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The latest legislative and regulatory activity that impacts you and the services we provide
Policy Matters Brief - December 6, 2023
December 6, 2023 · Public Policy & Regulatory Affairs Team
Alaska workers’ comp medical fee schedule updated
The 2024 edition of the Alaska Workers’ Compensation Medical Fee Schedule was adopted, with an effective date of January 1, 2024. Changes to the fee schedule include updated procedure coding and source documents; updated evaluation and management language; modified hearing aid language; clarification on invoices for reimbursement of durable medical equipment, prosthetics, orthotics, and supplies (with no code identifiers); and expansion of chiropractic codes allowable. Although conversion factors were not adjusted, changes may have occurred to individual maximum allowable reimbursement amounts for services and items. Note that after adopting the annual fee schedule, the Alaska Workers’ Compensation Board often adopts additional amended source materials towards the end of the year.
California workers’ comp treatment guidelines updated
The California Division of Workers’ Compensation (DWC) adopted updates to its medical treatment guidelines, known as the Medical Treatment Utilization Schedule (MTUS). These updates incorporate the latest published guidelines from the American College of Occupational and Environmental Medicine (ACOEM) for the following:
- Hand, Wrist, and Forearm Disorders (ACOEM June 28, 2023)
- COVID-19 (ACOEM June 28, 2023)
Although California workers’ compensation law provides that the MTUS treatment guidelines are presumptively correct concerning the extent and scope of medical treatment, the presumption is rebuttable and may be negated by a preponderance of scientific medical evidence proving that a variance from the guidelines is reasonably required to cure or relieve the injured worker from the effects of an industrial injury.
Maryland continues workers’ comp fee schedule discussions
The Maryland Fee Guideline Committee, part of the Maryland Workers’ Compensation Commission, recently held another meeting to discuss its current pharmacy fee schedule. After holding several open meetings this year, the Committee is continuing to discuss potential tweaks to the pharmacy fee schedule, the possible need for legislative activity, and how to modify the fee schedule in order to reduce the growing issue of fee disputes based upon the current U&C based pharmacy fee schedule. The Committee will continue to research and discuss the issue at its next meeting on January 11. Information on the Committee, as well as its past and future meetings, can be found here.
Oregon workers’ comp rules updated to account for physician assistant and sign language interpreter legislation
The Oregon Workers’ Compensation Division (WCD) amended rules to account for two recently signed bills (House Bill 3412 and House Bill 2696). HB 3412 increases the time a physician assistant (PA) can act as an attending physician under workers’ compensation to 180 days and clarifies that a PA who is not a member of the managed care organization (MCO) is authorized to provide the same level of services as a primary care physician if the PA meets certain conditions. We previously discussed HB 3412 here. HB 2696 establishes the State Board of Sign Language Interpreters under the Health Licensing Office, giving the Board the authority to license sign language interpreters.
These rules amendments include removing PAs from the WCD’s existing "Type B" attending physician category, instead categorizing them as "Type C" attending physicians, so that they may serve as attending physicians for up to 180 days (rather than the current 60 days or 18 visits). The amendments also specify that all sign language interpreters must be licensed by the Health Licensing Office under HB 2696. These rule changes take effect January 1, 2024, which is also the effective date for HB 3412.
More public policy actions
As a reminder – for more information on these policy developments and others we have been tracking this year, be sure to visit our Legislative and Regulatory Tracker. Bills or regulations can be filtered by insurance line, topic, status and jurisdiction.
