REGULATORY ACTIVITY:

• Issued bulletin 046-1108 as a reminder for clarification regarding form submission guidelines.  To improve customer service for all stakeholders and to reduce system costs, the Workers’ Compensation Board issued guidelines on submitting forms and other documents on Subject No. 046-909 dated January 4, 2017. The following are an addition to, or a re-emphasis of, those guidelines.
  • Avoid Duplicate Filing of Forms

The Board asks that you refrain from submitting forms more than once or in multiple formats. The quality of customer service diminishes when resources must be dedicated to sorting through duplicate forms to resolve an issue. Duplicate filings increase the amount of time required to respond to a customer request for further action or a status update on a pending request.

Duplicate submissions may be deemed to be raising or continuing an issue without reasonable grounds, will never result in higher fees being granted, and may subject the sender to penalties under Workers’ Compensation law § 114-a (3).

• Forms Applicable to Multiple Claims for the Same Claimant

Forms may reference more than one WCB Claim Number for the same claimant, but the submitter is required to submit a separate copy of the form for each claim (with the relevant WCB Claim Number listed first and/or underlined/circled) to ensure that a copy is placed in each case folder. Failure to submit a copy for each claim and properly identify the WCB Claim Number may result in duplicate filings to the same claim and therefore a penalty.

• If you experience technical difficulty with the electronic submission of forms, please contact the WCB Customer Support Unit by email at WCBCustomerSupport@wcb.ny.gov or by phone at (844) 337-6305. For assistance with forms submitted through the Web Upload Link, please email nywcb.helpdesk@conduent.com.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1106.jsp.
• Published bulletin subject number 046-1108 regarding public comment period for revised medical fee schedule.  The New York State Workers’ Compensation Board has prepared a revision to the proposed Medical Fee Schedule announced in Subject Number 046-1071, Board Announces Public Comment Period for Proposed Medical Fee Schedule on June 6, 2018. The changes have been made in response to comments and feedback from our stakeholders. The proposed revision was published in the State Register on October 3, 2018, and the Board will accept comments from the public for 30 days. Please note, these are proposed changes and have not yet been formally adopted. Therefore, the current fee schedule, adopted on June 1, 2012, continues to remain in effect. 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 November 1, 2018, 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 new schedule.  To view this bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1108.jsp.
• Pursuant to WCL §151, the Chair of the Workers' Compensation Board shall annually establish an assessment rate for all employers by November 1 of each year, to be effective January 1 of the subsequent calendar year. For calendar year 2019, the rate shall be 12.6% of the standard premium or premium equivalent. Please contact the Workers’ Compensation Board by email at: WCBFinanceOffice@wcb.ny.gov with any questions on the assessment rate.  To view the announcement, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1111.jsp.
• The Division of Workers’ Compensation (DWC) has posted the 2017 DWC Audit Unit annual report on its website. The Audit Unit annual report provides information on how claims administrators audited by the DWC performed and includes the Administrative Director’s ranking report for audits conducted in calendar year 2016.   The 2017 Audit Unit annual report details the results of audits conducted in 2016 and provides the name and location of each insurer, self-insured employer, and third-party administrator audited during that time. This report to the Legislature summarizes audits conducted in accordance with Labor Code sections 129 and 129.5 to assure that injured workers, and their dependents in the event of their death, are provided with all benefits due them in an expeditious manner. The audit findings, by law, must detail the number of files audited, the number and type of violations cited, and the amount of an undisputed compensation found due and unpaid to the injured worker. The audit findings presented in this report are statistical and do not identify any individual injured worker. The Labor Code provides that contents of the claim files and the Audit Unit working papers are confidential.  Performance of insurers, self-insured employers, and third-party administrators subject to profile audit review and full compliance audit is rated in accordance with the performance standards set annually by the Administrative Director. The DWC Administrative Director’s 2017 Audit Ranking Report lists, in ascending order by performance rating, the administrators audited in calendar year 2016.   The Audit Unit report can be found at https://www.dir.ca.gov/dwc/audit.html.
• Published Bulletin subject number 046-1112 regarding revised New York State Workers' Compensation Drug Formulary Regulations.  The New York State Workers' Compensation Board (Board) has prepared a revision to the proposed NYS Workers' Compensation Drug Formulary (Formulary) announced in Subject Number 046-1012, Board Announces Draft Regulations for New York State Pharmacy Formulary on December 28, 2017. The proposed revision is in the October 17, 2018 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 substantially expanded the list of drugs on the Formulary, clarified the criteria for when certain drugs are on the Formulary and more fully defined the prior authorization process for drugs that are not listed on the Formulary. 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 November 16, 2018, to regulations@wcb.ny.gov. The Board will evaluate all comments received and will consider necessary revisions as the process advances.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1112.jsp.  To view the associated documents, go to http://www.wcb.ny.gov/drug-formulary-regulation/.

