REGULATORY ACTIVITY:

• Tennessee has posted notice a hearing for a new rule set. The proposed new rule is 0800-02-27 Adjuster and Adjusting Entity Certification Program. The general purposes of this program are to assure that employees sustaining an injury arising out of and in the scope of employment are treated fairly and to assure that workers' compensation claims are handled in an appropriate and uniform manner.  This chapter and the rules within apply to all adjusting entities and adjusters subject to the provisions of the Tennessee workers' compensation Law who choose to participate in the adjusting entity certification program or adjuster certification program, respectively.  The projected effective date of the rule is May 31, 2018.  To view a copy of the notice and the rule, go to http://publications.tnsosfiles.com/rules_filings/03-01-18.pdf.
• Posted notice of proposed amendments to rule 0800-02-01 General Rules of the Workers' Compensation Program. This chapter shall apply to all employees, employers, adjusting entities, and providers of services related to workers' compensation claims subject to the Tennessee Workers' Compensation Law. To view a copy of the notice and rule, go to http://publications.tnsosfiles.com/rules_filings/03-02-18.pdf.

LEGISLATIVE ACTIONS:

House Bill 1651

The enacted legislation extends the Bureau of Workers’ Compensation for 6 additional years through June 30, 2024.  Effective Date March 16, 2018.

REGULATORY ACTIVITY:

• The Insurance Rate Service Organization designated for Bureau purposes that include the filing of insurance policy provisions and coverages and the determination of job classifications for applicable Bureau Rules is the National Council on Compensation Insurance (NCCI).
• Posted notice regarding Chapter Number 0800-02-21 Mediation and Hearing Procedures Rule Number 0800-02-21-08 The rule establishes the form that pursuant to TCA Section 50-6-244 the department will use for settlements approved by the court of workers' compensation claims involving injuries occurring on or after July 1, 2014.  A copy of the notice which includes the form can be viewed by going to http://publications.tnsosfiles.com/rules_filings/02-06-18.pdf.
• The new Form SD-2, the replacement form for the current Statistical Data Form SD-1, will go into effect May 6, 2018.  The change to the new form is reflected in recently adopted rule 800-02-21-.08 Mediation and Hearing Procedures -  Forms.  To view the adopted rule, go to http://publications.tnsosfiles.com/rules_filings/02-06-18.pdf. To view the new form, go to https://www.tn.gov/content/dam/tn/workforce/documents/injuries/SD-2%20Final.pdf.
• Posted notice of amendment to rule 800-02-20 Medical Impairment Rating Registry Program - Peer Review. Rule 0800-02-20-.12 Peer Review is amended by deleting the prior subsections (1) and (2) and replacing subsections (1) and (2) as follows: (1) All MIR Reports are subject to peer review for appropriateness and accuracy by a physician designated by the Administrator.  (2) The peer review shall be completed within ten (10) business days of referral from the Program Coordinator. The peer review physician may recommend an MIR Report for reconsideration by the examining MIR physician if the peer review physician deems the report to be incomplete, inaccurate, or unclear pursuant to the requirements of Rule 0800-02-20-.11. Reconsideration and any revision shall be completed by the examining MIR physician within ten (10) business days of referral from the Program Coordinator. Authority: T.C.A. §§ 4-5-202 and 50-6-204 (2005).  Administrative History: Public necessity rule filed June 15, 2005; effective through November 27, 2005. Public necessity rule filed November 16, 2005; effective through April 30, 2006. Original rule filed January 30, 2006; effective April 15, 2006. Repeal and new rule filed March 25, 2013; effective June 23, 2013.  This proposed rule is scheduled to become effective May 9, 2018.  To view the posted notice, go to http://publications.tnsosfiles.com/rules_filings/02-13-18.pdf.

FEE SCHEDULE NEWS:

• The Tennessee Labor and Workforce Development has made revisions to Rule 0800-02-17 Rules for Medical Payments, Rule 0800-02-18 Medical Fee Schedule and Rule 0800-02-19 Inpatient Hospital Fee Schedule that become effective on February 25, 2018.  Most notable is the adoption of the Medicare Home Health PPS for the reimbursement of home health services and updated inpatient hospital per diem rates.

REGULATORY ACTIVITY:

• Rule 0800-02-25, Workers' Compensation Medical Treatment Guidelines, became effective on February 5, 2018.  To view the proposed changes that will become effective on February go to http://publications.tnsosfiles.com/rules_filings/11-09-17.pdf.

