Legislative Updates

Resources Legislative Updates

StateWatch: Bill Review May 2017

Posted by Genex on May 30, 2017

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.

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The Centers for Medicare and Medicaid Services has posted updates for the Healthcare Common Procedure Coding System (HCPCS) ‘C’ and ‘G’ codes, effective April 1; and other codes (other than ‘C’ and ‘G’ codes) effective July 1.



WATCHLIST: On April 10, the Alabama Department of Labor posted Revision 1 for ambulatory surgery centers (ASC) and hospitals.



WATCHLIST: On April 27, the Industrial Commission of Arizona held a public hearing regarding proposed changes for the medical fee schedule. The proposed values for the fee schedule can be viewed here.


The Office of Administrative Law (OAL) has approved the Worker’s Compensation Information System (WCIS) Medical Billing, First Report of Injury (FROI), and Subsequent report of Injury (SROI) updated rules. The Electronic Data Interchange (EDI) Implementation Guide for Medical Bill Payment Records, Version 2.0, will go into effect Sept. 27. Reporting guidelines for the FROI and SROI will be effective March 27, 2018


WATCHLIST: Proposed changes regarding the prescription of opiates have been updated to the Mississippi’s Workers’ Compensation Guidelines.


WATCHLIST: The Montana Department of Labor and Industry posted the proposed documentation for the Professional Fee Schedule and the Facility Fee Schedule to become effective July 1. A public hearing on the schedules was held May 5.


The New York State Workers’ Compensation Board has released its Inpatient Payment Rates and Inpatient Chemical Dependency Detox Per Diem Rates. These rates went into effect Jan. 1. Also, the board updated its online FAQs for Dental, Pharmacy and DME fee schedules.


The Ohio Bureau of Workers’ Compensation recently updated its Hospital Outpatient, Cost-to-Charge Ratios, and ASC date files. The new regulations went into effect May 1.


The Oklahoma Workers' Compensation Commission has announced there will be no changes to the state’s medical fee schedule this year. However, rules may be added to address new or eliminated codes, the commission said.


Bulletin No. 359 was released by the state on April 11. This notice indicates which insurers and self-insured employers are required to report medical bill payment data to the state.


WATCHLIST: The South Dakota Department of Labor and Regulation held a public hearing regarding the proposed rule changes for this year’s fee schedule May 15. The division is now considering all written and oral comments it has received.


The Virginia Workers’ Compensation Commission has posted a timeline for implementation of its medical fee schedule. The commission will next meet June 13 to review fee schedules, ground rules, dispute resolution processes and supporting documents for final approval. The fee schedule is set to go in effect Jan. 1, 2018.


WATCHLIST: The state has posted a notice regarding the change to the Medical Requirements tables for the Washington EDI Version 1.2, effective March 1. Under the new changes, mandatory provision of the rule is now targeted and Medical EDI trading partners reporting is expected, but not mandatory. Also, changes to the requirements as indicated by the International Association of Industrial Accident Boards and Commissions (IAIABC) are included.

Genex will continue its implementation and testing with Washington as initially scheduled July 1.


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