REGULATORY ACTIVITY:

• Issued bulletin subject number 046-1099:  The provisions of the World Trade Center Registry legislation signed by Governor Andrew M. Cuomo on September 11, 2016, have been extended to September 11, 2022. The extension keeps the World Trade Center Registry open until September 11, 2022; extends the deadline period for filing the Registration of Participation in World Trade Center Rescue, Recovery and/or Clean-up Operations (Form WTC-12) to September 11, 2022; and directs the Board to reconsider claims previously disallowed under §§ 18 or 28 with dates of disablement between September 11, 2015 and September 11, 2017. To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1099.jsp.

FEE SCHEDULE NEWS:

• The State has adopted new changes to the DME fee schedule effective September 1, 2018.

REGULATORY ACTIVITY:

• Published Bulletin Subject No 187-1 regarding the 2019 Legal Holidays and Board Closures for 2019.  To view the notice, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn187_1_2019.jsp.
• Effective August 1, 2018, the New York State Workers’ Compensation Board is rescinding the designation of ICE Exams, Inc. as an entity registered to derive income from independent medical examinations in workers’ compensation cases. This rescission is made pursuant to Section 13-n of the Workers’ Compensation Law and 12 NYCRR §300.2(e)(6)(iv). Pursuant to 12 NYCRR § 300.2(e)(6)(ii)(a)(3), ICE Exams, Inc.’s name shall be removed from the list of registered entities effective August 1, 2018. This rescission is permanent. The entity’s address is: 1 Oakland Street; Mansfield, MA 02048. On the effective date of this rescission, the entity named above is permanently prohibited from deriving income from independent medical examinations in workers’ compensation cases. Examinations conducted prior to August 1, 2018 are valid. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.
• Effective August 1, 2018, the New York State Workers’ Compensation Board is rescinding the designation of Aimes Enterprises, Inc. as an entity registered to derive income from independent medical examinations in workers’ compensation cases. This rescission is made pursuant to Section 13-n of the Workers’ Compensation Law and 12 NYCRR §300.2(e)(6)(iv). Pursuant to 12 NYCRR § 300.2(e)(6)(ii)(a)(3), Aimes Enterprises, Inc.’s name shall be removed from the list of registered entities effective August 1, 2018. This rescission is permanent. The entity’s address is: 73-26 Yellowstone Blvd., Suite 26C Forest Hills, New York 11375. On the effective date of this rescission, the entity named above is permanently prohibited from deriving income from independent medical examinations in workers’ compensation cases. Examinations conducted prior to August 1, 2018 are valid. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.

LEGISLATIVE ACTIONS:

• Senate Bill 08929

The enacted legislation extends workers' compensation coverage to certain TNC drivers including a TNC driver that is logged onto a TNC digital network and is not engaged in a TNC prearranged trip but is engaged in an activity reasonably related to driving as a TNC drive.  Effective Date July 10, 2018.

FEE SCHEDULE NEWS:

• The State has adopted new Inpatient Fee Schedule rates for hospitals with effective dates of January 1, 2017, April 1, 2017 and January 1, 2018.
• A new EAPG data set was released with an effective date of July 1, 2018. The next update is expected in October 2018.

