REGULATORY ACTIVITY:

• Pursuant to Section 31-280b, Chairman John A. Mastropietro has appointed Commissioners Scott A. Barton and Jodi M. Gregg to sit as panel members on appeals before the Compensation Review Board for the calendar year beginning January 1, 2018.

FEE SCHEDULE NEWS:

• The new Official Connecticut Practitioner Fee Schedule has been adopted with an effective date of July 15, 2020.  “This new schedule will include revisions and clarification of some rules, and the new 2020 CPT codes. This new publication will be effective for medical services rendered on or after July 15, 2020, regardless of the date of injury, that are payable to health care providers authorized or permitted to render care under the Connecticut Workers’ Compensation Act.” The next update is expected July 15, 2021.

REGULATORY ACTIVITY:

• In order to comply with the social distancing measures made necessary to combat the spread of COVID-19 and the existing measures taken by the Workers’ Compensation Commission to dramatically reduce the need for in person hearings, the Compensation Review Board is now offering the following alternatives for the scheduled June 26, 2020 CRB docket.
  • Parties may file a motion to postpone oral argument. As always, we ask the parties to communicate if they are in agreement as to the postponement. Requests to postpone will be generally favored.
  • As always, parties may choose to waive oral argument and proceed on the basis of the papers submitted in the prosecution or defense of the scheduled appeal. It will be up to each party to individually decide if this is how they wish to proceed. Stated another way, if one side wishes to waive oral argument, the other side may choose to participate in oral argument. Thus, the legal argument of the party waiving oral argument will be considered on the basis of the papers submitted, and the oral argument of the other party will go forward as stated below.
  • Oral argument will be conducted via telephonic conferencing. We will be utilizing procedures that are similar to those used for district office hearings. In order to facilitate the process please email to Jackie Sellars at the Compensation Review Board the telephone number at which you may be reached for the telephone conference. Her email address is Jackie.Sellars@ct.gov. Any questions related to a hearing scheduled to be heard in a District Office should be directed to the District Office.  We envision that parties who participate in oral argument should anticipate a conference call at some point during the time period their appeal is slotted to be heard. E.G., if you are scheduled for a 9:00 AM hearing be prepared to participate in a conference call starting at sometime between 9:00 AM and 10:30 AM. We know that these are challenging times for all of us. We also know that our ability to accommodate your needs will be dependent on both our levels of staffing and consequently, may be subject to change. We appreciate your patience and understanding.  To view this notice, go to https://wcc.state.ct.us/.
• The Commission's 6th District Office in New Britain is scheduled to move to a new address, beginning at the end of this week; office telephone and fax numbers will remain the same. New Britain's new address and contact information—effective June 29, 2020—are as follows: Workers' Compensation Commission, Sixth District Office, 24 Washington Street, New Britain, CT 06051; Phone: (860) 827-7180; Fax: (860) 827-7913. All WCC offices continue to be closed to the public. Hearings are being done telephonically.

REGULATORY ACTIVITY:

• The Workers' Compensation Commission is encouraging the use of telemedicine in response to the COVID-19 pandemic. Providers have been instructed to bill telemedicine visits with the appropriate CMS or CPT identified telemedicine code, utilizing modifier 95 together with place of service 02. Carriers have been advised to reimburse these visits at the fee schedule rate with no reduction (excluding contractual discounts).  Until further notice, the Workers' Compensation Commission is instructing that workers' compensation claims billed with place of service 02 shall be reimbursed at the non-facility rate.
• In order to comply with the social distancing measures made necessary to combat the spread of COVID-19 and the existing measures taken by the Workers’ Compensation Commission to dramatically reduce the need for in person hearings, the Compensation Review Board is now offering the following alternatives for the scheduled May 22, 2020 CRB docket. 1. Parties may file a motion to postpone oral argument. As always, we ask the parties to communicate if they are in agreement as to the postponement. Requests to postpone will be generally favored.  2. As always, parties may choose to waive oral argument and proceed on the basis of the papers submitted in the prosecution or defense of the scheduled appeal. It will be up to each party to individually decide if this is how they wish to proceed. Stated another way, if one side wishes to waive oral argument, the other side may choose to participate in oral argument. Thus, the legal argument of the party waiving oral argument will be considered on the basis of the papers submitted, and the oral argument of the other party will go forward as stated below.  3. Oral argument will be conducted via telephonic conferencing. We anticipate utilizing procedures that are similar to those used for district office hearings. In order to facilitate the process please email to Jackie Sellars at the Compensation Review Board the telephone number at which you may be reached for the telephone conference. Her email address is Sellars@ct.gov.  We envision that parties who participate in oral argument should anticipate a conference call at some point during the time period their appeal is slotted to be heard. E.G., if you are scheduled for a 9:00 AM hearing be prepared to participate in a conference call starting at sometime between 9:00 AM and 10:30 AM. We know that these are challenging times for all of us. We also know that our ability to accommodate your needs will be dependent on both our levels of staffing and consequently, may be subject to change. We appreciate your patience and understanding.

FEE SCHEDULE NEWS:

• The Connecticut Workers’ Compensation Commission issues an addendum to 2019 Official Connecticut Practitioner Fee Schedule, which addresses telehealth/telemedicine during the COVID-19 crisis. Published by Optum, the addendum assigns fees to new codes for telemedicine services provided by physical therapists and occupational therapists and gives instruction on the proper codes to use for billing of telemedicine services provided by a physician. There will be no reduction in reimbursement for telemedicine services. They are to be reimbursed at the same fee schedule amount as listed for non-telemedicine services. Information in this addendum will be valid for dates of service beginning March 1, 2020 and continuing through the publication of the 2020 fee schedule on July 15, 2020. The addendum may be obtained from Optum at https://www.optum360coding.com/support/product-updates#2019 under "Product Support." To view this notice, go to  https://wcc.state.ct.us/memos/2020/2020-10.htm.

REGULATORY ACTIVITY:

• Issued Memorandum Number 2020-09 on April 1, 2020 a policy regarding the use of telemedicine.  To view the memorandum, go to https://wcc.state.ct.us/.
• WCC update regarding the reimbursement of telemedicine services: Posted Thursday, April 23, 2020. The Workers' Compensation Commission is encouraging the use of telemedicine in response to the COVID-19 pandemic. Providers have been instructed to bill telemedicine visits with the appropriate CMS or CPT identified telemedicine code, utilizing modifier 95 together with place of service 02. Carriers have been advised to reimburse these visits at the fee schedule rate with no reduction (excluding contractual discounts). Until further notice, the Workers' Compensation Commission is instructing that workers' compensation claims billed with place of service 02 shall be reimbursed at the non-facility rate.
• Issued Bulletin FS-37. The Connecticut Insurance Department (CID) recognizes the severity of COVID-19 and in order to comply with the social distancing policies, many of its employees are working remotely to the greatest extent possible while still accomplishing the essential functions of their jobs. However, the social distancing restrictions and the limitations of personnel in the office will disrupt certain scheduled practices, including the processing and issuance of license renewals for insurance companies, health care centers and fraternal benefit societies as the current procedure requires the presence of numerous personnel in the office to manually process, print, and physically mail out each of the licenses. Connecticut Governor Ned Lamont, in recognition that it may be necessary to extend statutory and regulatory administrative deadlines in order to properly respond to the COVID-19 pandemic, has issued Executive Order No. 7M, dated March 25, 2020, to permit department heads, including the Insurance Commissioner, to extend statutory, regulatory, or other time limitations by up to 90 days.  Therefore, in light of the current COVID-19 situation, the Insurance Commissioner finds that it is in the public interest and consistent with efforts to slow the spread of the virus and minimize serious illness or death for the CID to extend the renewal date for licenses issued to insurance companies, health care centers and fraternal benefit societies as described herein.  To view this bulletin, go to https://portal.ct.gov/CID/Bulletins/Current-List-of-Bulletins.

