REGULATORY ACTIVITY:

• The New York State Workers’ Compensation Board is developing a web-based Medical Portal to submit medical information and access other Board information electronically. The Portal will be available in the upcoming weeks. To help medical providers learn more, the Board has created five-minute training video that explains how to access the Portal. For an overview of the Medical Portal, go to http://www.wcb.ny.gov/medicalportaloverview/.
• In preparation for the NYS Workers’ Compensation Board Drug Formulary Prior Authorization System, the Board has created a Drug Formulary Administration webpage providing detailed instructions and requirements for entering payer contact information for the system. On September 5, 2019, payers were able to start using the Formulary Administration application to enter their Level 1, Level 2, and Order of the Chair contacts for their organization. To enter Formulary contacts, each payer’s eClaims administrator must log into the online Formulary Administration application using their NY.gov ID and password. To view the Drug Formulary Administration website, go to http://www.wcb.ny.gov/content/ebiz/drugformulary/.

• The Chair has proposed amendments to 12 NYCRR §300.14 that clarify the process governing applications to reopen a claim. This proposal was published in the September 11, 2019, State Register. The proposal also includes minor clarifications to 12 NYCRR §300.13. The Board will be accepting comments from the public until November 12, 2019. The proposed changes are available on the Board’s website. See: Proposed Amendment of 12 NYCRR 300.13 and 300.14.  To view the rules, go to http://www.wcb.ny.gov/content/main/wclaws/Part-300_13_300_14/.
• The Workers’ Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers’ compensation system. The Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers’ compensation patients.  To view the training video, follow this link: CMS-1500 Training Video or go to https://www.youtube.com/watch?v=CHJwAvSJ_eM.

REGULATORY ACTIVITY:

• The New York State Workers’ Compensation Board proposes to adopt Medical Treatment Guidelines for: Hip/Groin Injuries; Foot/Ankle Injuries; Elbow Injuries; and Occupational Interstitial Lung Disease. These Guidelines will be added to the Board’s existing set of Medical Treatment Guidelines for the treatment of Mid and Low Back Injuries, Neck Injuries, Knee Injuries, Shoulder Injuries, Carpal Tunnel Syndrome and Non-Acute Pain. Consistent with previous Guidelines, these new Guidelines have been prepared in consultation with the Board’s Medical Advisory Committee. The proposed Medical Treatment Guidelines are available on the Board’s website. The proposed regulations to support the additional Medical Treatment Guidelines have been published in the State Register Link to External Website on July 31, 2019.The Board encourages the public, injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys, medical providers, and labor and business organizations to comment on these Guidelines. Please submit your comments on or before September 29, 2019, to regulations@wcb.ny.gov. To view the proposed guidelines, go to http://www.wcb.ny.gov/content/main/wclaws/MTG-Amendment-324-2/. To view this announcement, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1196.jsp.

• The Workers’ Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers’ compensation system. To help you prepare, the Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers’ compensation patients. The Board will also hold two follow-up Q&A webinars so that you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ on the Board’s website. To view the training video, follow this link: https://www.youtube.com/watch?v=CHJwAvSJ_eM

The webinars will be held on: September 17, 2019 8:30 a.m. - 9:30 a.m.   September 18, 2019 4:00 p.m. - 5:00 p.m. Please direct questions to CMS1500@wcb.ny.gov

• In support of the new Drug Formulary, the Board is developing an electronic Drug Formulary Prior Authorization System.  This system will be accessed on the Board’s website through the Medical Portal and will:
  • Allow providers to request prior authorization from payers (i.e., insurance carriers, third-party administrators (TPAs) and self-insured employers) for medications that deviate from the published Drug Formulary.
  • Provide a dashboard feature that will enable users to track and respond to submitted requests.
  • Include an administrative feature where user access, roles, and contact information can be maintained and updated.
  • Claim administrators may update on behalf of the payer.
• The Drug Formulary Prior Authorization System will have a web-based application for administrators.  This web application will be populated by the payer using each payer's existing eClaims Trading Partner information. When the application becomes available, each payer’s administrator will be notified. The administrator must then log into the application using their NY.gov ID and password to identify their organization’s contacts described below. What Should be Done Now? Identify Contacts: The Drug Formulary regulations were adopted on May 21, 2019, with an effective date of June 5, 2019.  As part of the regulations, payers must identify Level 1, Level 2, and Order of the Chair contacts for their organization, as well as an electronic mailbox for each. These contacts will be used for required review of requests for prior authorization.
  • Level 1 contact – May be claim administrator of insurance carrier or TPA, or Pharmacy Benefit Manager (PBM) if designated.
  • Level 2 contact – Must be the Medical Director of insurance carrier or TPA. Order of the Chair (OOC) contact – Insurer and Claim administrator of insurance carrier or TPA.