REGULATORY ACTIVITY:

• As announced on April 17, 2018, in Subject Number 046-1058 Proposals to Improve Medical Care for Injured Workers, the New York State Workers' Compensation Board (Board) will replace the current Board treatment forms: Doctor's Initial Report (Form C-4), Doctor's Progress Report (Form C-4.2), Occupational/Physical Therapist's Report (Form OT/PT-4), Psychologist's Report (Form PS-4), and Ancillary Medical Report (Form C-AMR) with the CMS-1500 to help reduce paperwork and lower provider administrative burdens. This initiative will leverage providers' current medical billing software and medical records while promoting a more efficient workers' compensation system. It is expected that the initiative will roll out in three phases, as follows:
  • Phase 1: Commencing January 1, 2019 providers may voluntarily transmit CMS-1500 medical bills (and required medical narratives, and/or attachments as applicable) through an approved XML Submission Partner ("clearinghouse") to workers' compensation insurers/payers. Guidance on required medical narratives and attachments is available on the Board's website. As previously conveyed in Subject Number 046-785, if a CMS-1500 is submitted without the detailed narrative report or office note, it is not a valid bill submission. A listing of approved clearinghouses for the CMS-1500 will be posted on the XML Forms Submission section of the Board's website after each entity successfully completes testing and executes an XML Submission Partner agreement with the Board. Workers' compensation insurers/payers will accept CMS-1500 medical billing files from clearinghouses and electronically return acknowledgments of receipt of CMS-1500 files. Such acknowledgements (including receipt date) will be forwarded from the clearinghouses back to providers and the Board. The Board will receive CMS-1500 files, narrative attachments and acknowledgements of receipt from clearinghouses in a designated XML format. The CMS-1500 forms and narrative attachments will be combined and displayed in the applicable claimants WCB case folders.
  • Phase 2: On or about July 1, 2019 workers' compensation insurers/payers will electronically transmit Explanations of Benefits (EOB) to their clearinghouses upon adjudication of the associated electronic CMS-1500 medical bills. Such EOB data will be forwarded from the clearinghouses back to providers and the Board. The Board will receive EOB data from clearinghouses in a designated XML format. The Board plans to eliminate the requirement for the insurer/payer to file Form C-8.1B or C-8.4 form (to object to full or partial payment of a medical bill) when an EOB for the medical bill was transmitted through the clearinghouse and the Provider may file Health Provider's Request for Decision on Unpaid Medical Billing (Form HP-1) (based on receipt of EOB).
  • Phase 3: On or about January 1, 2020 providers will be required to submit electronic CMS-1500 medical bills (and required medical narratives, as applicable) through their clearinghouses to workers' compensation insurers/payers and to receive EOBs back through their clearinghouse. Providers will be required to electronically transmit any disputes for unpaid medical bills to their clearinghouse using the Board-prescribed form. The clearinghouses will electronically transmit medical disputes to the Board in a designated XML format. The Board will eliminate Forms C-4, EC-4, C-4.2, EC-4.2, C-4.1, PS-4, C-4AMR, EC-4AMR, OT/PT-4, EOT/PT4 and EC-4NARR forms. Web submission and XML submission of these forms will no longer be available. The Board will establish a hardship exception process for providers who are unable to meet the mandatory electronic reporting requirements.
• Visit the CMS-1500 Initiative section of the website to access technical specifications for the CMS-1500 medical billing and associated acknowledgement data and to find periodic updates. Please direct questions to CMS1500@wcb.ny.gov.  A copy of the notice can have viewed at http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1079.jsp.
• Pursuant to New York Public Health Law § 2807-c (6-1), the workers' compensation fee schedule for inpatient hospital care tracks New York Medicaid rates, with limited statutory modifications. The New York State Department of Health (DOH) is required by statute to announce the workers' compensation inpatient rates. The DOH recently provided the Workers' Compensation Board (Board) with updated reimbursement rates for acute per case inpatient rates, exempt hospitals, exempt units and detoxification inpatient rates for the period of April 1, 2017 through December 31, 2017, and new reimbursement rates for January 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, are posted on the Board's website. Please see 2017 Medical Care Fee Schedules and 2018 Medical Care Fee Schedules.
• New York Bulletin Subject Number 046-1085 Form C-4AUTH Denials-Form C-8.1 Part A No Longer Required Date: July 25, 2018; The Attending Doctor's Request for Authorization and Carrier's Response (Form C-4AUTH) has been revised to remove the instruction that a Notice of Treatment Issue(s)/Disputed Bill Issue(s) (Form C-8.1 Part A) must be filed in cases where the insurer denies the request for authorization. Per a Memorandum of Decision (MOD) in the Matter of J&A Concrete Corporation, 2017 NY Work Comp G1078502 (filed 9/5/2017), Form C-8.1A is no longer required to be submitted with a Form C-4AUTH Denial. The matter held: The Board Panel finds that the carrier's denial of the request for the bone growth stimulator was a sufficient response and the failure to file a timely C-8.1A form was not ultimately dispositive under these circumstances. The C-4AUTH form was filed March 17, 2016 and the denial, along with its supporting medical opinion, was timely filed on March 29, 2016. The carrier's denial of authorization for special services must be effectuated by the timely filing of a Board-prescribed form, coupled with the timely filing of a supporting medical opinion. As the timely filing of a C-4AUTH denial, coupled with a supporting medical opinion, sets forth the carrier's objection to the special services and provides the basis for that objection, the filing of a C-8.1A form, which mirrors the C4-AUTH, is redundant and unnecessary. Therefore, the C4-AUTH denial was timely and properly filed herein. This revision is effective immediately. Please contact Claims@wcb.ny.gov if you have any questions.

