Policy Matters Brief February 24, 2020

Continued legislative focus on PTSD and cancer presumptions
Post-Traumatic Stress Disorder (PTSD) and cancer presumption(s) for first responders remain an area of immense focus in numerous state legislatures. Arizona, California, Colorado, Idaho, New Mexico, Ohio, Pennsylvania, Virginia and Wisconsin are moving bills that address compensation for various PTSD and cancer presumptions.

Alabama House Bill 44 and South Carolina House Bill 4777 are the latest states to consider bills addressing these issues. With several bills passed in 2019 and the explosion of bills in 2020, claims handling for these types of claims will become more complex and possibly more expensive in the future.

Alabama and New Jersey considering medical marijuana

Alabama
The Alabama legislature continues to debate a bill that would legalize utilization of medical marijuana across the state. Senate Bill 165 provides that medical marijuana – for certain listed conditions including cancer, anxiety and chronic pain – can be purchased at a dispensary licensed by the State.

The bill would limit medical marijuana use to pills, gelatinous cubes, skin patches and gels/creams and would prohibit consumption by smoking. At present, the bill remains in the Senate Judiciary Committee.

New Jersey
Because a recent court decision complicates the issue, the New Jersey legislature introduced Assembly Bill 1708 to clarify the confusion. The bill would permit medical marijuana use to treat work-related injuries and auto/personal injury protection (PIP) claims.

The legislation would require workers’ compensation and auto/PIP payers to reimburse qualified claimants for their medical marijuana treatments when the claimant receives authorization from their medical provider and unsuccessfully tried other treatments or medications. Presently, the bill remains in the Assembly Appropriations Committee.

Regulators support state regulation of air ambulance fees
Critical of the lack of cost controls for air ambulance services, the International Association of Industrial Accident Boards and Commissions (IAIABC) recently submitted a letter of concern to the federal Air Ambulance and Patient Billing (AAPB) Advisory Committee.

In the letter, IAIABC strongly recommends legislation allowing states to regulate air ambulance services under state workers’ compensation laws. Federal law regulating air carriers currently pre-empts states from regulating air ambulance fees via a state fee schedule, which leads to extremely high costs for these services. The Texas Division of Workers’ Compensation also commented in a white paper recommending permitting states to regulate fees.

Michigan DIFS clarifies new law concerning PIP opt-out for Medicare enrollees
The Michigan Department of Insurance and Financial Services (DIFS) recently issued a bulletin clarifying provisions in the 2019 no-fault auto insurance reform legislation. The reform bill passed last year permits Medicare enrollees to “opt out” of personal injury protection (PIP) medical benefits as part of their auto policies.

The bulletin notes that after July 1, 2020, Michigan Medicare enrollees who renew or purchase a new no-fault auto insurance policy and wish to opt out of PIP benefits must demonstrate that they are enrolled in Medicare Parts A and B. In addition, their spouse or any relative residing in the same household must have qualified health coverage or auto insurance coverage that includes PIP medical benefits.

Oklahoma publishes revised fee schedule draft for comment
The Oklahoma Workers’ Compensation Commission (WCC) has published a proposed medical fee schedule update, pursuant to a 2019 legislative mandate, with changes mostly focused on medical services and facilities. Language also clarifies that medications addressed under existing pharmaceutical services rules do not include medical marijuana, which concurs with existing state law.

The WCC is accepting comments until February 27, 2020. A summary of proposed changes is available online here.