REGULATORY ACTIVITY:

• The Utah Labor Commission held an Open Meeting on December 13, 2018 (Thursday) at 9:00 am to discuss changes to rule R612-300 Medical Care in Workers Compensation claims. The purpose for this change was to adopt, with modifications, the Optum 2018 Essential Resource-=Based Relative Value Schedule (RBRVS), 2018 1st Quarter Update and to adjust the conversion factors regarding certain medical specialties.

REGULATORY ACTIVITY:

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

REGULATORY ACTIVITY:

• Published a notice of review and statement of continuation regarding rule R602-4 Procedures for termination of temporary total disability compensation pursuant to reemployment under section 34A-2-410.5. Subsection 34A-1-104(1) and Section 34A-1-304 authorize the Labor Commission (Commission) to adopt rules and conduct adjudicative proceedings relating to the administration of the Utah Workers' Compensation Act (Act).  Section 34A-2-41.5 of the Act provides a means for an employer or its insurance carrier to request the Commission's permission to reduce or terminate an injured worker's temporary total disability compensation.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish rules that govern the adjudication of such a request.  Also posted same for R602-5 regarding Procedures for Resolving Disputes Regarding "Cooperation" and "Diligent Pursuit" Under Subsection 34A-2- 413(6)(e)(iii) and Subsection 34A-2- 413(9) Consistent with Utah Administrative Code Subsection R612-200-7(D)(4). Subsection 34A-1-104(1) and Section    34A-1-304    authorize    the    Labor    Commission (Commission) to adopt rules and conduct adjudicative proceedings   relating   to   the administration of   the   Utah Workers' Compensation Act (Act).  Subsection 34A-2-413(6) (c)(iii) of the Act requires an administrative law judge to issue a decision on a claim for permanent total disability benefits based on an employer's failure to pursue a reemployment plan.  Subsection 34A-2-413(9) of the act requires an administrative law judge to dismiss a claim for permanent total disability benefits based on an employee's failure to cooperate with an approved reemployment plan.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish procedural requirements for hearings   related to an employer’s failure to pursue a reemployment plan or an employee's failure to cooperate with a reemployment plan.  Also posted for same was R602-6 regarding Subsection 34A-1-104(1) and Section    34A-1-304    authorize    the    Labor    Commission (Commission) to   adopt   rules   and   conduct   adjudicative proceedings   relating   to   the administration of   the   Utah Workers' Compensation Act.   Section 34A-2-420 of the Act requires   the   Commission   to   review   all   settlement   or commutation agreements for workers' compensation claims or occupational disease benefits.  It also grants the Commission the discretion to approve such agreements.  In order to administer an orderly adjudication system, it is necessary for the Commission to establish the procedural requirements for Commission approval of these agreements. To view the posting, go to https://rules.utah.gov/publications/utah-state-bull/.

FEE SCHEDULE NEWS:

• New ambulance rates have been updated with an effective date of July 1, 2018. The next expected update is October 2018.

REGULATORY ACTIVITY:

• Utah has proposed amendments to rule R612-100-4 Designation as Informal Proceedings. The purpose of this amendment is to designate a proceeding initiated under Section 34A-2-114 as an informal adjudicatory proceeding. This proposed rule change provides that proceedings initiated against employers who unlawfully interfere with an employee's workers' compensation claim will be designated as informal adjudicatory proceedings.  To view the rule, go to https://rules.utah.gov/publications/utah-state-bull/ and click on the Volume 2018 No. 9 Bulletin.

REGULATORY ACTIVITY:

• Posted notice of proposed rule. The purpose of this rule change is to correct a typographical error in the rule text. The anesthesiology conversion factors were approved by the Workers' Compensation Advisory Council at $62, and not $65 as stated in the current rule text. To view a copy of the notice and proposed rule, go to https://rules.utah.gov/publicat/bull_pdf/2018/b20180301.pdf.

LEGISLATIVE ACTIONS:

House Bill 127

This enacted legislation amends portions of the Controlled Substance Database Act. This legislation changes the requirements for checking the controlled substance database.  It delays enforcement of the requirements in this bill to check the controlled substance database. The legislation modifies the authority of the Division of Occupational and Professional Licensing to review the controlled substance database to identify any prescriber who may be overprescribing opioids.  The legislation grants the Division of Occupational and Professional Licensing the authority to provide education or training to certain prescribers and to take other enforcement action.  The legislation modifies enforcement provisions.  Effective Date July 8, 2018.

House Bill 288

This legislation enacts provisions related to claiming workers' compensation benefits.  It makes it unlawful for an employer to interfere with an employee's ability to seek workers' compensation benefits or retaliate against an employee for seeking workers' compensation benefits.  The legislation provides penalties for violating a provision of this bill. Effective Date July 8, 2018.