REGULATORY ACTIVITY:

• Published bulletin Subject Number 046-1071 regarding comment period for proposed medical fee schedule. Date: June 6, 2018: As announced on April 17, 2018, in Subject Number 046-1058 Proposals to Improve Medical Care for Injured Workers, the New York State Workers' Compensation Board (Board) proposes to increase reimbursement fees paid to medical providers. The proposed changes to the Medical Fee Schedule have been published in the June 6, 2018, State Register, and the Board will accept comments from the public for 60 days. The proposal includes updated Current Procedural Technology (CPT) codes, increased conversion factors and amended Ground Rules, which are available under the Medical Fee Schedules section on the Board's website. Those who do not have access to CPT codes with descriptions can arrange to review them in person at Board offices by contacting regulations@wcb.ny.gov. 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 August 6, 2018, to regulations@wcb.ny.gov. The Board will evaluate all comments received and will consider necessary revisions as the process advances.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/subjectNos.jsp.  To view the proposed rule, go to https://docs.dos.ny.gov/info/register/2018/jun6/toc.html.

FEE SCHEDULE NEWS:

• The state has adopted revised fees for 2 codes in the DME fee schedule with an effective date of May 15, 2018.”

REGULATORY ACTIVITY:

• New York has posted notice in the May 2nd register of rule changes being proposed by the New York Workers' Compensation Board to correct typographical citation errors and a clarifying change.  The text of the proposed rule can be viewed at https://docs.dos.ny.gov/info/register/2018/may2/toc.html.
• The Board Review forms (Form RB-89 series) have been updated to accommodate appeals that arise from Paid Family Leave discrimination cases. The updated forms have a version date of 1-18. The Board will continue to accept the 9-16 versions of the forms until June 1, 2018. After that date, no prior versions will be accepted. The update applies to the following forms:
  • Application for Board Review (Form RB-89)
  • Rebuttal of Application for Board Review (Form RB-89.1)
  • Cover Sheet—Application for Reconsideration/Full Board Review (Form RB-89.2)
  • Cover Sheet—Rebuttal of Application for Reconsideration/Full Board Review (Form RB-89.3)
  • Note: This update supersedes the update to Forms RB-89 and RB-89.1 previously announced in Subject Number 046-878 Board Adopts New Administrative Review, Full Board Review, and Applications for Board Reconsideration Regulations dated September 29, 2016, which required the adoption of updated Forms RB-89 and RB-89.1 (version date 9-16) by December 1, 2016.
• Issued Bulletin Subject Number 046-1067 dated May 16, 2018.  The bulletin is in regards to updates to accommodate 2018 Permanent Impairment Guidelines for Scheduled Loss of Use Evaluations.  To view the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1067.jsp.
• The Board has received a number of inquiries associated with Subject Number 046-1067, specifically related to the timing of the implementation of forms associated with Schedule Loss of Use evaluations. We understand that the new forms may take some time to implement due to programming requirements. However, the guidelines are not new, and the associated requirements were released and effective 1/1/18. Until such time that users can get the new forms programmed into their systems, all required elements should be captured on the existing forms and/or included in the submitted narrative. As you are aware, new paper forms are available for use now and have been posted on the Board's website. The revised electronic C4.3 should be available by mid-July. We ask that all users totally transition to and utilize the new forms by mid-July. Until that time no forms will be precluded as long as all the required elements are either included on the forms and/or incorporated into the narrative. If you have any questions about the new forms, please write to 2018Guidelines@wcb.ny.gov.
• Posted notice in the state register on proposed amendments to the Workers' Compensation Board Legal Internship Program.   To view the proposed rule, go to  https://docs.dos.ny.gov/info/register/2018/may23/toc.html.