Effective September 1, 2019, payers (or their designee) will need to access the online Formulary administration application and enter the above described contacts. It will be the payer’s responsibility to update and maintain the accuracy of these contacts. The electronic mailboxes will be used by the Formulary Prior Authorization system to automatically route provider prior authorization requests to the payer-designated contact. If a payer designates a PBM as their Level 1 contact, the PBM must register and identify their users, using the online registration process that the Board is developing before a payer can select them as the Level I contact in the administration web application. The Level 2 contact will be used if the provider wishes to appeal a Level 1 denial or partial approval. The OOC contact will be used by the system to notify the payer and their designee that an OOC has been issued due to either non-response to provider-submitted prior authorization requests for a Level 1 or Level 2 request, or for a Level 3 (WCB Medical Director’s Office) approval of a Level 2 denial or partial approval. The electronic mailbox address will also be utilized to route requests to a user-specific dashboard.  Additionally, each payer must identify individuals within the organization to administer the workload and reviewers to respond to requests. If contacts are not identified, the payer may be subject to the following: Orders of the Chair approving prior authorization requests submitted when the name and contact information is missing, incomplete or incorrect. Penalties issued pursuant to Section 114-a of the Workers’ Compensation Law for every case where prior authorization was requested. For More Information See Subject Number 046-1157 that was issued on April 17, 2019. Updates about the system, the online Formulary Administration application and registration process will be posted on the Board’s website as it becomes available; please watch for more information.

• New York published bulletin 046-1198 regarding planning for drug formulary implementation. The Chair adopted a Drug Formulary on June 5, 2019. This Subject Number outlines important information regarding the implementation of the Drug Formulary and the transition of prescriptions to Drug Formulary medications. New Prescriptions: As of December 5, 2019, any newly prescribed drug must be for a Drug Formulary medication. As of that date, a medical provider must obtain prior authorization for any non-formulary drug prior to writing a new prescription. A new prescription means a prescription for a drug that the patient is not currently taking (different drug or different strength or frequency). Note: A newly written prescription for continuation/renewal of a medication (same drug, strength and frequency) that the patient is taking is considered a renewal prescription and must follow the process described below.
  • Refills and Renewals

Insurers, self-insured employers and third-party administrators must notify medical providers and injured workers by December 5, 2019, that a currently prescribed drug is not included on the Drug Formulary. These notifications must be in the format required by the Chair. On or after June 5, 2020, all refills or renewals of prescriptions must use a Drug Formulary medication unless prior authorization has been obtained before the date of the refill or renewal. A refill means any subsequent fill of a prescription when the number of refills is explicitly included in the original prescription. A renewal means a prescription that the injured worker has been taking but for which there are no available refills.

• Narcotics/Opioids

The Drug Formulary does not include narcotics/opioids after the first 30 days following an injury (except in the immediate pre- and post-operative period). It is important to understand that:

• On or after December 5, 2019, during the 30 days following an injury, narcotics/opioids may not exceed a single seven-day supply; and,
• Prior to June 5, 2020, medical providers and injured workers must plan for a transition to a Drug Formulary medication. If such a transition is not medically appropriate, the medical provider must obtain prior authorization for a refill or renewal of a non-formulary narcotic/opioid well in advance of June 5, 2020.

To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1198.jsp.

• Published information regarding the recently adopted statute that imposes an excise tax on opioids.  Article 20-D of the New York State Tax Law, enacted in April of 2019, imposes an excise tax on the first sale of every opioid unit in New York State. The tax imposed by the law is paid by the “registrant” (i.e., manufacturer, wholesaler, or outsourcing facility) making the first sale (Tax Law § 498[a]). The law explicitly excludes from the definition of sale the dispensing of opioids pursuant to a prescription to an ultimate consumer (Tax Law § 497[h]). In Workers’ Compensation cases, an injured worker who receives opioid prescription medications is the ultimate consumer. As such, an injured worker receiving opioids prescription medications is not responsible for the cost of the excise tax and the tax is not payable per the Medical Fee Schedule or Drug Formulary. Injured workers should not pay the opioids excise tax, and any workers who are told to do so should contact the Workers’ Compensation Board immediately. Additional information can be found at: https://health.ny.gov/professionals/narcotic/opioid_excise_tax.htm.  To view this notice, go to http://www.wcb.ny.gov/content/main/hcpp/hcpp.jsp#opioid-excise-tax.

