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June Compliance Updates
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As we officially begin summer, several states have made recent legislative updates. See the top updates for workers' comp and auto casualty below.
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Updates in This Email
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The following states and hot topics are highlighted in this email:
- New York
- Michigan
- Colorado
- Florida
- Nevada
- Pharmacy Updates
- Additional Workers' Comp Updates
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Payer CMS 1500 Update WC
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New York posted a notice regarding the update to the payer implementation of the CMS-1500 initiative, which includes revised implementation dates to the submission partners requirements and use of the CARC/RARC codes. Learn more →
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DME Fee Schedule and Rules Delayed WC/Auto
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New York posted a notice that the effective date of the DME Fee Schedule, Prior Authorization Requests and Drug Formulary will be delayed from its previously noted date of June 7, 2021. The new effective date will coincide with the summer 2021 OnBoard: Limited Release. Learn more →
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Updated NF-10 Form Auto
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The Final Adoption of Consensus Amendments to Insurance Regulations 78, 96, 68-C, 118, 85, 64 and 90 (11 NYCRR 55, 62, 65-3, 89, 136, 216, and 218) has been posted to the Department's website. NYDFS has updated the Denial of Claim Form for PIP. Learn more →
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SB 197 - Employee Choice of Physician WC
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This bill would have reversed employer-led direction-of-care in Colorado and allowed an injured worker to choose from any Level 1 or 2 accredited physician. This bill was ultimately defeated in committee.
Status: Failed on May 27, 2021, in House Committee on Business Affairs & Labor. Learn more →
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Opioid Antagonist WC
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The Colorado Legislature passed SB 11, requiring pharmacists to offer to dispense an opioid antagonist if the opioid prescription dosage is 90 morphine milligram equivalents or greater; or the individual is concurrently prescribed a benzodiazepine, a sedative hypnotic drug, carisoprodol, tramadol, or gabapentin. This law goes into effect September 6, 2021. Learn more →
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Florida PIP Repeal WC
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Bill has not been presented to the Governor as of the date of publication.
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SB 289 - Workers' Comp Omnibus Bill WC
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This bill makes a number of changes to the NV workers’ comp system, including:
- Reduces the availability of apportionment for partial PD cases
- Permits an Advance Practice Nurse or Physician Assistant to perform an exam and provide “necessary immediate medical treatment”.
- NPs and PAs will also be able to complete and file the Claim for Compensation
- Requires a payer to provide a claimant with an electronic copy of a determination related to a claim for benefits, if requested
- Provides that benefit awards may be subjected to a lien for attorney fees
- Tolls the timeframe for an injured worker to request a hearing, if the injured worker has not received an electronic copy of a determination related to a claim for benefits
- Provides for an additional award of costs in the event that a claimant prevails at a hearing on a contested claim for compensation
- Expands the availability of topic matters that may be settled via lump sum
- Requires that the list of three (3) vocational rehab providers furnished by employers, to each be employed by a different entity
Status: Passed/engrossed on 5-31-21 and signed by governor. Learn more →
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South Carolina Opioid Antagonist WC/Auto
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The South Carolina Legislature passed SB 571, requiring a prescriber to offer a prescription for an opioid antagonist if the opioid prescription dosage is 50 morphine milligram equivalents or greater per day, the opioid medication is concurrently prescribed with benzodiazepine, or the patient presents an increased risk for overdose. This law goes into effect July 25, 2021. Learn more →
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Kentucky Fee Schedule WC
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The Kentucky Department of Workers' Claims amended pharmacy fee schedule was referred by the Legislative Research Commission to the Economic Development and Workforce Investment Committee on June 2, 2021. This committee has 90 days to schedule a hearing on the proposed regulation. If no hearing is scheduled within that time, the regulation will become effective at the end of the 90-day period. Learn more →
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Connecticut Marijuana Legalization WC
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During a special legislative session on June 17, 2021, the Connecticut Legislature passed SB 1201, allowing for persons to grow and possess up to 5 oz. of marijuana for recreational use. Formal retail sales will begin in May of 2022. Learn more →
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Additional Workers' Comp Updates
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California SB 335 WC
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Reduction in Carrier Liability Decision Period Timeframe
This bill would reduce the timeframe that carriers have to accept/deny/delay a claim from the current 90 days from notification of a claim, to 45 days for most claims. For specified injury/illness types, this timeframe would be reduced further, to 30 days, for specified members of law enforcement and specified first responders.
Existing law requires an employer to authorize the provision of medical treatment during the decision period, and to continue to provide treatment until the date that liability is accepted or rejected. Existing law limits this liability for medical treatment to $10,000; this bill would increase that amount to $17,000. The bill also contains additional penalty provisions for unreasonable delays/denials on specified injury types.
Status: Referred to Assembly Insurance Committee on 6-10-21. Learn more →
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