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The latest legislative and regulatory activity that impacts you and the services we provide

Policy Matters Brief - November 20, 2024

November 20, 2024 · Public Policy & Regulatory Affairs Team

Alaska Workers’ Compensation Fees for Medical Treatment & Services Amended

The Department of Labor and Workforce Development and the Alaska Workers’ Compensation Board posted an order amending the material utilized for fees for medical treatment and services. The effective date is October 1, 2024, of the material described below:

International Classification of Diseases, 2025 edition, valid October 1, 2024, through September 30, 2025, published by the American Medical Association.

Further details can be viewed online here.

Alaska Workers’ Compensation Board Second Independent Medical Examiners

The Alaska Department of Labor and Workforce Development and the Alaska Workers’ Compensation Board posted a bulletin containing a list of second independent medical examiners effective November 1, 2024. Further details can be viewed online here.

California Workers’ Compensation updates the Notice to Employees Poster

The Division of Workers’ Compensation (DWC) posted an updated DWC Form 7 (Notice to Employees—Injuries Caused By Work) on its website. The updated Form 7 contains additional information required by Assembly Bill 1870, as enacted in 2024, which amended Labor Code section 3550(d)(4) to require notice to injured workers that: (1) they may consult a licensed attorney to advise them of their rights under workers’ compensation laws; and (2) in most instances, attorney’s fees will be paid out of what they recovery as a result of their claims. The amendment to Labor Code section 3550 becomes operative on January 1, 2025.

The form is available at no charge by downloading it here .

California Workers’ Compensation Pathology & Clinical Laboratory Fee Schedule Adjusted

The DWC posted an order adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2024 changes in the Medicare payment system. The order adopts the Medicare 2024 Quarter Four update to the Pathology and Clinical Laboratory Fee Schedule.

The OMFS adjustment is effective for services rendered on or after October 1, 2024. More information can be found here .

New York Emergency Adoption and Proposal of Amendment to Title 12 of NYCCR, Section 329-1.2 (Physical Therapy Assistants and Occupational Therapy Assistants)

New York Governor Kathy Hochul recently signed an amendment into law allowing occupational therapy assistants and physical therapy assistants (under the supervision of a board-authorized occupational or physical therapist) to treat injured workers in the New York State workers' compensation system. This amendment to Section 13-b of the Workers' Compensation Law takes effect on October 27, 2024.

The Notice of Emergency Adoption and Proposed Rule Making will be published in the November 13, 2024, edition of the State Register. Comments on the revised proposal will be accepted for 60 days after publication. Please submit comments by emailing regulations@wcb.ny.gov.

New York continues to move forward with workers’ compensation eBilling requirements

The New York Workers’ Compensation Board (WCB) recently issued an updated bulletin outlining coming steps in the move forward towards eBilling. The bulletin Reminder: CMS-1500 submission requirement for health care providers provides additional information on how New York medical providers will be required to electronically submit their bills to the WCB. Starting on August 1, 2025, the WCB will require health care providers to contract with an electronic submission partner to submit the CMS-1500 universal medical billing form electronically on their behalf. This new requirement will allow for faster payments, greater accuracy and efficiency, as well as improve injured workers’ access to timely, quality medical care. Training for providers and payers will be available in the coming months.

The WCB will not act on or enforce payment of a paper CMS-1500 form submitted on or after August 1, 2025. Although forms submitted prior to that date will continue to be processed, providers are encouraged to switch to electronic submission well in advance. More information on the CMS-1500 project can be found here.

Washington adopts rule making Naloxone as over the counter

On October 11, the Washington State Pharmacy Quality Assurance Commission adopted emergency rule WSR 24-21-069 for OTC 3mg and 4mg naloxone hydrochloride nasal spray. This permanent rule took effect on November 11, 2024. Published in the Washington State Register as an adopted revision to section WAC 246-945-034, the rule can be found here.

Additional Optum resources:

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.

If you have questions on these or any other public policy developments, please contact our team at OptumWC.PolicyMatters@optum.com.

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