Policy Matters Brief June 8, 2020
Arizona Industrial Commission to hold public hearing
on fee schedule
The Industrial Commission of Arizona (ICA) will hold a public hearing at 1:00 P.M. local time on June 25, 2020, to review proposed changes/modifications to their medical fee schedule. Proposed changes include reviewing current medical conversion factors for possible revision and other minor changes. The ICA will accept public testimony via telephonic hearing and written comments no later than July 1, 2020.
California plans future adoption of COVID-19 treatment guidelines for workers’ comp.
The California Division of Workers’ Compensation announced they plan to adopt and incorporate the American College of Occupational and Environmental Medicine (ACOEM) Coronavirus (COVID-19) Clinical Practice Guideline into their Medical Treatment Utilization Schedule (MTUS). The DWC will wait until the frequency of updates slows to a point where the formal adoption process can be completed, noting that at this point the evidence-based management of the virus is fluid and evolving and as a result guidelines are published frequently. In the meantime, the DWC stated stakeholders should follow the MTUS Medical Evidence Search Sequence found in existing regulations. This regulatory search sequence requires a search of the most current version of ACOEM guidance, and the ACOEM COVID-19 guideline meets that criteria.
Kentucky requests COVID-19 workers’ comp. payment information
The Kentucky Department of Workers’ Claims (DWC) recently distributed a memorandum to workers’ compensation carriers and self-insurers requesting information on their COVID-19 payment experience. The DWC is conducting a study to assess the early impact of COVID-19 on losses incurred and reserves established by payers. The data requested included the number of first reports of injury related to COVID-19, amount of indemnity and medical benefits paid for COVID-19-related claims, and total reserves as of May 22, 2020 for COVID-19-related claims.
Kentucky is one of several states with a recently established COVID-19 presumptive claims payment policy in place for workers’ compensation. Governor Andy Beshear issued an executive order on April 9, 2020, providing for a limited period of temporary total disability benefits for those workers who are removed from work by a physician for a period of self-quarantine as a result of occupational exposure to COVID-19.
Louisiana Legislature expands medical marijuana usage
The Louisiana legislature passed legislation expanding current conditions eligible for treatment under state medical marijuana laws. House Bill 819, which now heads to the Governor for final approval, adds certain additional conditions for usage of medical marijuana such as neurological disorders, traumatic brain injuries and chronic pain associated with certain diseases. The inclusion of chronic pain as a condition for treatment will be of great interest as to how it is fully applied in the coming years.
Oklahoma workers’ comp. medical fee schedule approved; Separate legislation signed adding chiropractors
An update to the Oklahoma workers’ compensation medical fee schedule by the state’s Workers’ Compensation Commission, which was required under 2019 legislation, was recently approved by the legislature and governor. The update, which takes effect July 1, 2020, includes adjustments to maximum allowable reimbursement amounts for many medical services. For pharmacy, no substantive changes were made; however, statements were added to clarify that the pharmacy ground rules are not intended to cover or address medical marijuana. Existing state law provides that a workers’ compensation carrier or self-insured employer is not required to reimburse a person for costs associated with the use of medical marijuana.
Separate legislation was also recently signed in Oklahoma adding chiropractic services as allowable medical treatment and authorizing selection of chiropractors to provide certain services under the workers’ compensation law. This change in law, which takes effect November 1, 2020, will also require the Commission to incorporate fees for chiropractic care into their medical fee schedule. This addition of chiropractors in the law came after the Commission submitted its final 2020 fee schedule update for approval, so this will have to be accounted for in a separate future update to the fee schedule.
New York adopts additional workers’ comp. treatment guidelines
The New York Workers’ Compensation Board (WCB) recently adopted changes adding new medical treatment guidelines. The changes add new guidelines for Elbow, Foot & Ankle, Hip & Groin injuries and Interstitial Lung disease. Medical providers will be required to follow these new treatment guidelines when providing medical service or care for injured workers. Treatments which are recommended/approved by the guidelines do not automatically required prior authorization while deviations from the guidelines may require authorization under current variance rules. Of interest will be the projected modification of the current drug formulary so as to synergize with the newly adopted medical treatment guidelines. The guidelines take effect for care provided on or after January 1, 2021.