Legislative Updates

Resources Legislative Updates

StateWatch: Bill Review May/June 2019

Posted by Genex on May 23, 2019

Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the bill review services Genex provides.

Click here to download the PDF.

 

CALIFORNIA

The Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) posted a progress report on the department’s Independent Bill Review (IBR) program. The “2018 Independent Bill Review (IBR) Report: Analysis of 2013-2017 Application Filings” summarizes the activity of an essential component of SB 863, providing an evaluation of the program during the first five years following its enactment. The report accounts for all applications filed to dispute payments not resolved through second bill review during this period.

Highlights of the report include:

  • The number of IBR applications received averaged 165 filings per month
  • Seven of 10 decided cases resulted in additional payment for the provider
  • Nearly $12.3 million was awarded in overturned case decisions

MARYLAND

The Workers’ Compensation Commission has published a notification regarding Ambulatory Surgical Center implants. Effective June 1, the surgeon should include the number of implants and type of implants at the end of the operative notes when submitting the claim in a separate paragraph.

MASSACHUSETTS

The Executive Office of Health and Human Services has adopted the proposed adjustments to 101 CMR 310.00: Adult Day Health Services, effective May 1.

WATCHLIST: The 101 CMR 350.00 Home Health Services Fee Schedule update has been proposed and if adopted will go into effect June 1.

OHIO

The Bureau of Workers’ Compensation has posted adjustments to the Ambulatory Surgical Center and Outpatient fee schedules, effective May 1.

WASHINGTON

The Department of Labor and Industries has made the decision to cover acupuncture services under certain conditions. The changes will take effect June 1.

 

   

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