FEE SCHEDULE NEWS:

• The Connecticut Workers’ Compensation Commission has adopted the 2020 Official Fee Schedule for Hospitals and Ambulatory Surgical Centers effective for medical services rendered on or after April 1, 2020. The next update is expected in April 2021.

REGULATORY ACTIVITY:

• The Workers’ Compensation Commission has received numerous inquiries recently regarding contingency plans during the coronavirus outbreak. The Commission is an agency of the executive branch and as such, until directed otherwise, will continue to operate normally and hearings will go on as scheduled. If any party to a claim or member of the public has a concern about appearing for a hearing, filing documents, or other interactions which require their appearance at a district office, they are encouraged to contact the district office. Commissioners and staff will do their best to accommodate such concerns. This is obviously a very fluid situation. Any directed changes to Commission policy will be posted to the website and forwarded to all district offices for distribution immediately upon receipt. For additional information you are urged to please visit ct.gov/coronavirus.
• A detailed temporary telehealth policy from Labor & Industries (L&I) is now available and effective March 9th. The detailed policy is also available on the Medical Aid Rules and Fee Schedules (MARFS) Updates and Corrections website.  To help support containment of the COVID-19 outbreak this new temporary telehealth policy allows injured workers to use their home as an origination site.
• Effective Tuesday, March 24, 2020, parties to any telephone hearing are required to either:
  • Contact the other party and initiate the conference call to the district office; or
  • The day before the hearing, provide the district with a telephone number (direct line preferably) at which you will be available at the time of the hearing.
• Monday, March 23, 2020, Governor Lamont has suspended non-critical Workers’ Compensation Commission statutory, regulatory and administrative deadlines. WCC is hopeful these temporary deadline suspensions outlined in the Governor’s Executive Order will help to alleviate the many concerns parties have expressed to WCC during this difficult time. All parties are expected to continue to abide as closely as possible to ALL of the deadlines outlined in the Workers’ Compensation Act, including, but not limited to, Section 31-303. These are extraordinary times, and one of the several purposes of these deadline waivers is to facilitate the transacting of business. WCC is counting on all parties to not take advantage of the executive order to unnecessarily delay the processing and providing of benefits.
• WCC had to make significant staff cuts effective Tuesday, March 24, 2020, in response to the ongoing Covid-19 health crisis and the Governor’s directive to “work at home, stay at home” which is aimed at slowing the trajectory of the virus. The WCC mission to serve the needs of the people of Connecticut remains intact. There are no reductions in the number of commissioners. Commissioners remain fully dedicated and will continue to conduct hearings telephonically in order to not unnecessarily jeopardize the health of WCC staff and the public. WCC will evaluate as we go and make whatever reasonable adjustments to staff levels as are necessary and possible, to ensure WCC continues to function at the highest level possible during this health crisis. WCC will only be able to continue to function at the highest level possible, with the continued level of outstanding cooperation and patience by claimants and respondents.
• Published updated Memorandum No 2020-07 Submission of forms; Memorandum No 2020-06 WCC Form 36; and  Memorandum No 2020-05 regarding stipulation approval /hearing process.  All of these memorandums set forth policies impacted by COVID-19.  To view the memorandums, go to  https://wcc.state.ct.us/.

REGULATORY ACTIVITY:

• Published a memo regarding Guidelines for Mediation Services.  The Memorandum No 2020-1 replaces memorandum no 2018-09.  Memorandum 2020-01 becomes effective on February 1, 2020.   To view the memorandum, go to https://wcc.state.ct.us/.
• The mileage reimbursement rate for all travel expenses incurred on or after January 1, 2020 has fallen to $0.575 per mile. This rate change applies to all claimants, regardless of injury date, and coincides with the federal mileage reimbursement rate pursuant to Section 31-312(a) of the Workers’ Compensation Act.
• Pursuant to Section 31-280b, Chairman Stephen M. Morelli has appointed Commissioners Randy L. Cohen and William J. Watson III to sit as panel members on appeals before the Compensation Review Board for the calendar year beginning January 1, 2020.

