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Policy Matters Brief - March 30, 2022

March 30, 2022 · Public Policy & Regulatory Affairs Team

Georgia efforts on PTSD for first responders stall

A recent House proposal to extend PTSD coverage to first responders in Georgia has hit a speedbump as it failed to pass out of the House Labor and Industry committee. The bill found here would have provided workers’ compensation benefits for first responders who experience one or more on-the-job psychologically traumatic events and are then diagnosed with PTSD by a certified mental health professional. At present, companion bill SB 484 sits in the Senate Labor and Insurance committee.
 

Kansas considering medical marijuana usage

Bill SB 560 is currently working through the Kansas Legislature and sits in the Senate Committee on Federal and State Affairs. The bill would provide for the use of medical marijuana for conditions such as cancer, spinal cord diseases or injury, traumatic brain injury, a debilitating psychiatric disorder or other chronic, debilitating or terminal conditions if so diagnosed by a treating physician. The bill would limit existing research related to the use of medical marijuana and would not require any governmental assistance program, private health insurer or workers’ compensation insurer to provide reimbursement for the costs associated with the use of medical marijuana.

 

Louisiana adopts changes to existing MTGs

The Louisiana Office of Workers’ Compensation Administration published revised portions of their existing treatment guidelines for final adoption. The revised guidelines, published in the State Register - on pages 512 – 518, include General Applicability, Diagnostic Imaging and Testing and Specific Lower Extremity Injury Diagnosis, Treatment and Testing. All existing treatment guidelines can be found on their webpage. The Administration continues to work on their Chronic Pain guidelines via the rule-making process.
 

Kentucky workers’ comp UR and medical bill audit regulation changes seem uncertain

The legal status of the amendments to Kentucky’s workers’ compensation utilization review (UR) and medical bill audit regulation seems uncertain. The amendments create a new DWC medical director position and amend the method by which UR appeals are handled and have gone through several regulatory actions.

  • Originally proposed by the Department of Workers’ Claims (DWC) in February of 2021
  • The DWC published modifications to the proposal that were subject to the state’s legislative committee review process.
  • The legislature’s Administrative Regulation Review Subcommittee found it “deficient” on November 9, 2021, yet the governor determined the regulation would become effective notwithstanding that finding of deficiency.
  • The amended regulation was published as adopted and listed as effective March 1, 2022 (the substantive changes to the UR process are not set to take effect until June 1, 2022).
  • Separately, Senate Bill 65 was introduced in January of 2022 to prevent the amended regulation from becoming effective and would prohibit the DWC from promulgating a regulation that is identical to, or substantially the same as, the amended regulation for a period through June 1, 2023. The bill passed the first chamber January 25 and is pending in the second chamber.
     

More legislation introduced to amend Michigan auto no-fault reform law

Attempts to address perceived concerns or flaws in Michigan’s 2019 auto no-fault reform law have continued with more recently-filed legislation amending provisions related to the fee schedule and utilization review (UR) in the law. Recently-filed legislation includes:

  • SB 945: With respect to UR, this bill would add the phrase "medically accepted standards." This includes "standards or guidelines that are generally relied on by medical professionals in rendering medical treatment and developed by the federal government or national or professional medical academies, associations, boards, or societies," but it excludes "any set of standards or guidelines developed by private, for-profit corporations for commercial gain."
  • SB 946: This bill would amend fee schedule provisions to limit them to "medical" treatment (current law says “treatment”). The added “medical treatment” definition would exclude several services and items from the fee schedules, including (among others), medications, durable medical equipment, transportation, vehicle or home modifications and attendant care.
  • SB 947: This bill would amend fee schedule provisions to add that the existing attendance care hourly limitation only applies when rendered by a single individual. No such hourly limit would apply to attendant care services that must be paid or reimbursed to a group of individuals.
  • HB 5931: Among other notable repealed provisions, this bill would repeal the 2019 law’s fee schedule provisions.

For more details on these latest bills and other previously-filed Michigan auto no-fault bills, visit our Legislative and Regulatory Tracker webpage (select “Auto” as the category in the dropdown menu).
 

Oregon firefighter cancer presumption law expanded

Legislation in Oregon, House Bill 4113, was recently signed into law and adds to the list of cancer types presumed compensable under workers’ compensation for certain firefighters. The bill specifically adds bladder and female reproductive cancers to the list of cancers presumed compensable for non-volunteer firefighters with five or more years of service. The bill also requires the state’s Workers’ Compensation Management-Labor Advisory Committee to review and consider reports, findings and analysis made public by the National Institute for Occupational Safety and Health related to cancers associated with non-volunteer firefighters.

An insurer or self-insured employer can rebut these presumptions by providing clear and convincing medical evidence that cancer was not caused or materially contributed to by the firefighter's employment. Existing law already had provided that certain cancers (brain, colon, stomach, testicular, prostate, multiple myeloma, non-Hodgkin’s lymphoma, throat, mouth, rectal, breast or leukemia) were presumed to be compensable occupational diseases for these non-volunteer firefighters who have been on the job for at least five years.

To review other workers’ comp presumption bills we are tracking this year, visit our Legislative and Regulatory Tracker webpage (select “Presumptions” as the topic in the dropdown menu).
 

South Dakota bill expressly exempts medical marijuana from workers’ comp reimbursement

On March 7, 2022, Senate Bill 17, was signed into law in South Dakota that expressly states that nothing in the law requires workers' compensation reimbursement for medical marijuana. The bill amends an existing provision to state that nothing within the law requires a government medical assistance program or private health insurer, workers' compensation insurance carrier, or self-insured employer providing workers' compensation benefits, to reimburse a person for costs associated with the medical use of cannabis (the italicized words were added).

To review other medical marijuana bills or regulations we are tracking this year which may address reimbursement or coverage under workers’ compensation or auto no-fault, check out our Legislative and Regulatory Tracker webpage (choose the line(s) of insurance under “Select a Category” and “Marijuana, Cannabis, CBD” as the topic in the dropdown menu).


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