FEE SCHEDULE NEWS:

• The medical fee schedule has been updated with an effective date of January 1, 2018.

FEE SCHEDULE NEWS:

• The Bureau of Workers’ Compensation has adopted new Outpatient and ASC Fee Schedule with an effective date of May 1, 2020. The next update is expected in May 2021.

FEE SCHEDULE NEWS:

• The Bureau of Workers’ Compensation has issued three policy alerts to address the expansion of telemedicine.
  • Policy 2020-01, effective March 16, 2020, announces a more flexible use of telemedicine and expands the site of care delivery to the injured worker’s home, as well as relaxing the requirements for using a secure platform of communication. To view the policy, go to https://www.bwc.ohio.gov/downloads/blankpdf/PolicyAlert-TempTeleHealthCOVID-19.pdf.
  • Policy 2020-02, effective March 20, 2020, permits telephonic communication as a temporary substitute for some vocational rehabilitation services. To view the policy, go to https://www.bwc.ohio.gov/downloads/blankpdf/PolicyAlert-TempTeleHealthVocRehabCOVID-19.pdf .
  • Policy 2020-03, effective March 26, 2020, expands the service providers eligible to provide and bill for virtual check in and/or telephone services (audio only). To view the policy, go to https://www.bwc.ohio.gov/downloads/blankpdf/PolicyAlert-TempTeleHealthCheckinServicesCOVID-19.pdf.

REGULATORY ACTIVITY:

• Issued Bulletin 2020-09 regarding financial filing deadlines and procedural requirements as a result of COVID-19 recommendations and orders.
• Published a rule package in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review:  - Package Title: BWC - Credentialing Rules - Rule Numbers: 4123-6-02.2 and 4123-6-02.22. To view the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Published a rule package in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: - Package Title: BWC - Pharmacy Rules - Rule Numbers: 4123-6-21.3, 4123-6-21.6, 4123-6-21.7 and 4123-6-21.8. To view the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Ohio published notice that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: - Rule Title: Employer access to HPP; - Rule Number: 4123-6-05.2; -Proposed Action: Amended.  To view the notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.

REGULATORY ACTIVITY:

• Published three business impact analyses on proposed rules.  The business impacts were published for Medical Services and Professional Fee Schedule 4123-6-08; Payment of Ambulatory Surgical Center Services 4123-6-37.3 and Payment of Hospital Outpatient Services 4123-6-37.2.  To view the business impact statements, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• A published notice of a five-year rule review of the QHP Rule 4123-6.  To view a copy of the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• The Ohio Bureau of Workers’ Compensation notifies you that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Rule Title: Vocational rehabilitation fee schedule -Rule Number: 4123-18-09 and -Proposed Action: Amended.  To view the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Ohio’s Bureau of Workers' Compensation (BWC) system is the exclusive provider of workers’ compensation insurance in Ohio and serves 249,000 public and private employers. To help businesses facing difficulties due to the COVID-19 pandemic, the Ohio BWC is announcing that insurance premium installment payments due for March, April, and May for the current policy year may be deferred until June 1, 2020. At that time the matter will be reconsidered.   "BWC will not cancel coverage or assess penalties for amounts not paid because of the coronavirus pandemic," said Lt. Governor Husted. "Installment payments due for the three-month period are totaled at approximately $200 million, and that money will now stay in the economy." For more information, visit bwc.ohio.gov.

FEE SCHEDULE NEWS:

• A new inpatient fee schedule has been adopted with an effective date of February 1, 2020. The next expected update for the inpatient fee schedule is in February 2021.

REGULATORY ACTIVITY:

• Posted notice that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: Professional Provider Fee Schedule -Rule Number: 4123-6-08 -Proposed Action: Amended. 
• This is to notify you that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Rule Title: Payment of ambulatory surgical center services. Rule Number: 4123-6-37.3 - Proposed Action: Amended.  
• Ohio is notifying you that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: - Rule Title: Payment of hospital outpatient services.-Rule Number: 4123-6-37.2 -Proposed Action: Amended. 

FEE SCHEDULE NEWS:

•  A new medical fee schedule has been adopted with an effective date of January 1, 2020. The next expected update for the medical fee schedule is in January 2021.

REGULATORY ACTIVITY:

• Posted a notice of 5-year rule review of rule 4123-6-37.1 regarding payment of hospital inpatient services. To view the proposed rule, go to https://www.bwc.ohio.gov/downloads/blankpdf/OAC4123-6-37.1-FiveYearRR.pdf .