FEE SCHEDULE NEWS:

• New Ambulance rates effective 1/1/2020 have been released. The next update to Ambulance rates is expected in January 2021.

REGULATORY ACTIVITY:

• Published bulletin 2019-14 on December 20, 2019 regarding an update to Professional Guide for Attorneys, Physicians and Other Health Care Practitioners Guidelines for Cooperation. To view the bulletin, go to https://wcc.state.ct.us/memos/2019/2019-14.htm . This update deals specifically with the definitions to the roles of Physician Assistants and Advanced Practice Registered Nurses, to bring them in line with Memorandum No. 2018-04 and the Official Connecticut Practitioner Fee Schedule Guidelines.

REGULATORY ACTIVITY:

• Published three bulletins regarding wage benefits.   The bulletins published were Bulletin 2019-10 Weekly Wage, Maximum Compensation Rate, and Cost of Living; Bulletin 2019-11 Calculating Weekly Benefit Amounts without FICA and/or Medicare Deductions; and Bulletin 2019-12 Workers' Compensation Benefits Rate Tables October 1, 2019-September 30, 2020.  To view the bulletins, go to https://wcc.state.ct.us/.
• The Commission’s newest Workers’ Compensation Commissioner is Soline M. Oslena, whose legal experience includes practice in the areas of workers’ compensation, personal injury, real estate, family, and housing law. Born in Port-au-Prince, Haiti, Oslena immigrated to Brooklyn, New York with her family when she was just eight years old. Later, while in college, she worked a full-time and a part-time job, hard work which in 2005 earned her a bachelor’s degree in Legal Studies from the New York City College of Technology.  A few years later, Oslena became a resident of Connecticut and pursued her dream of becoming a lawyer. Working full-time and traveling over an hour to attend law school at night and on weekends made that dream a reality in 2010, when she earned her Juris Doctor from the Southern New England School of Law. She was admitted to the Connecticut Bar in 2011. Commissioner Oslena worked as a paralegal for Attorney Bart A. Sayet during her time as a law school student. After graduating with her law degree, she became an Associate in that practice, during which time she gained broad knowledge in multiple areas of the law while handling a large and varied caseload representing a diverse clientele. Oslena says that, “amongst my areas of practice, workers’ compensation has brought me the most satisfaction because I have been able to help people through a difficult time in their lives,” representing her clients in hundreds of workers’ compensation hearings.
• Published Memorandum Number 2019-13 regarding findings and awards by Stipulation with allocations for future medical expenses, including Medicare Set-Asides, or with allocations of indemnity benefits.  To view the memorandum, go to https://wcc.state.ct.us/.
• In October, the RETAIN-CT project was launched as a pilot in the Greater Hartford region. RETAIN is an early return-to-work initiative funded by the U.S. Department of Labor to prevent long-term disability.  In Connecticut, the RETAIN-CT study is being piloted with Workers’ Compensation claimants of The Hartford Insurance Group with musculoskeletal conditions, and the work involves elements of provider training with special billing codes to reimburse for proactive return-to-work communication, early return-to-work coordination, and use of employment specialists from local workforce development boards. Major partners on the pilot project include the CT Department of Labor, UConn Health, The Hartford Insurance Group, and Capital Workforce Partners. To learn more about the RETAIN-CT study, or if you would like to register as a RETAIN-CT provider, visit retainct.com.

