REGULATORY ACTIVITY:

• The Commission’s new Self-Insurer Web File system for reporting of the 2020 Annual Survey is entering its testing phase with a Beta Group of self-insured stakeholders. The testing phase will run from March 2019 thru October 2019. Web File users outside of the Beta Group are welcomed to continue viewing its reported data on record through Web File. Please refrain from initiating the Annual Survey or Change Request during the test period.  To view this notice, go to http://www.vwc.state.va.us/news/Self-Insurer-Special-Notice.  If you have any questions please email Selfinsurance@workcomp.virginia.gov.

LEGISLATIVE ACTIONS:

• House Bill 1804

The enacted legislation adds cancers of the colon, brain, or testes to the list of cancers that are presumed to be an occupational disease covered by the Virginia Workers' Compensation Act when firefighters and certain employees develop the cancer. The measure will become effective if reenacted by the 2020 Session of the General Assembly. The measure also directs the 2020 Session of the General Assembly, in considering and enacting any legislation relating to workers' compensation and the presumption of compensability for certain cancers, to consider any research, findings, and recommendations from the Joint Legislative Audit and Review Commission's review of the Virginia Workers' Compensation program. The provisions of this bill do not become effective unless reenacted by the 2020 Session of the General Assembly. Effective Date July 1, 2019.

• House Bill 2022

The enacted legislation provides that if an employer has received notice of an accident resulting in compensable injury to an employee and the employer has paid compensation or wages to such employee during incapacity for work resulting from such injury or the employer has failed to file the report of said accident with the Virginia Workers' Compensation Commission or otherwise has under a workers' compensation plan or insurance policy furnished or caused to be furnished medical service to such employee, the statute of limitations applicable to the filing of a claim shall be tolled until the last day for which such payment of compensation or wages or furnishment of medical services is provided and that occurs more than six months after the date of accident. The measure provides that no such payment of wages or workers' compensation benefits or furnishment of medical service occurring after the expiration of the statute of limitations applies to this provision. The measure also provides that (i) if the employer has failed to file a first report, the statute of limitations shall be tolled during the duration thereof until the employer filed the first report of accident and (ii) if more than one of the above tolling provisions applies, whichever of those causes the longer period of tolling shall apply.  Effective Date July 1, 2019. 

• Senate Bill 1729

The enacted statute prohibits a health care provider from submitting a claim to the Workers' Compensation Commission seeking additional payment for medical services rendered to a claimant before July 1, 2014, if the health care provider has previously accepted payment for the same medical services pursuant to the federal Longshore and Harbor Workers' Compensation Act. The measure prohibits the Commission from adjudicating any such claim.  Effective July 1, 2019.

REGULATORY ACTIVITY:

• Posted notice of medical fee schedule update regarding transition review timeline. To view the notice, go to  vwc.state.va.us/documents/medical-fee-schedule-transition-review-timeline.
• Published their final E-billing regulations.  To view the notice, go to http://www.vwc.state.va.us/news/Final-E-Billing-Regulation.  The regulation become effective on July 1, 2019.

REGULATORY ACTIVITY:

• Announced the release of a new claim form effective December 14, 2018. To view this announcement, go to http://www.vwc.state.va.us/news/New-Claim-Form.

REGULATORY ACTIVITY:

• On September 18, 2018, the Commission adopted a proposed final E-billing regulation and Companion Guide. After consideration of comments received during the public comment period, the initial proposed regulation has been revised to: (a) change the mandatory effective date from December 31, 2018 to July 1, 2019; (b) clarify and broaden the small provider exemption; (c) add an exemption for small payers; (d) clarify the requirements for electronic payment; and (e) make the regulation consistent with the provisions of the prompt-pay statute (Va. Code. 65.2-605.1). The Companion Guide has been revised to update the Commission’s address and contact numbers and to clarify the requirements for electronic payment.

REGULATORY ACTIVITY:

• Published the Virginia Workers' Compensation 2017 Annual Report.  To view the report, go to http://www.vwc.state.va.us/news/2017-VWC-Annual-Report.

REGULATORY ACTIVITY:

• Posted notice in the state register of intended regulatory action.  Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Pharmacy intends to consider amending 18VAC110-20, Regulations Governing the Practice of Pharmacy. The purpose of the proposed action is to regulate brown bagging of drugs requiring reconstitution or compounding prior to administration and to set specific requirements for specialty pharmacies participating in white bagging. The intent of the regulatory action is to ensure drugs are appropriately dispensed and administered. The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.  Statutory Authority: §§ 54.1-2400 and 54.1-3307 of the Code of Virginia. Public Comment Deadline: September 5, 2018. Agency Contact: Caroline Juran, RPh, Executive Director, Board of Pharmacy, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4456, FAX (804) 527-4472, or email caroline.juran@dhp.virginia.gov.  To view the notice, go to http://register.dls.virginia.gov/details.aspx?id=6991.
• Posted final regulation for the practice of pharmacy. The amendments (i) add eight compounds into Schedule I of the Drug Control Act as recommended by the Virginia Department of Forensic Science pursuant to § 54.1-3443 of the Code of Virginia, which will remain in effect for 18 months or until the compounds are placed in Schedule I by legislative action of the General Assembly; and (ii) add one drug to Schedule I, add one drug to Schedule II, and remove one drug from Schedule II to conform Virginia's Drug Control Act with federal law.  To view the final notice and regulation, go to http://register.dls.virginia.gov/details.aspx?id=7006.   The regulation becomes effective September 5. 2018.
• The regulatory advisory panel appointed by the Virginia Workers’ Compensation Commission has been charged with reviewing several issues related to workers’ compensation. One issue being reviewed and studied centers on attorney’s fees paid to claimant attorneys when they assist in obtaining payment for health care services in a case where the employer or insurance carrier has denied liability. These attorney’s fees are commonly referred to as “714” fees as that references the statute number that authorizes their payment under the workers’ compensation act. There are no current means to track the amount of 714 fees that are paid by providers. Often a claimant’s attorney will contact a provider and negotiate the amount of the fees. Some fee amounts are rumored to be as low as 15% of the provider’s bill recovered to as high as 40%. While the Workers’ Compensation Commission has authority to adjudicate disputes over 714 fees, rarely are they called upon to do so. The regulatory advisory panel asked the VHHA and MSV to survey providers to gather data on 714 fees, their frequency and amounts. DISCLAIMER: This survey was developed by the Medical Fee Schedule Regulatory Advisory Panel Members. The Virginia Workers’ Compensation Commission is placing this survey on its website as a courtesy to the Panel so that the public is aware of it.

