinsured motorist coverage.  The amendments became effective April 1, 2020.
  • Published notice of adoption of section 68.1 adoption of certain workers' compensation schedules.

North Carolina VIEW STATE →

REGULATORY ACTIVITY:

  • In response to feedback from stakeholders, the Industrial Commission is now accepting all agreements that have been signed by one or more parties via DocuSign or a similar vendor that provides a graphic image of a signature placed on a document using secure software that verifies the identity of the user.
  • In order to protect public health and safety by encouraging social distancing, and in light of Emergency Directive 5 contained in Chief Justice Beasley’s April 2, 2020 Order, the Industrial Commission has adopted the following policy, effective immediately and continuing until further notice: When it is required that any pleading, motion, petition, supporting affidavit, or other document of any kind to be filed at the Industrial Commission be verified, or that an oath be taken, it shall be sufficient if the subscriber affirms the truth of the matter to be verified by an affirmation or representation insubstantially the following language: “I(we) affirm, under the penalties for perjury, that the fore going representation(s) is(are) true. (Signed)_____________________.”
  • Consistent with Chief Justice Beasley’s April 2, 2020 Order, all mediations held in Industrial Commission cases prior to June 1, 2020 shall be conducted with all parties appearing remotely or, in the alternative, be rescheduled for a date on or after June 1, 2020. If all parties do not consent to appear remotely, then the mediation must be rescheduled for a date on or after June 1, 2020.
  • For the Commission to efficiently process forms and other filings while working remotely, it is essential that all filers comply with Rule 11NCAC 23A .0108 when filing forms and other documents. Represented parties and Insurance Carriers/TPAs/Self-Insured Employers are required to file forms and documents electronically via EDFP, with the following limited exceptions: 1.A Form 19 (in which case you are required to file the Form 19 via EDI, unless an exception listed in Paragraph (d) applies); 2.A form or document listed in Table 1 of 11 NCAC 23A .0108; or 3.A Notice of Appeal to the Court of Appeals. To view this notice and obtain additional information, go to http://www.ic.nc.gov/index.html.
  • Based upon stakeholder feedback and effective immediately, extended compensation claims pursuant to G.S. 97-29(c) will be ordered into mediation under the same procedures that are applicable to other claims upon the filing of a Form 33 Request for Hearing.  To view this notice, go to http://www.ic.nc.gov/index.html
  • Notice of Proposed Rulemaking- Proposed Amendments: 11 NCAC 23A .0108, .0109, and .0302; 11 NCAC 23B .0104 and .0105; 11 NCAC 23L .0101, .0102, .0103, and .0105. Please go to http://www.ic.nc.gov/efilingandotheramendments.html for the notice of proposed Industrial Commission Rulemaking published April 15, 2020 in the North Carolina Register (Volume 34, Issue 20). The Industrial Commission will accept written comments from April 15, 2020 through June 15, 2020. Written comments may be sent to Gina Cammarano, Rulemaking Coordinator, via e-mail at gina.cammarano@ic.nc.gov or via U.S. mail at 1240 Mail Service Center, Raleigh, NC 27699-1240. The Industrial Commission will hold a public hearing on the proposed rule amendments on May 6, 2020 at 2 p.m. Out of an abundance of caution and to address protective measures to help prevent the spread of COVID-19, the public hearing will be held via teleconference only instead of being held in person. The teleconference phone number is: 1-888-363-4735. The access code is: 4465746.
  • Technical Amendments to Rules 11 NCAC 23E .0101 (Instructions for Filing a Petition for Rule-Making) and 11 NCAC 23E .0102 (Mailing List), Effective April 1, 2020 Pursuant to N.C. Gen. Stat. § 150B-21.5(a) (4), Rules 11 NCAC 23E .0101 (Instructions for Filing a Petition for Rule-Making) and 11 NCAC 23E .0102 (Mailing List) have been amended. The reason for these amendments was to correct the Mail Service Center address stated in these rules. Go to http://www.ic.nc.gov/news.html#hot  for a copy of amended Rule 11 NCAC 23E .0101. Go to http://www.ic.nc.gov/news.html#hot  for a copy of amended Rule 11 NCAC 23E .0102.
  • Pursuant to N.C. Gen. Stat. § 150B-21.5(a), Rule 11 NCAC 23A .0619 (Foreign Language and Sign Language Interpreters) has been amended, effective April 1, 2020. The reason for this amendment is that the rule contained outdated information with regard to:
    • (1) the title of a publication of the Office of Administrative Courts;
    • (2) the section number of the Code contained in this publication of the Office of Administrative Courts; and
    • (3) the name of the Code contained in this publication of the Office of Administrative Courts.