FEE SCHEDULE NEWS:

• A new update to the EAPG data tables has been released with an effective date of July 1, 2019. The next update is expected October 1, 2019.

REGULATORY ACTIVITY:

• The New York State Workers’ Compensation Board has prepared proposed revisions to the medical fee schedules to incorporate the expanded list of medical providers that can be authorized to treat injured workers in the New York State workers' compensation system. The proposal was published in the State Register on July 3, 2019, and the Board will accept comments from the public for 60 days. Please note these are proposed changes and have not yet been formally adopted. Therefore, the current fee schedule that became effective April 1, 2019, continues to remain in effect. The Board encourages the public, injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys and licensed representatives, medical providers, and labor and business organizations to provide comment. Please submit your comments on or before September 3, 2019, to regulations@wcb.ny.gov. Following the public comment period, the Board will evaluate all comments received, and consider any necessary revisions. When final regulations are adopted, the Board will announce an effective date for the revised schedules. To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1184.jsp.
• To align with payers’ business practices, the Board has developed a process to enable insurance carriers, self-insured employers, and third-party administrators (TPAs) to provide an electronic signature on a Section 32 Waiver Agreement. A new form, Section 32 – Electronic Signature (Form C-32E), will be used by the payer to affirm that the electronic signature used on the Section 32 Waiver Agreement conforms to the requirements in Form C-32E and is binding for the Section 32 waiver agreement. The person who electronically signs Section 32 Waiver Agreements on behalf of the payer executes the Form C-32E on one occasion. The original signed version of Form C-32E should be maintained by the payer. When a payer is preparing to submit a Section 32 Waiver Agreement that has an electronic signature the payer should copy Form C-32E and complete the case information.  The complete Form C-32E must be submitted with the Section 32 Waiver Agreement that has an electronic signature. A Section 32 Waiver Agreement with an electronic signature that is submitted without Form C-32E attached will be returned. To learn more about the process and view the form, go to http://www.wcb.ny.gov/content/main/Workers/Section32_Workers.jsp to  Section 32 Waiver Agreements. Section 32 Waiver Agreements can be submitted to the Board by U.S. mail, fax, email, or web upload. U.S. mail: NYS Workers’ Compensation Board Centralized Mailing Address PO Box 5205 Binghamton, NY 13902-5205; Fax (877) 533-0337; Email wcbclaimsfiling@wcb.ny.gov.  If you have any questions about the electronic signature process, please contact Customer Service at (877) 632-4996. You may also email questions to claims@wcb.ny.gov.

FEE SCHEDULE NEWS:

• A new update to reimbursement rates for DMEPOS was released with an effective date of August 1, 2019.

REGULATORY ACTIVITY:

• Published Subject Number 046-1173 regarding updates to disability benefits claim forms.  The New York State Workers' Compensation Board (WCB) has made updates to forms that are used for disability benefits claims. Two disability benefits claim forms have been updated to streamline the process of reviewing a total or partial payer rejection of a disability benefits claim, while two other disability benefits forms have been made obsolete. In addition, the mailing address of the Board’s Disability Benefits Bureau has changed.  The forms that changed are Notice and Proof of Claim for Disability Benefits (Form DB-450 and Notice of Total or Partial Rejection of Claim for Disability Benefits (Form DB-451). The bulletin also noted two forms that are obsolete and no longer in use. The obsolete forms are Notice of Disability Benefits Payment (Form DB-455 and Tables of Permanent Contributions (Form DB-791.  To view this notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1173.jsp.
• Posted a notice of a proposed rule with no hearing scheduled.  The affected parties of the proposed rule are Group self-insured trusts that are inactive but not insolvent. The purpose of the rule is to provide assistance with inactive but not insolvent group self- insured trusts to purchase ALPs to wind down liabilities.  To view the rule as published, go to https://www.dos.ny.gov/info/register/2019.html and click on the May 29th edition of the state register. 
• The New York State Workers' Compensation Board Summer 2019 Conference; Coming to three locations across the State:
  • Albany - July 1, 2019
  • Rochester - July 31, 2019
  • New York City - August 5, 2019

All sessions will be from 1:00 pm to 4:30 pm. These half-day, afternoon programs are targeted to all who have a professional interest in the New York State workers' compensation system. Multiple CLEs and CMEs will be available!  For more information about the Board's regional conferences, write to Outreach@wcb.ny.gov.