Senate Bill 14

The enacted legislation modifies provisions relating to the Industrial Accident Restricted Account.  The legislation eliminates language that provides for a repeal of provisions related to the Industrial Accident Restricted Account.  Effective Date July 8, 2018.

Senate Bill 40

This bill modifies provisions related to workers' compensation disability benefits.  It modifies the calculation of benefits paid to one or more dependents of an employee with a disability under the Workers' Compensation Act.  Effective Date July 1, 2018.

Senate Bill 64

This legislation amends provisions of the Workers' Compensation Act related to health care providers. The legislation modifies the membership of the workers' compensation advisory council.  It amends a required report to the Business and Labor Interim Committee.  The legislation authorizes the Labor Commission to use funds from the Industrial Accident Restricted Account for specific purposes.  The enacted legislation addresses the rate at which certain workers' compensation carriers and self-insured employers must reimburse a hospital for covered medical services. The legislation allows carriers or self-insurers to reimburse hospitals through a contract between the entities.  In lieu of a contract, payment shall be made to hospitals in a county of the first, second or third class at 75% of the billed hospital fees for the covered services provided. If the hospital is in a county of the fourth, fifth or sixth class at 85% of the billed hospital fees for the covered medical services.   Effective Date July 8, 2018.

Senate Bill 75

The enacted legislation modifies provisions of the Utah Labor Code.  The legislation defines certified mail as a method of mailing by any carrier that is accompanied by proof of delivery.  It modifies the mailing requirements under Title 34A, Utah Labor Code. The legislation provides the circumstances under which the Division of Industrial Accidents may waive or reduce a penalty against an employer for conducting business without securing workers' compensation benefits for the employer's employees. The waiver includes noncoverage was less than 180 days and no injury were reported to the division during the period of noncompliance.  Effective Date July 8, 2018.

Senate Bill 92

This bill modifies provisions of the Workers' Compensation Act related to attorney fees.  The enacted legislation provides that to the extent allowed by court rule, an employee may be awarded reasonable attorney fees in an adjudication of a workers' compensation claim where only medical benefits are at issue. Effective Date July 8, 2018.

REGULATORY ACTIVITY:

• It has come to our attention that there was a mistake in the recent filing of R612-300-4 with the Utah Office of Administrative Rules.-  Specifically, R612-300-4(C)(1), published as part of our yearly Medical Fee Standards update, incorrectly raises the allowable charge for one unit (15 minutes) of anesthesiology to $65.  The amount agreed upon by the Medical Committee and approved by the Workers’ Compensation Advisory Council is $62.  The correct rule has been re-filed with the Office of Administrative Rules and should be made effective shortly after the 30-day notice period.  Though the rule currently states otherwise, I would encourage providers to bill, and payors to pay, the $62 per unit for anesthesiology services as intended.

REGULATORY ACTIVITY:

• Proposed a new rule R982-800 regarding the Utah Data Research Center.  The purpose of this proposed rule is to set forth procedures governing the submission of data research requests to the Utah Data Research Center (Center), to establish criteria for how the Center will prioritize the data research requests it receives, and to set minimum standards for the information that must be included in a data research request.

REGULATORY ACTIVITY:

• Published a notice regarding review and statement of continuation regarding Subsection 34A-1-104(1)   and Section   34A-1-304   authorize   the   Utah   Labor   Commission (Commission) to   adopt   rules   and   conduct   adjudicative proceedings   relating   to   the   administration   of   the   Utah Workers' Compensation Act.  Section 34A-2-422 of the Utah Workers' Compensation Act specifically prohibits any transfer of   workers'   compensation   payment   rights   unless   the proposed transfer is first submitted to and approved by the Commission.    Therefore, in   order   to   administer   an   orderly system of adjudication, it is necessary for the Commission to establish   the   procedural   and   substantive   requirements   for Commission approval of any request for transfer of workers compensation payment rights.

FEE SCHEDULE NEWS:

• Ambulance rates have been updated as of July 10, 2017. The next expected update is scheduled for July 2018.

REGULATORY ACTIVITY:

• The Utah Labor Commission and the Utah Industrial Accident Division are sponsoring a Workers' Compensation Educational Conference. The full-day conference held on September 29th will feature current information topics, broadening your understanding and knowledge of workers' compensation, claim assistance, compliance enforcement, dispute mediation and hearings in the State of Utah. We’ll also celebrate 100 years of workers’ compensation and the Labor Commission in Utah.   To register go to https://www.eventbrite.com/e/utah-labor-commission-workers-compensation-educational-conference-tickets-34754104462