Go to http://www.ic.nc.gov/news.html#hot for a copy of the amended Rule.

North Dakota VIEW STATE →

REGULATORY ACTIVITY:

Ohio VIEW STATE →

FEE SCHEDULE NEWS:

REGULATORY ACTIVITY:

Ohio-Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Issued Bulletin 2020-07. This bulletin pertains to all insurers (“Insurers”) providing property and casualty, life, and long-term care insurance policies (“policies”) in the State of Ohio. The purpose of this bulletin is to notify Insurers that they must provide their insureds with at least a 60-day grace period to pay insurance premiums or submit information.

Oregon VIEW STATE →

REGULATORY ACTIVITY:

  • Published revised Bulletin 315 regarding Spanish translations available for correspondence with injured workers.  To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
  • Published revised Bulletin 337 regarding worker request for claim classification review and related forms.  To view the bulletin, go to https://wcd.oregon.gov/forms/Pages/bulletins.aspx.
  • Kate Brown has appointed Andrew Stolfi as the DCBS director.  As director of DCBS, Stolfi will continue in his role as the state's insurance commissioner. He will also oversee the Building Codes Division, Division of Financial Regulation, the Oregon Health Insurance Marketplace, Oregon OSHA, the Ombudsman for Injured Workers, Small Business Ombudsman, Workers’ Compensation Division, Workers’ Compensation Board, as well as the Central Services Division.
  • Issued bulletin 2020-09 regarding rerating businesses that have changed operations in response to the COCID-19 pandemic and suspense of field audits. To view the bulletin, go to https://dfr.oregon.gov/laws-rules/Pages/bulletins.aspx.
  • Issued bulletin 2020-10 regarding payments to employees of business closed due to pandemic to be excluded from workers' compensation premium basis.  To view the bulletin, go to https://dfr.oregon.gov/laws-rules/Pages/bulletins.aspx.

Oregon-Auto VIEW STATE →

REGULATORY ACTIVITY:

  • Several auto insurance companies have been working with the Oregon Division of Financial Regulation to provide auto insurance premium refunds and credits to Oregonians. The refunds and credits are due to the reduced risk of auto accidents because of Gov. Kate Brown’s Stay Home, Save Lives executive order. The division encourages all carriers to consider providing refunds that reflect the reduced risk of auto liabilities due to the emergency order. This includes taking steps to reclassify vehicle usage, and properly adjusting any mileage-based policy metrics. Last week, the division provided guidance to insurance carriers for issuing the refunds to help process the filings and get money to consumers as quickly as possible. “Thank you to the insurance companies that have stepped up to provide these refunds to their customers,” said Andrew Stolfi, Oregon insurance commissioner. “Our division is proud to help insurance companies provide this much needed relief to Oregonians.”  In addition to the premium refunds, the division has asked all insurers to provide temporary private passenger auto insurance coverage for drivers delivering food, prescriptions, and other products for their employers. “The coronavirus has forced many businesses to rely on delivery services as a primary source of income. This has created an urgent need for insured delivery drivers,” said Stolfi. “Providing this coverage helps employers maintain essential income and keeps many of their employees working.” Consumers who have insurance or financial services questions related to COVID-19 can visit the division’s COVID-19 page. If you have questions about your auto insurance premium refund or about your insurance coverage, contact your insurance company. If you have issues with an insurance company or agent, contact the division’s advocacy team one of three ways: Visit: dfr.oregon.gov; Email: insurancehelp@oregon.gov; Call: 888-877-4894 (toll-free). Emailing documents to the DWC district offices where the filing party cannot e-file, JET file or file by U.S. mail. Documents that must be filed with DWC and which are subject to statutory time limits, such as petitions for reconsideration, removal, disqualification, applications for adjudication of claim, and petitions to reopen, may be filed via email directly to the district office having venue. Documents that are not subject to statutory time limits may not be filed via email. If such documents cannot be e-filed or JET filed, they must be filed via U.S. mail. The division will reject documents that are improperly filed via email. DWC reminds parties to only use this alternative filing option for these limited documents.
  • Issued Bulletin DFR 2020-11 regarding rate reductions and rebates to auto insurance policy holders. The Division of Financial Regulation has received questions from insurers about how to address changes in exposure due to COVID-19 emergency orders. Some of these questions include adding coverage for people using their vehicles differently and temporary rate reductions from decreased claim exposure. This document provides guidance for insurers on how to inform the division about proposed changes and required communications with policyholders.
  • Issued Bulletin DFR 2020-12 regarding Implementation of 60-day advance notice of specified prescription drug price increases as required by 2019 House Bill 2658. This Bulletin provides guidance on the form and manner of reports due from pharmaceutical manufacturers at least 60  days in advance of  specified increases in the price of prescription drugs, and clarifies the Department of Consumer and Business Services (department), Division of Financial Regulation's (division) approach to implementing the reporting program under HB 2658.
  • Issued bulletin 2020-08 regarding personal automobile policies.  To view the bulletin, go to https://dfr.oregon.gov/laws-rules/Pages/bulletins.aspx.

