National – The Coordination of Medicare Payments and Workers’ Compensation Act (COMP Act, HR 4368) was reintroduced in the US House of Representatives by Rep. Carey (R-OH) and Rep. Thompson (D-CA). The bill proposes to legislate work comp MSAs. The bill was previously introduced in 2019, 2020, and 2021, failing each year. If passed, it would modify 42 U.S.C. 1395y(b)(2)(A)(ii) of the Medicare Secondary Payer Act ("MSP Act”). In particular, the bill addresses the procedure of WCMSAs under the Centers for Medicare & Medicaid Services (“CMS”) The current policy for WCMSA procedure is outlined in CMS’s Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, Version 3.9 (“Reference Guide”). Under this policy, CMS established a voluntary review and approval process with clear submission workload review thresholds for Medicare beneficiaries and reasonable expectation claimants. The COMP Act is pursuing to establish legislation for portions of CMS’s WCMSA process, including dictating appeal options and payment administration methods, among other things.
Georgia – HB 451 would require that after a qualifying diagnosis of occupational PTSD, first responders have financial resources readily available to them, including identifying a mental healthcare provider of their choice and beginning treatment, as well as having additional financial resources available for the continuation of treatment, pursuit of recovery, and return to service. The bill passed the house and is scheduled for hearing in the Senate Insurance and Labor Committee March 20th.
New York – After dying in Assembly back in January and being returned to the Senate, NY S1947 this week passed the Senate in a 61-1 vote sending the previously introduced and failed bill back to the Assembly. If passed, NY S1947 would allow a claimant to choose a pharmacy of their choosing, with some restrictions, to receive their prescription medications.
Kansas – SB 555 would create a pilot program allowing possession and use of cannabis for qualifying medical conditions that include cancer, AIDS, Lou Gehrig’s disease, traumatic brain injury, PTSD and chronic, severe or intractable pain. It declares that work comp carriers and self-insured employers shall not be required to reimburse a person for the costs associated with the use of medical cannabis.
Oklahoma – The House passed HJR 1035 which approves the 2024 Medical Fee Schedule. The new Medical Fee Schedule will take effect July 1st. The House also voted to pass HB 3601 which would eliminate a requirement that one member of the work comp physician advisory committee represents a rural community. Both bills were sent to the Senate for hearings.
Louisiana – HB 198, HB 360, HB 703, and SB 315 were tagged as “draconian” by Sen. Luneau (D-Alexandria). HB 198 would require doctors to be paid 150% of the Medicare rate or actual charged rates, whichever is less. Current rates are the mean of U&C charges. HB 360 would eliminate the Workers’ Compensation Advisory Council and HB 703 would eliminate the $50 per day penalty for failure to pay medical or indemnity benefits on disputed claims. It would also cap attorney fees at $8000 for penalty hearings regardless of the number of penalties. SB 315 would increase burial expenses but terminate TTD when an injured worker “is engaged or has the capacity to engage in any self-employment or occupation for wages.” It would also terminate TD benefits after 26 weeks. It may be extended up to 350 weeks if the treating physician provides monthly documentation.
Maryland – The Senate passed a bill that would expand the list of cancers that are presumed to be compensable for firefighters and other public safety workers. The bill adds thyroid, colon, and ovarian cancer to state they were caused by contact with a toxic substance in the line of duty. The bill now heads to the House for hearings. The House passed a bill modifying how hearing loss must be calculated for worker’s comp benefits. Current law calculates hearing loss across 4 frequency ranges- 500 hertz to 3000 hertz and includes an offset based on the average amount of hearing loss from nonoccupational causes. The bill would require testing for hearing loss up to 4000 hertz. It would also require that tinnitus be considered part of the employee’s hearing loss.
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