REGULATORY ACTIVITY:

• On May 21, 2019, the Board of Directors voted to adopt an assessment rate for insurers of 2.76% for Fiscal Year 2020 beginning on July 1, 2019.  Assessment letters for insurers and self-insured employers will be mailed shortly and payments are due by June 7, 2019. For questions contact Jan Adams (207) 287-7084 or see the Business Services/Annual Assessment section of this site located at https://www.maine.gov/wcb/Departments/businessservices/annualassessment.html.

FEE SCHEDULE NEWS:

• The state has adopted changes to the physician, outpatient and ASC facility fee schedule with an effective date of January 1, 2019. The next medical fee schedule update is expected in January 2020.

REGULATORY ACTIVITY:

• Published in the state register notice of adoption of Chapter 5 Medical Fees, Reimbursement Levels and Reporting requirements. The effective date of the adopted rule is January 1, 2019. To view the adopted rule, go to http://www.maine.gov/wcb/Departments/legaldivision/proposed.html.

REGULATORY ACTIVITY:

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

REGULATORY ACTIVITY:

• Maine published a product of discussions between the Board Staff and the insurance/Self-Insured Community.  To view the document, go to https://www.maine.gov/wcb/index.html.

FEE SCHEDULE NEWS:

• Maine has adopted a new Inpatient Fee schedule effective October 1, 2018. The next update is expected October 2019.

REGULATORY ACTIVITY:

• In accordance with 39-A M.R.S.A.  Section 209-A, the first part of the annual update has been completed. The IP Facility Fee Schedule/Appendix III has been updated for dates of discharge on or after 10-1-18. Questions or concerns regarding the annual update may be addressed to Barriere@maine.gov.  To view the notice, go to https://www.maine.gov/wcb/index.html.

FEE SCHEDULE NEWS:

• Maine has adopted new rules that become effective on September 1, 2018.  To view the rules, go to https://www.maine.gov/wcb/rules.html.

REGULATORY ACTIVITY:

• Posted notice in the state register that rules that were proposed in April of 2018 have been adopted and will become effective September 1, 2018. AGENCY: 90-351 - Workers’ Compensation Board; CHAPTER NUMBERS AND TITLES:
  1, Payment of Benefits; Ch. 2, Section 213 Compensation for Partial Incapacity; Ch. 3, Form Filing
  Ch. 4, Independent Medical Examiner; Ch. 5, Medical Fees; Reimbursement Levels; Reporting ; Requirements; Ch. 6, Rehabilitation; Ch. 7, Utilization Review, Treatment Guidelines, Permanent Impairment; Ch. 8, Procedures for Payment; Ch. 9, Procedures for Coordination of Benefits
  Ch. 12, Formal Hearings; Ch. 13, Rules of Appellate Division; Ch. 14, Review by Full Board
  Ch. 15, Penalties; Ch. 16, Confidentiality of Files; Ch. 18, Examinations by Impartial Physician(s) Pursuant to 39-A MRSA Section 611; ADOPTED RULE NUMBER: 2018-122 thru 136
  CONCISE SUMMARY: The changes define terms, prescribe forms and clarify procedures regarding the processing and payment of workers’ compensation claims. EFFECTIVE DATE: September 1, 2018.
  AGENCY CONTACT PERSON / RULEMAKING LIAISON: John C. Rohde, General Counsel, Workers’ Compensation Board, 27 State House Station, Augusta, ME 04333. Telephone: (207) 287-7086. Email: John.Rohde@Maine.gov .

REGULATORY ACTIVITY:

• On May 8, 2018, the Board of Directors voted to adopt an assessment rate for insurers of 2.77% for Fiscal Year 2019 beginning on July 1, 2018.  Assessment letters for insurers and self-insured employers will be mailed shortly and payments are due by June 8th. For questions contact Jan Adams (207) 287-7084. To find out more information regarding the assessment, go to http://www.maine.gov/wcb/Departments/businessservices/annualassessment.html.

REGULATORY ACTIVITY:

• The Workers’ Compensation Board has scheduled a public hearing on May 8, 2018 at 10:00 a.m. for proposed amendments to Rule Chapters 1-9, 12-16, and 18. The deadline for written comments is May 18, 2018 at 5:00 p.m. For more information, go to http://www.maine.gov/wcb/Departments/legaldivision/proposed.html.
• Published the following notice in the state register:

AGENCY: 90-350 - Workers’ Compensation Board (WCB)
CHAPTER NUMBER AND TITLE: Ch. 1-9, 12-16, 18
PROPOSED RULE NUMBERS: 2018-P050 thru P064
BRIEF SUMMARY: The proposed changes define terms, prescribe forms and clarify procedures regarding the processing and payment of workers’ compensation claims.
DETAILED SUMMARY: The following is a summary of the major changes:
Ch. 1 §1-A: Provide a means for employees to give notice of a claim in cases where the employer is out of business and the insurer is unknown.
Ch. 1 §5(1)(A)(3): Defines when 401(k) matching funds are considered fringe benefits.
Ch. 1 §5(2)(C): Allow a one-time adjustment, by filing a modification form, to an estimated average weekly wage.
Ch. 1 §11: Establishes process for meeting with the Maine Insurance Guaranty Association as required by 39-A MRS §153(9).
Ch. 2: Permanent impairment and benefit extension sections are simplified and the process for notifying employees of the right to request extensions of benefits pursuant to §213(1) is clarified.
Ch. 3 §1-A: Clarifies medical only First Reports of Injury must be sent to an employer’s insurance company.
Ch. 4: Clarifies eligibility to serve as an independent medical examiner and the procedure for requesting/paying for an independent medical examination.
Ch. 5: Procedures are clarified and new medical releases are proposed to ensure appropriate medical records can be received in a timely manner.
Ch. 6: Vocational rehabilitation rules have been rewritten to provide needed clarity.
Ch. 8 §11: Provides additional basis to reduce or discontinue benefits pursuant to 39-A MRS §205(9)(A).
Ch. 9: Requires use or benefit release form approved by Social Security Administration and permits employers/insurers to notify employees near the age of 62 of the obligation to inform employer/insurer of application for and receipt of old age Social Security benefits.
Ch. 12: Reorganized in a more logical manner. Also clarifies timeframe for requesting medical examinations prior to hearing and adds requirement that employees provide to employers reports generated by health care providers who attend examinations under 39-A MRS §207.
Ch. 13: Clarifies procedures before the Appellate Division.
PUBLIC HEARING: May 8, 2018, 10:00 a.m., Workers' Compensation Board, Central Office, 442 Civic Center Drive, Suite 100, Augusta, Maine
COMMENT DEADLINE: May 18, 2018
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS IMPACT INFORMATION / WCB RULEMAKING LIAISON: John C. Rohde; 27 State House Station, Augusta, ME 04333. Telephone: (207) 287-7096. Email: John.Rohde@Maine.gov .
FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES: N/A
STATUTORY AUTHORITY FOR THIS RULE: 39-A MRS §152(2)
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
WCB WEBSITE: www.maine.gov/wcb.

LEGISLATIVE ACTIONS:

Legislative Document 1030

The enacted legislation requires that a naturopathic doctor be entitled to the same benefits and right to treat as any other licensed physician providing services under the terms of coverage included in any insurance policy providing health benefits.  Effective Date January 1, 2019.