 

Pennsylvania WC VIEW STATE →

REGULATORY ACTIVITY:

Rhode Island VIEW STATE →

FEE SCHEDULE NEWS:

REGULATORY ACTIVITY:

  • Rhode Island General Law Section 28-33-17 (3) (i) establishes spendable base wage criteria for the purpose of determining weekly compensation. The Spendable Base Wage Information effective May 10, 2020 is now available on the web site at http://www.dlt.ri.gov/wc/infowages.htm.  You can view, print, and save an electronic copy. Please note – the documents hosted on the DLT website between April 7th and April 17th contained an error in the table-based lookup method for married persons (the formula-based calculation approach was unaffected). Please replace any previously obtained copy. For questions on how to use spendable earnings, please contact a Claims Analyst at (401) 462-8100, option #6 then #1 or WCClaimsAnalyst@DLT.ri.gov.
  • Rhode Island General Law Sections 28-33-17(f) (1), Weekly Compensation for Total Incapacity, 28-33-18.3(b) (1), Continuation of Benefits – Partial Incapacity and 28-37- 30, Cost of Living Increase, provide for annual benefit increases to certain classes of employees. By the statutes listed above, the increases to these employees shall be by an amount equal to the total percentage increase in the (CPI-W) Consumer Price Index, United States city average for urban wage earners and clerical workers as formulated and computed by the Bureau of Labor Statistics of the United States Department of Labor for the period of March 1 to February 28 each year. The Cost of Living Increase for 2020 will be 2.3%.  Effective May 10, 2020, weekly benefits paid to these employees should be increased 2.3%. By statute, increases shall be paid by insurers and employers without further order of the court. Late payment of the increase may result in the assessment of a 20% penalty on the unpaid amount. Questions may be addressed to a Workers’ Compensation Education Unit Representative at (401) 462-8100, option #1.
  • Under Rhode Island Executive Order 20-06 Expanding Access to Telemedicine Services and Rhode Island Insurance Bulletin 2020-5 Emergency Telemedicine Measures – Covid-19 the following telemedicine codes will be assigned temporary fee schedule reimbursement rates increasing rates for telephonic (CPT codes 99441-99443) and online digital (CPT codes 99421- 99423 and 98970-98972) evaluation/assessment, management services and Physical/Occupational Therapy to mirror payment rates for an equivalent office visit. When billing for these codes use modifier 95 or CR (catastrophe response) and place of service code 02 (telehealth). Providers should reflect the length of the interaction in their supporting documentation.

South Carolina VIEW STATE →

REGULATORY ACTIVITY:

Texas VIEW STATE →

FEE SCHEDULE NEWS:

  • A new dental fee schedule has been adopted retroactive to January 1, 2020. No update to Home Health rates has been released.  The next updates are expected in July 2020.

REGULATORY ACTIVITY:

  • Issued notice regarding COVID-19 Centers for Medicare and Medicaid Services guidance on telemedicine and telehealth. To view a copy of the notice, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.
  • Issued bulletin B-0019-20: On March 13, 2020, Governor Greg Abbott declared COVID-19 a statewide public health disaster. The Division of Workers’ Compensation (DWC) is working diligently to help system participants and protect the health and safety of the public in our response to COVID-19. Governor Abbott suspended Health and Safety Code Section 81.050(j) and 28 Texas Administrative Code Section 122.3(c) regarding 10-day testing requirements. As symptoms of COVID-19 exposure may take over 10 days to manifest, strict compliance with these laws could prevent, hinder, or delay state efforts to provide workers’ compensation coverage for emergency responders. This bulletin is in effect for the duration of the governor’s COVID-19 declaration, or until further notice from DWC. Please continue to follow the CDC’s recommendations, and refer to the DWC COVID-19 resource page for updates, FAQs, and contact information. Cassie Brown Commissioner of Workers’ Compensation
    Texas Department of Insurance, Division of Workers’ Compensation.
  • The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is adopting new 28 Texas Administrative Code §167.1 on an emergency basis. The rule relates to telemedicine and telehealth and will go into effect immediately for physical medicine and rehabilitation services provided on or after April 13, 2020.  The emergency adoption is necessary to ensure enhanced access to telemedicine and telehealth services in response to the COVID-19 disaster declaration.  This emergency rule builds on the existing telemedicine and telehealth rules by creating an exception to current CMS distant site practitioner requirements. This rule allows health care providers licensed to perform physical medicine and rehabilitation services, including physical therapists,  occupational therapists, and speech pathologists to bill and be reimbursed for services currently allowed under CMS telemedicine and telehealth billing codes. To view the notice, go to https://www.tdi.texas.gov/alert/whatsnew/index.html.  To view the rule, go to https://www.tdi.texas.gov/wc/rules/2020rules.html.
  • The Texas Department of Insurance (TDI) has issued bulletin 0020-20 to encourage insurers to work with commercial policyholders that have premiums based on payroll, sales, or a similar auditable exposure. TDI requests that insurers conduct midterm audits and accept self-reports of changes to adjust premiums as appropriate. To view the bulletin, go to  https://www.tdi.texas.gov/bulletins/2020/B-0020-20.html.
  • On March 13, 2020, Governor Greg Abbott declared COVID-19 a statewide public health disaster. The Division of Workers’ Compensation (DWC) is working diligently to help system participants and protect the health and safety of the public in our response to COVID-19. On March 27, 2020, Governor Abbott approved DWC’s request to suspend testing, training, and application requirements for DD and MMI/IR re-certification under 28 Texas Administrative Code (TAC) Sections 127.110(b)(1) and (3), 127.110(d), and 180.23. As a result, DWC will issue interim re-certifications to certified Texas-licensed DDs with no relevant practice restrictions, as described in 28 TAC Section 127.110(e)(3) and MMI/IR-only doctors certified to perform examinations under 28 TAC Section 180.23. DWC will issue the interim re-certifications to doctors whose prior certifications lapse March 27, 2020, through August 31, 2020. All interim re-certifications will expire December 31, 2020. As this issue evolves, DWC will continue to evaluate the need to issue interim re-certifications for doctors with DD and MMI/IR certifications lapsing after August 31, 2020. This bulletin is in effect for the duration of the governor’s COVID-19 declaration, or until further notice from DWC. Please continue to follow the CDC’s recommendations, and refer to the DWC COVID-19 resource page for updates, FAQs, and contact information. To view the complete bulletin, go to https://www.tdi.texas.gov/bulletins/2020/B-0023-20.html.
  • The National Council on Compensation Insurance (NCCI) filed Item U-1401- Nature and Cause of Injury Codes for COVID-19 (Coronavirus) Claims. The filing proposes that the changes in Item U-1401 apply to new and renewal policies effective for claims attributable to COVID-19 with accident dates on and after December 1, 2019. To view this filing, go to https://www.tdi.texas.gov/rules/2020/nccimanual.html.

Utah WC VIEW STATE →

REGULATORY ACTIVITY:

Vermont VIEW STATE →

REGULATORY ACTIVITY:

Washington VIEW STATE →

REGULATORY ACTIVITY:

  • New temporary policies
      • Activity Prescription Forms (APFs) may temporarily be performed using telehealth. A detailed policy will be published soon.
      • Independent Medical Exams (IME) may temporarily be performed using telehealth. A detailed policy will be published soon that also captures the process for IME record reviews.
      • The Temporary TeleBrainRehab payment policy is now available. An update allowing initial evaluations will be published soon.
  • Updates
  • Additional details about temporary policies
      • L&I will not provide the worker with or reimburse the worker for equipment. If a worker does not have access to high-speed internet with a computer or a camera phone with reliable connectivity, the provider must work with the worker to identify an alternative.
      • Use the Place of service 02 modifier when submitting bills when the worker’s home is the origination site for telehealth services.
        • Do not use the –GT modifier when billing for telehealth services.
        • Do not use HCPCS Code Q3014 if the worker’s home was the origination site for telehealth services.

Wyoming VIEW STATE →

REGULATORY ACTIVITY:



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