REGULATORY ACTIVITY:

• The Bureau held a public rulemaking hearing on August 16 at 2:00 pm CDT. The hearing was held in the Tennessee Room of the Department of Labor and Workforce Development offices located at 220 French Landing Drive in Nashville. This hearing was open to the general public, where Workers' Compensation Appeals Board rules were addressed.
• The Bureau will conduct a hearing on September 28, beginning at 10:00 am CDT. The hearings will be held in the Tennessee Room of the Department of Labor and Workforce Development offices located at 220 French Landing Drive in Nashville. Proposed revisions to the current Drug Free Workplace Program rules will be addressed. This hearing is open to the general public.

REGULATORY ACTIVITY:

• Published its Annual Report to the Legislature.
• The Bureau will conduct three public rulemaking hearings on August 29, beginning at 1:00 pm CDT. The hearings will be held in the Tennessee Room of the Department of Labor and Workforce Development offices located at 220 French Landing Drive in Nashville. Proposed General, Claims Handling Standards, and Adjuster Certification rules will be addressed at the hearing along with recommended revisions required to comply with recent revisions to T. C. A. 50-6-419 and to implement a voluntary Adjuster Certification. These hearings are open to the public.

REGULATORY ACTIVITY:

• The Bureau of Workers' Compensation published a document summarizing legislative changes to the state's workers' compensation statutes.
• Rule-making Hearing on Proposed Electronic Medical Billing, "E-Billing": The Bureau will be conducting a public rulemaking hearing on August 8 at 10:00 am CDT. The hearing will be held in the Tennessee Room of the Department of Labor and Workforce Development offices located at 220 French Landing Drive in Nashville. Proposed rules would govern the processes by which carriers pay medical providers for treatment provided in workers' compensation claims.
• Filed notice of a hearing regarding the Workers' Compensation Appeals Board.  Hearing will be to consider amendments to the Appeals Board rule 0800-02-22.  The hearing will be held on August 16, 2017 at the Tennessee Room 220 French Landing Drive, 1-A Nashville, TN at 2:00p.m.

LEGISLATIVE ACTIONS:

• Senate Bill 297
  The enacted legislation requires that utilization review will be required for any invasive procedure.  The legislation also establishes that utilization review will not be required for diagnostic procedures ordered in accordance with the treatment guidelines by the authorized treating physician or chiropractor in the first 30 days after the date of injury or diagnostic studies recommended by the treating physician in the event the initial treatment regimen is nonsurgical, without diagnostic testing, and is not successful in returning the injured worker to employment. The legislation clarifies the requirement that the panel of independent reputable providers not be associated in practice by defining "not associated in practice together" to mean at least one physician, surgeon, chiropractor, or specialty practice group is not associated in practice with another physician, surgeon, chiropractor, or specialty practice group that is on the list or panel provided to an employee. In addition, the legislation increases employee's community of residence the area from which an employer must provide a panel of independent reputable providers from 100-mile radius to 125-mile radius.  The legislation increases burial expenses from $7,500 to $10,000.  Effective Date May 18, 2017.