REGULATORY ACTIVITY:

• Published the proposed IPPS - Hospital Inpatient Reimbursement Rule and appendix which become effective February 1, 2020.  The state also published the proposed PPMS - Professional Provider Medical Services Fee Schedule which becomes effective January 1, 2020.  To view the notices and rules, go to https://www.bwc.ohio.gov/provider/services/FeeSchedules.asp.

REGULATORY ACTIVITY:

• Posted notice of rule for 5-year review. Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: Package Title: Chapter 4123-5 (5YRR) Rule Numbers: 4123-5-01 Assignment of duties to the bureau's operational units. 4123-5-11 Employer's reports must be signed by officer or person in employ of employer. 4123-5-13 Expenses related to the death of an injured worker. 4123-5-18 Medical proof required for payment of compensation. 4123-5-20 Payment of compensation when advancements are made during period of disability. 4123-5-21 Abatement of claims. To view this notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Posted notice of rule for 5-year review. Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Package Title: Chapter 4123-14 (5YRR) -Rule Numbers: 4123-14-01 Non-complying employers within the meaning of the law. 4123-14-02 Procedures for the collection of premiums from non-complying employers. 4123-14-03 Requests for waiver of a default in the payment of premium, for approval of the original workers' compensation coverage retroactively, and for abatement of penalties. 4123-14-04 Procedure to recover from a non-complying employer the amount of money paid out of the state insurance fund for an industrial injury, occupational disease and/or death. 4123-14-05 Settlement of liability of a non-complying employer. 4123-14-06 Bureau of workers’ compensation adjudicating committee. To view this notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Posted notice of rules proposed to BWC Board of Directors for consideration. Rules proposed are 4123-6-34 Payment for Treatment of Concussion Injuries.  The rule is open for comment through August 15, 2o19.  To view the rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.

REGULATORY ACTIVITY:

• Posted notice that a rule package in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Package Title: Vocational Rehabilitation Rules.-Rule Numbers: 4123-18-03 Guidelines for referral to and acceptance into vocational rehabilitation.4123-18-04 Living maintenance allowance.  4123-18-14 Injured workers suffering compensable injuries, occupational diseases or death while in an approved vocational rehabilitation plan.  To view the information, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Posted notice that a rule package in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: -Package Title: BWC Chapter 4123-19 Rules - Rule Numbers:
  • 4123-19-01 Definition: state risks, self-insuring risks.
  • 4123-19-03 Where an employer desires to secure the privilege to pay compensation, etc., directly.
  • 4123-19-05 Where an employer is a self-insuring risk and desires to become a state risk.
  • 4123-19-08 Renewal of self-insuring risks.
  • 4123-19-09 In regard to complaints filed by employees against self-insuring employers under the provisions of section 4123.35 of the Revised Code.
  • 4123-19-13 Self-insuring employer’s evaluation board. 4123-19-14 Self-insured review panel.
  • 4123-19-15 Assessment for self-insuring employers’ guaranty fund.
  • 4123-19-16 Self-insured construction projects.

To view the information, go to https://www.bwc.ohio.gov/downloads/blankpdf/Chapter19SIRules.pdf.

• The bureau posted a notice that a rule in the category Workers’ Compensation - Bureau of Workers’ Compensation is being considered for review: - Rule Title: Payment for treatment of concussion injuries. Rule Number: 4123-6-34, - Proposed Action: New.  To view the notice and a proposed rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.  This rule is proposed for public comment but has not been filed for adoption.

REGULATORY ACTIVITY:

• Published notice of proposed rules to the BWC Board of Directors.  The rules under consideration are 4123-6-01.2 Provisional treatment reimbursement approval pilot program.  Public comments will be received through May 14, 2019.  To view the notice and proposed rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Published notice of proposed rules to the BWC Board of Directors.  The rules under consideration are Chapter 3 - BWC claims procedure rules- 5-year review.  Public comments will be received through May 14, 2019.  To view the notice an proposed rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Published notice of proposed rules to the BWC Board of Directors.  The rules under consideration are Chapter 19- Self-insuring employer rules.  No cutoff date for public comments has been announced.  To view the notice and proposed rule, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp.
• Published notice that comments due to rules 4123-6-08 Bureau fee schedule; 4123-6-37.2 Payment of hospital outpatient services; and 4123-6-37.3 Payment of ambulatory surgical center services have been extended to May 1, 2019.  To view the notice, go to  https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp
• Published notice that comments due to rules Chapter 6 - Lumbar fusion surgery, HBAI and medical treatment reimbursement requests and 4123-6-21.3 Outpatient medication formulary have been extended to June 1, 2019.  To view the notice, go to https://www.bwc.ohio.gov/basics/guidedtour/generalinfo/OACInReview.asp