• The Board has published Bulletin Subject No. 046-1175 regarding Emergency Room, Clinic and Psychiatric Hospital Fee Schedule Effective Date Changed. The Chair adopted regulations increasing fees for emergency room services, and creating fees for rural area outpatient clinics, hospital-based mental health clinics, and private psychiatric hospitals on May 1, 2019 (Amendment of Subpart 329-3 of 12 NYCRR (ER, Clinic, and Psychiatric Hospital Fee Schedule)).  Pursuant to the Order of the Chair Number 997, the amendments will be effective July 15, 2019.  To view the notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1175.jsp. For additional information,  go to  http://www.wcb.ny.gov/content/main/wclaws/Subpart_329_3ERandClinic/Subpart_329_3ERandClinic.jsp
• New York has posted notice of adoption of the published Drug Formulary.  The notice was filed with the Department of State and published on June 5, 2019 and became effective on June 6, 2019.  To view the notice, go to https://docs.dos.ny.gov/info/register/2019/jun5/toc.html. 

FEE SCHEDULE NEWS:

• A new update to reimbursement rates for Acute per Case Inpatient Hospital rates was released with a retroactive date of July 1, 2018.

REGULATORY ACTIVITY:

• Issued bulletin number 046-1163 regarding updated 2018 Reimbursement Rates for Acute per Case Inpatient Hospital Rates. The New York State Department of Health (DOH) recently provided the Workers' Compensation Board with updated reimbursement rates for acute per case inpatient rates for the period of July 1, 2018, through December 31, 2018. Rates of payments for these services are based upon rates determined for state governmental agencies (Medicaid) in accordance with Article 2807-c (6) (1). These rates, which also apply to treatment provided under the Comprehensive Motor Vehicle Reparations Act, Volunteer Firefighters' Benefit Law, and Volunteer Ambulance Workers' Benefit Law. Please see 2018 Medical Care Fee Schedules. To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/subjectNos.jsp.
• Published in the state register notice of adoption regarding fees for emergency room, rural area outpatient clinics, hospital based mental health clinics, and private psychiatric hospitals in the May 1st edition. To view the notice, go to https://docs.dos.ny.gov/info/register/2019/may1/toc.html.

FEE SCHEDULE NEWS:

• A new EAPG data set was released with an effective date of April 1, 2019. The next update is expected in July 2019.

REGULATORY ACTIVITY:

• New York provided a quick update to let you know that the CMS-1500 project is moving forward, and that the Workers’ Compensation Board will inform you when the implementation phase of the project will begin. The Board recently released an onboarding guide for XML Submission Partners (clearinghouses) to prepare for testing in late April 2019. Check here to see the status of XML Submission Partners with whom you currently partner. We also want to take this opportunity to clarify whether a payer can reject a medical bill/report received prior to the employer’s notice of the underlying injury. They cannot. Since the medical report must be filed within 48 hours of the first medical exam, the first medical report could be filed before the employer notifies the payer that there has been a workplace injury, and so before the payer submits the FROI. Please stay tuned for additional updates, and monitor the CMS-1500 section of the Board’s website for the latest information, including updates about phase one of the project, upcoming training and the most recent FAQs. If you have any questions, please email CMS1500@wcb.ny.gov.
• Published Bulletin Subject Number 046-1048 regarding revised medical request authorization forms. The revised forms include:  Attending Doctor's Request for Authorization and Carrier's Response (Form C-4AUTH), Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's Response (Form MG-1), Continuation to Form MG-1, Attending Doctor's Request for Optional Prior Approval (Form MG-1.1), Attending Doctor's Request for Approval of Variance and Carrier's Response (Form MG-2), and Continuation to Form MG-2, Attending Doctor's Request for Approval of Variance (Form MG-2.1). To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1048.jsp.
• The Rating Board will hold the 2019 New York State Workers’ Compensation Forum at Convene, 730 Third Avenue, New York, New York, on Thursday, September 12, 2019 (“Forum”).  The Forum will be immediately preceded by the 2019 Annual Meeting of the Rating Board membership. The Forum is an annual event hosted by the Rating Board to bring the New York State workers’ compensation community together and provide marketplace insight through the release and presentation of the 2019 State of the System Report and New York State focused research studies.  For a fuller understanding of the types of presentations made at the Forum, please visit http://www.nycirb.org/forums.php to view the 2018 Forum presentations and download the corresponding reports and studies.
• New York issued the following notice. Insurance carriers have the option of paying benefits on a workers’ compensation claim without liability if they are unsure of their liability for a claim. The provisions of Workers’ Compensation Law (WCL) Section 21-a enable an insurance carrier to take up to a year (365 days) to determine whether to accept or deny a claim, as long as the insurance carrier continues to make timely benefit payments on the claim and notifies the claimant and the Board that these payments are made without liability.  Avoid Losing 21-a Status; Insurance carriers may lose their status of without liability if they do any of the following: Provide Notice of Objection to Payment of a Bill for Treatment; Provided (Form C-8.1B) stating treatment provided was not causally related to the compensable injury, or stating that the claim is controverted when there is no controversy (FROI/SROI-04) present in the case; and Fail to continue payments consistent with the claimant's treating provider's medical reports, including reducing payments based on an Independent Medical Examination (IME). This information has been updated on the eClaims section of the Board's website in addition to the Insurers, Representatives and Self-Insured Employers sections. On January 18, 2019, the Board issued a Subject Number announcing changes to the eClaims process for Section 21-a and Claims Paid Without Liability.  Questions?  Contact Claims@wcb.ny.gov.
• The New York State Workers' Compensation Board (Board) has prepared a third revision to the proposed NYS Workers' Compensation Drug Formulary (Formulary) originally announced in Subject Number 046-1012, Board Announces Draft Regulations for New York State Pharmacy Formulary on December 28, 2017. The proposed revision was in the April 17, 2019, State Register, and the Board will accept comments for 30 days. The revised proposed regulations are also available on the Board's website. The Board encourages the public, injured workers, employers, self-insured employers, insurance carriers, third-party administrators, attorneys, medical providers, and labor and business organizations to provide comment. Please submit your comments on or before May 17, 2019, to regulations@wcb.ny.gov. The Board will evaluate all comments received and will consider necessary revisions as the process advances. To review the revised proposed regulation, go to http://www.wcb.ny.gov/drug-formulary-regulation/.
• The Chair of the New York State Workers' Compensation Board adopted a revised Pharmacy Fee Schedule on April 17, 2019. The amended Pharmacy Fee Schedule updates the methodology for calculating fees for pharmaceuticals and the reporting of rebates from pharmaceutical manufacturers to insurers and employers. The amended Pharmacy Fee Schedule will take effect for all prescriptions filled (both new and refills) on or after October 1, 2019. The adopted regulations providing the updated methodology is available on the Board's website. To view the revised pharmacy fee schedule, go to http://www.wcb.ny.gov/content/main/wclaws/PharmacyFeeSchedule/PharmacyFeeSchedule.jsp.

FEE SCHEDULE NEWS:

• The Workers’ Compensation Commission has adopted a new Medical Fee Schedule with an effective date of April 1, 2019.

REGULATORY ACTIVITY:

• The new Medical Fee Schedule (Pathology and Laboratory section, Ground Rule 12), updating the reimbursement for services to injured workers, takes effect April 1, 2019. An excerpt of the Non-Acute Pain Medical Treatment Guideline criteria is provided as a reference. This communication is intended to clarify that the Non-Acute Pain Medical Treatment Guidelines recommendations govern urine drug testing.  The new Medical Fee Schedule incorporates standards from the Board’s 2014 Non-Acute Pain Medical Treatment Guidelines and offers guidance as to the frequency of urine drug testing based on the level of risk for each patient. The updated rules do not contain the same level of detail, medical analysis and instructions as are contained in the Board’s Non-Acute Pain Medical Treatment Guidelines. Every medical provider should always use any applicable Medical Treatment Guideline when providing treatment and care to a workers’ compensation patient.  The Medical Fee Schedule states in every section that the Medical Treatment Guidelines set forth the standard of care and will prevail when there is a conflict between the two documents.   In Ground Rule 12, the Medical Fee Schedule identifies low/moderate/high risk test results and behavior and provides guidance as to how frequently urine drug testing may be performed in a medical provider’s office. The chart in the Ground Rule indicates that testing should be performed at different frequencies depending on a patient’s level of risk. The NAP-MTG on page 54 includes a similar chart. The chart in the NAP MTG sets forth that urine drug testing should be performed at least the annual allowable indicated for the applicable level of risk. The NAP MTG provide more detail and set forth the medical standards required for managing patients being treated for non-acute pain management.