• Senate Bill 1214
  This bill renames the "second injury fund" the "subsequent injury and vocational recovery fund". Under present law, a sole proprietor, a partner, or a member of a LLC who devotes full time to the proprietorship, partnership, or LLC, respectively, may elect to be a covered employee for workers' compensation purposes by filing written notice of the election with the bureau of workers' compensation at least 30 days before the occurrence of any injury or death, and may at any time withdraw the election by giving notice of the withdrawal to the bureau. This bill instead authorizes a sole proprietor and a partner to elect to be a covered employee for workers' compensation purposes by filing written notice of the election with the partnership or proprietorship. Such a partner or proprietor may at any time withdraw the election by giving notice of the withdrawal to the partnership or proprietorship. Present law authorizes corporate officers, other than corporate officers engaged in the construction industry, to elect exemption from the Workers' Compensation Law by providing notice of the election to the bureau and the officer's employer along with an affidavit affirming that the election was not advised, counseled, or encouraged by the employer. Under this bill, only the employer must be provided the notice and affidavit. Present law generally exempts non-construction services employers who have less than five regular employees from the Workers' Compensation Law. Any such exempt employer may opt into the law by filing a notice with the bureau. Under this bill, an employer with less than five regular employees who wants to opt into the law must purchase a workers' compensation insurance policy rather than provide notice to the bureau. This bill authorizes any employee who has exhausted eligibility for permanent partial disability benefits and, following a workers' compensation injury, has not returned to work with any employer or has returned to work and is receiving wages or a salary that is less than 100 percent of the wages or salary the employee received from the employee's pre-injury employer on the date of injury, to request vocational recovery assistance from the subsequent injury and vocational recovery fund. Vocational recovery assistance may include, but is not limited to, vocational assessment, employment training, job analysis, vocational testing, GED classes and testing, and education through a public Tennessee higher education institution, including books and materials required for courses. All vocational recovery assistance is subject to the maximum limit of $5,000 per eligible employee in a fiscal year. The administrator of the bureau will determine whether to grant requests for vocational recovery assistance. The full text of this bill sets financial parameters for use of the monies in the subsequent injury and vocational recovery fund for vocational recovery assistance. This bill also deletes the present law requirement that the administrator cause the bureau of workers' compensation to refer all feasible cases for vocational rehabilitation to the department of education. This bill specifies that oral argument may be heard for appeals to the workers' compensation appeals board. This bill also deletes from present law the authorization for the workers' compensation appeals board to reverse or modify and remand the decision of a workers' compensation judge when the rights of any party have been prejudiced because findings, inferences, conclusions, or decisions of a workers' compensation judge: Violate constitutional or statutory provisions; Exceed the statutory authority of the workers' compensation judge; Do not comply with lawful procedure;  Are arbitrary, capricious, characterized by abuse of discretion, or clearly an unwarranted exercise of discretion; or  Are not supported by evidence that is both substantial and material in the light of the entire record.  Present law generally requires that a statistical data form be filed with the bureau for workers' compensation claims that are resolved by trial or settlement. If the administrator determines that an insurer or self-insured employer fails to complete substantially and file the statistical data more than five times, the administrator may assess a monetary penalty up to $100 against the insurance company for the employer or against the employer, if self-insured. Under present law, a statistical data form is not required for reconsideration of a prior settlement or trial judgment order for which a statistical data form was filed at the time of submission of the prior order, or when the only issue resolved by an order is the closing of future medical benefits that remained open pursuant to a prior order for which a statistical data form was filed at the time of submission of the prior order. This bill requires that a statistical data form must be filed for a settlement for initial benefits, a settlement for increased benefits, and a settlement for closure of future medical benefits that remained open pursuant to a prior order, even if a statistical data form was filed at the time of submission of the prior order. This bill removes present law language that prohibits entry of a settlement or trial order in a workers' compensation claim if the statistical data form is not filed. This bill also authorizes the administrator to assess a civil penalty of $100 to $1,000 against an employer or employer's agent who fails to fully complete and timely file the statistical data form within 10 business days of the date of a compensation hearing order. This bill requires any employer of a construction services provider to, upon request by the bureau, provide proof of valid workers' compensation insurance coverage at the employer's place of business and at job sites where the employer is providing construction services. This bill authorizes the administrator to assess a penalty of $50.00 to $5,000 per violation for failure to provide proof of valid workers' compensation insurance coverage. Present law generally requires all construction services providers to carry workers' compensation insurance; provided, that a construction service provider who meets certain criteria may apply to the secretary of state for an exemption. This bill authorizes the administrator to assess a penalty of $50.00 to $5,000 per violation against any person or representative of an entity who knowingly enters or directs a party to enter false or unauthorized information on a construction services provider's application to the secretary of state.  Effective Date May 9, 2017.

REGULATORY ACTIVITY:

• Tennessee has posted notice to amend two rules:  Rule 0800-02-07 Case Management and 0800-02-13 Procedures for Penalty Assessments and Hearing Contested Cases.  The rules were posted on March 29, 2017 and will become effective June 27, 2017.
• Reminder the State has posted amendments to rules 0800-02-17 Rules for Medical Payment, 0800-02-18 Medical Fee Schedule, and 0800-02-19 Inpatient Hospital Fee Schedule. The state will hold a public hearing for these rules on June 8, 2017.

REGULATORY ACTIVITY:

• The Bureau of Workers’ Compensation announces the appointment of Deana Seymour as a trial judge on the Court of Workers’ Compensation Claims. Ms. Seymour will sit in Memphis after her swearing-in on April 5, 2017. One judge currently sits in Memphis: the Honorable Jim Umsted, who will retire the first week of April.
• Registration is now open for the 3rd Annual Physicians/Attorney Education Conference. Please join as The Guest House at Graceland in Memphis hosts us on June 10-11, 2017. Saturday's sessions will teach the proper application of the AMA Guides™ to Permanent Evaluation, 6th Edition. Sunday's session will cover medical and legal aspects of a workers' compensation claim, including how to determine medical causation.

REGULATORY ACTIVITY:

• The 20th Annual Tennessee Workers' Compensation Educational Conference will be held on June 13-15, 2017 at the Embassy Suites by Hilton Nashville SE Murfreesboro.