REGULATORY ACTIVITY:

• The Workers’ Compensation Commission issued an update to the Professional Guide for Attorneys, Physicians, and Other Health Care Practitioners Guidelines for Cooperation. This update deals specifically with the definitions and reimbursement rates for One-Time Medical Evaluations and Second Opinions. The changes were effective for dates of service beginning September 1, 2019. The updated Professional Guide for Attorneys, Physicians, and Other Health Care Practitioners Guidelines for Cooperation can be found at https://wcc.state.ct.us/download/acrobat/proguide.pdf. To view this notice, go to https://wcc.state.ct.us/.
• Published memorandum no. 2019-08 regarding fee increase for Commissioner's Examinations and memorandum no. 2019-09 regarding commissioner's examination procedure.  Memorandum no. 2019-09 became effective on September 15, 2019.  To view the memorandums, go to https://wcc.state.ct.us/.

FEE SCHEDULE NEWS:

• The new Official Connecticut Practitioner Fee Schedule has been adopted with an effective date of July 15, 2019. The next update is expected July 15, 2020.

REGULATORY ACTIVITY:

• Published memorandum number 2019-03 regarding utilization review. From the Chairman: As I’m sure you are aware, the use of utilization review within the confines of an approved medical care plan is permitted by the Workers’ Compensation Commission pursuant to the regulations established within Administrative Regulation Sec. 31-279-10. Outside the confines of a medical care plan, while there is no explicit prohibition on utilization review, the outcome is not binding, and the Commission is not held to an “arbitrary and capricious” standard to overturn a decision. It is, in these cases, the commissioner who makes the final determination as to the reasonableness and necessity of medical treatment. It has been brought to my attention that utilization review is being used more and more frequently outside of medical care plans. The entities performing these reviews are not holding to the timelines and standards established by the regulations yet seem to be placing expectations on both claimants and providers that they need to follow the appeal timelines and regulations that they have set. In the absence of a medical care plan, the claimant can simply take an adverse ruling by utilization review to a hearing and have a commissioner determine the reasonableness and necessity of the treatment in question. The extensive use of UR outside of medical care plans is causing unnecessary delays in medical treatment for claimants and placing unacceptable burdens on medical providers. As the providers are led to believe that they must follow UR companies’ appeals processes, they are forced to participate in peer-to-peer reviews as well as submit additional documentation in order to appeal adverse decisions within the timelines established by said entities. I am aware that many payers use third party vendors to perform their utilization review. It has been, and continues to be, the Commission’s policy that the payer is the party responsible for ensuring the timely and accurate processing of Workers’ Compensation claims. Should you choose to use a third-party vendor for your utilization review needs, the onus is on you to ensure that the vendor is aware of the Workers’ Compensation guidelines surrounding utilization review. In order that all parties may respond to an UR decision appropriately, payers MUST advise all parties, in particular medical providers, if the UR is not binding as there is no medical care plan in place. In short, it is imperative that payers review their utilization review policies and procedures to ensure that they remain in line with the guidelines established by the Workers’ Compensation Commission. In cases where there is no medical care plan in place, subjecting claimants to unnecessary UR and holding them to arbitrary time frames and appeals processes that delay treatment may subject the payer to fines and sanctions for undue delay. Should you require any additional information on this matter, please feel free to contact my office.  To view the memorandum, go to https://wcc.state.ct.us/memos/2019/2019-06.htm.
• Connecticut published bulletin PC-88.  This Bulletin is intended to clarify and supersede Bulletin  PC-66, dated December 21, 2009to reflect the provisions of Public Act No. 18-158, effective July 1, 20191 and Public Act No. 19- 125, effective July 1, 2019 concerning electronic notification  requirements.  In addition, the provisions in section I.D. below concerning conditional renewal notices have been generally codified in Conn. Gen. Stat. § 38a-323.  See Public Act No. 17-198.
• The Department of Insurance posted a notice to Workers' Compensation Insurers and Producers concerning changes to treatment of single member LLC's following the supreme court ruling in Gould v. City of Stamford. To view the notice, go to https://portal.ct.gov/CID/Public-Hearing-Notices/Latest-Notices.