As set forth on page 54 of the Non-Acute Pain Medical Treatment Guidelines, Risk Category (Score) and Random UDT Frequency:

• • Low Risk patients should be tested at least once per year
  • Moderate Risk patients should be tested at least twice per year
  • High Risk patients should be tested at least 3-4 times per year
  • Any patient demonstrating aberrant behavior should be tested at the time of visit.

• Issued bulletin Subject No. 150-18.1 regarding change in rate of reimbursement to injured workers for travel by automobile.   This bulletin supersedes the same bulletin issued February 14, 2018.The mileage rate for reimbursement to injured workers for travel by automobile on or after January 1, 2019, is 58 cents per mile, in accordance with the Board resolution adopted on February 20, 1990.  In those instances where injured workers are entitled to reimbursement for travel expenses, insurers will reimburse injured workers for travel in accordance with this rate.  To view this updated version of 150-18.1, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp. 

FEE SCHEDULE NEWS:

• A new EAPG data set was released with an effective date of January 1, 2019. The next update is expected in April 2019.

REGULATORY ACTIVITY:

• The Workers' Compensation Board posted notice of two rule adoptions: Fees for Medical Testimony and Medical Fee Schedules.  To view the notice of adoption, go to https://docs.dos.ny.gov/info/register/2018/december26/toc.html.
• Published bulletin 046-1136 titled Changes to eClaims Process for Section 21-a and Claims Paid Without Liability.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1136.jsp.
• Issued a press release regarding addition of a new, free tool for state-of-the-art virtual hearings. New York State Workers' Compensation Board Chair Clarissa M. Rodriguez today announced the Board has launched a new tool that makes it even easier for injured workers, attorneys and other participants to attend workers' compensation hearings remotely. The Board's virtual hearings, a first-in-the-nation initiative, give injured workers a way to move the claim process forward without having to travel many miles for a hearing that may last only minutes, which is especially beneficial depending on the extent of their injuries. The Board is now offering an app that may further improve the user experience for those attending virtual hearings. The WCB VHC app is free in the iOS App Store and does not require users to install any additional software on their mobile device. It employs a simple interface that guides the user from sign on, to the virtual waiting room, and finally to the video hearing once a Judge calls the case. "The feedback we've received about virtual hearings has been overwhelmingly positive, and now we're making it even better with an easy-to-use app," Board Chair Rodriquez said. "This will help injured workers not just here in New York, but in other parts of the country as well, by removing the burden of travel, which can be treacherous this time of year." In addition to added convenience for injured workers, the new app may be particularly helpful for attorneys and licensed representatives who attend hearings regularly because it saves sign-on profile information, allowing users to log in faster. Users can also remove a hearing from their schedule if information was entered incorrectly or if they are no longer appearing for a case. Parties using the app can still use other apps or features on their mobile devices while waiting for their hearing to be called. A notification will automatically alert them when it's time to join a hearing, even if they're in another app or their screen is off. The New York State Workers' Compensation Board developed virtual hearings in partnership with the Office of Information Technology Services to give all parties involved the option of using a smart phone, tablet or computer to attend hearings. This is the first high definition, all access system for legal hearings in the nation, where multiple users in different locations log in once and then move from one hearing to another. Virtual hearings are entirely optional though, and parties can always choose to attend in-person if they prefer.  "The app release is just one more example of how the Board is committed to growing and improving the workers' compensation system," Board Chair Rodriguez said. "With virtual hearings, this new app and other recent initiatives, we're also demonstrating that we're a 'new and improved' Board – one that's better for workers and better for business." Virtual hearings were first tested in the Capital District Office in Menands in November 2017 and are now available at all Board locations except Newburgh and Allegany. More information on virtual hearings and the new virtual hearings app, including instructional videos and other training materials, is at wcb.ny.gov/virtual-hearings. To access the app in the iOS App Store, visit bit.ly/VHCApp.  To view the press release, go to http://www.wcb.ny.gov/content/main/PressRe/virtual-hearings-app-press-release.jsp.

