Policy Matters Brief May 20, 2020

CDC seeks comments on acute and chronic pain management

The Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (HHS) are looking for comments to learn stakeholders’ values and preferences relating to pain and pain management options for patients with acute or chronic pain.

Topics include the risks and benefits of pain management options, including each option’s accessibility cost, to better understand factors involved in making pain management decisions.

Feedback is requested from all stakeholders who care for patients with pain or conditions that can complicate pain management, including family members and/or caregivers and health care providers. Patients are encouraged to comment as well.

All comments must be submitted no later than June 16, 2020, referencing Docket No. CDC-2020-0029 as found on the Federal eRulemaking portal at www.regulations.gov
 

New York adopts final rule-setting date to apply workers’ comp medical fee schedule for auto-PIP claims

The New York Department of Financial Services (DFS) has ruled that the workers’ comp fee schedule will be applied to Auto/PIP (Personal Injury Protection) claims beginning October 1, 2020.

In early 2019, the Workers’ Compensation Board (WCB) adopted a revised medical fee schedule for workers’ compensation and Auto/PIP claims. In New York, the workers’ comp fee schedule also applies to provision of healthcare services and reimbursement policies for Auto/PIP claims. More info, here.

Florida Division of Workers’ Compensation to hold rule workshops

The Division of Workers’ Compensation (DWC) has posted notice of rule workshops on two areas of existing Florida workers’ comp rules.

The first workshop will focus on the rules regarding fee dispute and dispute resolutions. The DWC has scheduled discussions on these rules, found in 69L-31, for May 27, 2020 in Tallahassee. 

The DWC is also planning a separate rule workshop related to workers’ comp medical reimbursement and payment rules. This workshop is also scheduled for May 27 and will cover the rules for medical payment, reimbursements and billing. More info, here.
 

Minnesota adopts workers’ comp PTSD guidelines

In response to a 2018 legislative mandate, the Minnesota Department of Labor and Industry (DLI) adopted expedited rules governing treatment for post-traumatic stress disorder (PTSD), effective May 4, 2020.

The rules, which apply to patients treated for a compensable mental impairment of PTSD, establish standards to review the clinical consequences of services provided and include procedures to determine whether charges for services may be excessive.

For patients receiving treatment for PTSD before May 4, 2020, the payer must send the provider, patient and patient’s attorney of record (if any) written notice of the PTSD treatment rules at least 90 days before denying payment based on failure to comply with the rules. DLI also published a checklist to assist with complying with the rules.
 

Annual Washington workers’ comp medical fee schedule update delayed amid COVID-19

The Washington Department of Labor & Industries (L&I) announced they will continue to use the fees listed in the 2019 fee schedule until October 2020. Changes to the fee schedule and payment policies will be effective October 1, 2020. L&I normally announces changes to the fee schedule and payment policies in June of each year with an annual effective date of July 1. However, they have shifted the dates this year to put added focus on their COVID-19 response. Several Washington COVID-19 response resources are available online here.
 

SAWCA National Regulator Virtual Town Hall COVID-19 discussion available on demand

The Southern Association of Workers’ Compensation Administrators (SAWCA) held a virtual town hall in late April with many state workers’ compensation regulators from throughout the country (not just the South) and several key industry stakeholders. The goal was to provide regulators and industry stakeholders an opportunity to discuss COVID-19 issues and share their questions, concerns, challenges and successes to better prepare for the immediate future. A recording of the discussion, hosted by the WorkersCompensation.com Center for Education Excellence, can be viewed online here.