REGULATORY ACTIVITY:

• Published notice that the emergency rule regarding the option to self-insure the jockey fund has been permanently adopted. To view the notice, go to https://docs.dos.ny.gov/info/register/2018/april4/toc.html.
• Published Bulletin 046-1048 regarding revised medical authorization request forms. The following medical authorization forms have been revised to include a place for providers to include their National Provider Information (NPI) number. The forms also expand the certification area by adding a space for more than one fax number or email address. This will allow providers to indicate that the request for authorization was submitted to a second fax number or email address in addition to the designated fax number or email address found on the Board's website. Providers who search the Board's website but cannot locate the designated fax number or email address should check the box "designated contact information not available."  To view a copy of the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1048.jsp.
  • 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)

The Chair proposed the adoption of Part 441 of 12 NYCRR and amendment of Section 440.2 of 12 NYCRR to establish a drug formulary that includes high-quality and cost-effective pre-authorized medication. The Notice of Proposed Rule Making was published in the December 27, 2017, edition of the State Register. Comments on the proposed rule were accepted for 60 days after publication.  For more information regarding these proposed regulations, contact Heather M. MacMaster, Deputy General Counsel, Workers' Compensation Board, 328 State Street, Schenectady, New York 12305-2318, telephone: (518) 486-9564, e-mail: regulations@wcb.ny.gov.  To view a copy of the related documents, go to http://www.wcb.ny.gov/drug-formulary-regulation/.

• Issued bulletin subject number 046-1058 regarding proposals to improve medical care for injured workers. To increase provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is proposing an increase to provider fees and adoption of the universal CMS-1500 form to reduce administrative burden, among other measures. Access to quality medical care for injured workers is of utmost importance for a healthy workers' compensation system. When an injured worker has ready access to medical treatment, the worker heals and is restored to function more quickly and completely. This benefits not only the worker, but the employer as well. Today the Board announces a multipronged approach to address provider concerns around participating in the workers' compensation system and expand injured workers' access to medical care.
  • Proposal to Increase Medical Fees for All Medical Providers The Board's current medical fee schedule has remained relatively unchanged since 1996 and remains a significant obstacle to attracting new providers and retaining existing ones. Therefore, the Board will be advancing a regulatory proposal in June to raise provider fees; this will be effective for services provided on or after October 1, 2018. The proposal will include an overall statewide fee increase for all provider types, with additional increases for certain specialty provider groups that have an extreme shortage of authorized providers. These new fees will ensure providers in New York are receiving fair and reasonable reimbursement for prompt, quality treatment to our injured workers.
  • Proposal to Reduce Paperwork Providers have indicated that the unique paperwork requirements in the workers' compensation system result in significant additional administrative costs. Therefore, the Board will be consolidating and eliminating forms, including converting to the use of the CMS-1500 form. The CMS-1500 is the universal claim form used by medical providers to bill health insurers. Careful review and discussion with different stakeholders confirms that the CMS-1500 is easy to use and provides the necessary information. The Board proposes replacing the current Board treatment forms (C-4 and C-4.2, and equivalent OT/PT and PS forms) with the CMS-1500. As the CMS-1500 is already used by medical providers and insurance carriers to process claims, the Board anticipates an easy transition to the CMS-1500 and will be working towards a January 1, 2019, implementation date.
  • Other Enhancements to Improve Access to Quality Medical Care The Board is also committed to other improvements that will increase access to quality medical care and reduce administrative burdens. Medical Portal. The first phase of the Medical Portal, an important Business Process Re-engineering initiative, will be coming this year. This electronic medical portal will allow providers to quickly and easily identify whether their course of treatment is consistent with the Board's medical treatment guidelines and, if not, advise them that a variance is needed. The Medical Portal is an important step toward an easy-to-use, paperless system. Access to Different Medical Providers The Board is also exploring options that will increase access to medical care providers. This will afford injured workers access to expanded provider types and medical providers flexibility in the delivery of medical care. Governor Cuomo continues to support a comprehensive legislative solution that expands the types of providers that may treat injured workers. Currently only physicians, chiropractors, podiatrists, and psychologists can be authorized. The proposed legislation would amend the Workers' Compensation law to conform with the Education law by permitting medical providers who are licensed in New York State to become authorized, opening participation to nurse practitioners, physician's assistants, licensed clinical social workers, and other providers. In most instances, injured workers would be able to seek treatment for their workers' compensation illness and injuries with the same providers they use for non-work-related illness and injuries. The proposals announced today come in direct response to claimants' challenges in finding treating providers, and concerns from health care providers around low fees and complexity that keep some from participating. By addressing these concerns and bringing more providers into the workers' compensation system, injured workers can more readily access the care they need. To review the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1058.jsp.
• The maximum weekly benefit rate for workers’ compensation claimants is two-thirds of the New York State average weekly wage for the previous calendar year, as determined by the New York State Department of Labor (Workers’ Compensation Law §§ 2(16);15(6)). The Department of Labor reported to the Superintendent of the Department of Financial Services that the New York State average weekly wage for 2017 was $1,357.11. Accordingly, the maximum weekly benefit rate is $904.74 for compensable lost time for workers' compensation claims with dates of accident during the period from July 1, 2018 through June 30, 2019.