REGULATORY ACTIVITY:

• Issued Bulletin Subject No. 046-1119 regarding appeals, inventory and forms. The Board announces that the number of undecided workers’ compensation appeals continues to decline. As of November 1, 2018, there were only 3,927 applications for administrative review waiting to be decided, and 92% were decided in less than six months. The prompt processing of appeals aids both workers and employers by quickly making benefits and treatments available and lowering litigation costs. The Board continues to strive to resolve all appeals in less than six months. When parties properly complete the Application for Board Review or Application for Reconsideration/Full Board Review, it aids the responding party in identifying the exact issues, grounds and evidence used in support of the application and crafting a timely and effective rebuttal. A complete application or rebuttal also aids the Board in timely and effectively reviewing the application or rebuttal so the appeal is resolved quickly. To aid parties in properly completing applications and rebuttals, and to eliminate any possible confusion, the Board has revised the Application for Board Review (Form RB-89), Rebuttal of Application for Board Review (Form RB-89.1), Application for Reconsideration/Full Board Review (Form RB-89.2), and Rebuttal of Application for Reconsideration/Full Board Review (Form RB-89.3) to add clarifying information to the instructions.
• Item 15 of Form RB-89 and Item 16 of Form RB-89.1 have been clarified to state that the date when the objection or exception was interposed must be listed. 12 NYCRR 300.13(b)(2)(ii)
• Forms RB-89.2 and RB-89.3 have been revised to clarify that the forms are not coversheets but the actual Application for Reconsideration/Full Board Review and Rebuttal of Application for Reconsideration/Full Board Review.
• Finally, to provide additional support to all parties, the Board has prepared a Guidance Document on the Proper Application of Board Rule 300.13. The document sets forth the existing rules and the correct completion of Items 11 through 15 on Form RB-89, and Items 13 through 15 on Form RB-89.2. A companion document titled, Supplement: Decisional Examples, provides examples, item by item, as to how these rules are applied. The Board will continue to accept the prior version of the form (01-18) until February 1, 2019. After that date, any prior version of the application form shall not be considered to be in the format prescribed by the Chair and will be subject to denial of review. To view a copy of the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1119.jsp.
• Issued bulletin subject number 046-1121 on December 3, 3018 regarding updated independent medical examiner list. IMEs were notified that they were required to register with the Board by November 30, 2018, to maintain their authorization. They were advised that failure to register by this deadline would be deemed a refusal to provide information concerning authorization per Workers’ Compensation law section 13-d(2)(f), and that their authorization to perform independent medical examinations in the New York State workers’ compensation system would be rescinded on a contingent basis until they complete their registration. Independent medical examination reports or testimony from IMEs who failed to register by November 30, 2018, will be valid for examinations performed on or before November 30, 2018, but will be invalid for examinations performed after November 30, 2018. To reinstate their authorization to perform independent medical examinations, unregistered IMEs must register with the Board. A list of unregistered IMEs is available on the Board’s website. To find an authorized, registered health care provider or IME, use the Health Care Provider and IME Search on the Board’s website. For questions regarding the IME registration process, please contact the Medical Director’s Office at (800) 781-2362, option 6.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1121.jsp.
• Issued bulletin subject number 046-1123 regarding the eCase document upload feature. The Board has added a document upload feature to its eCase application that will enable users to upload documents directly to the electronic case folder to use as evidence at scheduled hearings. Purpose: The eCase document upload feature enables the parties in a hearing and the Workers' Compensation Law Judge to see vital evidence that will be used at hearings. The document upload feature is not a means to submit or process claim documents. The uploaded documents are for the purposes of the hearing only and will not be otherwise processed by the Board. Any documents uploaded that are not eligible to be uploaded or which are mislabeled, will not be processed by claims examiners before or after the hearing. The claims examiner will not be able to assist with mislabeled or improperly uploaded documents. Intended Users: The intended users of the eCase document upload feature are attorneys (both claimant and insurance carriers), insurers, third party administrators, self-insured employers, and claimants. IME entities and employers do not have access to the document upload functionality.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1123.jsp.

REGULATORY ACTIVITY:

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