Policy Matters Brief November 3, 2020

Kentucky proposes changes to workers’ comp hospital fee schedule
The Kentucky Department of Workers’ Claims has scheduled a public hearing for November 24, 2020 to discuss proposed changes to their hospital fee schedule regulation. The proposed changes amend the definition of "hospital" to include certain out-of-state facilities and rehabilitation agencies, define "surgical hardware" and "surgical implants," establish the method by which the cost of surgical implants will be reimbursed (invoice cost plus 15%) and clarify the calculation and use of a cost-to-charge ratio for ambulatory surgical centers. Written comments will be accepted through November 30, 2020. The full regulatory text, public hearing information and details on how to submit written comments can be viewed online here.

Michigan governor signs new workers’ comp COVID-19 presumption rules after court decision
Michigan Governor Gretchen Whitmer signed new emergency rules from the state’s Workers’ Disability Compensation Agency establishing a workers’ compensation COVID-19 presumption for certain workers, effective through March 20, 2021. The emergency rules apply to workers in the medical industry, including hospitals, medical care facilities and emergency medical services, as well as law enforcement, fire safety and related fields.

These workers are presumed eligible for compensable injuries under the state’s workers’ compensation law if they are confirmed as COVID-19 positive on or after March 18, 2020, either by physician diagnosis or by test. That presumption is subject to rebuttal by specific facts to the contrary. These new emergency rules replace similar provisions previously adopted in March, which were negated when the Michigan Supreme Court ruled that certain emergency powers previously exercised by the governor were unconstitutional.

For more information on COVID-19 presumptions across the country, review the map on our COVID-19 information and resources webpage.