REGULATORY ACTIVITY:

• Published a final regulation regarding the prescribing of opioids and buprenorphine.  The rule is not a specific workers' compensation rule but would apply to prescribing under any health care situation. The regulatory action adopts requirements for the prescribing of opioids and products containing buprenorphine as required by Chapters 291 and 682 of the 2017 Acts of Assembly. The regulations establish the practitioners to whom the regulations apply and the exceptions to or non-applicability of the regulations. Provisions for the management of acute pain include requirements for the evaluation of the patient, limitations on quantity and dosage, and medical record keeping. Provisions for the management of chronic pain include requirements for evaluation and treatment, including a treatment plan, informed consent and agreement, consultation with other providers, and medical record keeping. Provisions for the prescribing of buprenorphine include requirements for patient assessment and treatment planning, limitations on prescribing the buprenorphine mono-product (without naloxone), dosages, co-prescribing of other drugs, consultation, and medical records for opioid addiction treatment. Changes since the proposed regulation was published include (i) adding treatment for pain associated with sickle cell as an exception to the regulations, (ii) adding information regarding the nature of tramadol each time that drug is listed, and (iii) changing the requirement for drug testing following the first year of chronic pain management to be consistent with that of the Centers for Disease Control and Prevention. To view a copy of the rule as adopted, go to http://register.dls.virginia.gov/details.aspx?id=6950.
• Notice of Intended Regulatory Action was given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Nursing intends to consider amending 18VAC90-30, Regulations Governing the Licensure of Nurse Practitioners and 18VAC90-40, Regulations for Prescriptive Authority for Nurse Practitioners. The purpose of the proposed action is to eliminate the requirement for a separate license for a nurse practitioner to have prescriptive authority. 18VAC90-40, Regulations for Prescriptive Authority for Nurse Practitioners, likely will be repealed, and the necessary provisions will be incorporated into a new part in 18VAC90-30, Regulations Governing the Licensure of Nurse Practitioners. The goal is to reduce the financial and logistical burden on nurse practitioners, who currently must maintain a separate license to prescribe. The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register. Statutory Authority:§ 54.1-2400 and 54.1-2957.01 of the Code of Virginia. Public Comment Deadline: August 22, 2018.

Agency Contact: Jay P. Douglas, R.N., Executive Director, Board of Nursing, 9960 Maryland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4520, FAX (804) 527-4455, or email jay.douglas@dhp.virginia.gov.

REGULATORY ACTIVITY:

• Pursuant to Va. Code Sec. 65.2-605.1(H), the Commission has developed a proposed regulation to provide a legal framework for electronic billing, processing, and payment of medical services and products provided to an injured worker subject to the Virginia Workers' Compensation Act. The proposed regulation will expedite the submission, processing, and payment of bills for medical services rendered to injured workers pursuant to the Virginia Workers' Compensation Act utilizing nationally recognized standards. The proposed regulation is available in the June 11, 2018 edition of the Virginia Register of Regulations at http://register.dls.virginia.gov/details.aspx?id=6921. The Commission will accept public comment on the proposed regulation through August 10, 2018. Written comments may be sent by mail to James J. Szablewicz, Chief Deputy Commissioner, Virginia Workers' Compensation Commission, 333 East Franklin Street, Richmond, VA 23219, or by email to james.szablewicz@workcomp.virginia.gov. Additionally, the Commission will hold a public hearing on the proposed regulation at 1 p.m. on August 7, 2018, in the Commissioner’s Conference Room, 333 East Franklin Street, Richmond, VA 23219. To view a copy of the published documentation, go to http://register.dls.virginia.gov/.

REGULATORY ACTIVITY:

• Published its first Medical Fee Schedule eNews.  To view a copy of the newsletter, go to http://www.vwc.state.va.us/mfs-newsletters.

REGULATORY ACTIVITY:

• Published an updated Medical Fee Schedule Project Timeline.  To view the updated timeline, go to vwc.state.va.us/sites/default/files/documents/Medical-Fee-Schedule-Project-Timeline_0.pdf.
• Effective July 1, 2018 the maximum compensation rate will be $1,082.00, and the minimum compensation rate will be $270.50.  Effective October 1, 2018 the COLA rage will be 2.15%.