FEE SCHEDULE NEWS:

• The state has adopted a new DME fee schedule effective April 1, 2018.

REGULATORY ACTIVITY:

• Published the DME fee schedule that becomes effective April 1, 2018.  To view the schedule, go to https://www.emedny.org/ProviderManuals/DME/index.aspx.

REGULATORY ACTIVITY:

• The state issued Bulletin Subject Number 150-18.1 on February 14, regarding change in rate of reimbursement to injured workers for travel by automobile. The mileage rate for reimbursement to injured workers for travel by automobile on or after January 1, 2018, is 54.5 cents per mile.  In accordance with the Board resolution adopted on February 20, 1990, the mileage rate for reimbursement to injured workers for travel by automobile is the same rate that Management/Confidential state employees are reimbursed for travel by automobile. 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 the bulletin, go to http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp.
• Posted notice of emergency rule making regarding Option to Self-Insure for Jockey Fund.  This amendment adopted as an emergency measure because time is of the essence. On April 10, 2017, the New York Legislature adopted Chapter 59 of the Laws of 2017, which, among other things, significantly altered the New York Jockey Injury Compensation Fund, Inc. (hereinafter, Jockey Fund or Fund) (see Racing, Pari-Mutuel Wagering and Breeding Law section 221[6][b], as amended by L 2017, Ch. 59, part SS). Under Racing, Pari-Mutuel Wagering and Breeding Law section 221(6), the Jockey Fund is required to secure workers’ compensation coverage for the benefit of all jockeys, apprentice jockeys, and exercise persons licensed pursuant to Racing, Pari-Mutuel Wagering and Breeding Law articles two and four. Under the amended law, the Jockey Fund may now elect to secure workers’ compensation insurance coverage through a form of self-insurance (see id.). This amendment to the Jockey Fund took effect immediately (see L 2017, Ch. 59, part SS, section 12). Therefore, it is imperative that the Board adopt emergency regulations regarding the procedure the Jockey Fund must follow to self-insure before the Fund elects to become self-insured. To view the rule, go to https://docs.dos.ny.gov/info/register/2018/feb28/pdf/rulemaking.pdf.  The emergency rule will remain in effect through May 13, 2018.

LEGISLATIVE ACTIONS:

• Assembly Bill 1620
  • The purpose of this bill is to require that insurance carriers provide conditional renewal notices to workers' compensation policyholders when the premium will increase more than ten percent upon renewal with an affiliated insurance company that is under common control with the previous insurer.  This legislation amends the workers' compensation law by adding a subdivision 5b to section 54 of the workers compensation law. Effective Date April 30, 2018.

REGULATORY ACTIVITY:

• Posted proposed rule regarding an option to Self-Insure the Jockey Fund.