Legislative Updates

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StateWatch: Bill Review September 2017

Posted by Genex on September 14, 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 state’s Division of Workers’ Compensation (DWC) has recently dismissed nearly 300,000 unresolved liens by claimants who did not properly file the required forms. Dismissed liens can be found through a searchable database on the DWC website.

WATCHLIST: The DWC has issued modified proposed regulations to adopt a Medical Treatment Utilization Schedule Drug Formulary as called for by Assembly Bill 1124.


Gov. Scott’s recent state of emergency declaration for Hurricane Irma enacted statute section 252.358, which requires all health insurers to allow prescription medication coverage during a natural disaster. This statute also waives the “refill too soon” edits to pharmacies and enables insureds or subscribers to refill prescriptions in advance. This mandate remains in effect until the Governor’s Executive Order is rescinded or expires.


The Rhode Island Department of Labor and Training has updated its Medical Fee Schedule guidelines and rates. The new rates became effective Sept. 1.


WATCHLIST: The Department of Labor and Workforce Development has released a notification regarding the implementation of Electronic Medical Billing (e-billing). The changes are scheduled to go into effect Jan. 1, 2018.


Gov. Abbott’s recent disaster proclamation following Hurricane Harvey is impacting workers’ compensation procedures in the state. In the event of disaster, workers’ compensation issues concerning hurricane victims or evacuees requires the processing and delivery of workers’ compensation be continued. This includes processing and delivery of benefit checks and necessary medical care, services, and supplies, including physical therapy, pharmaceutical benefits, and medical equipment. Also, timely workers’ comp filing requirements have been lifted for 50 counties affected by the disaster.


The new medical fee schedule has been posted and will be effective Jan. 1. Updates have been made for health care providers, hospitals, and ambulatory surgery center.


The Department of Labor & Industries (L&I) has updated rule language for prescription drugs and interchangeable biologics. The changes went into effect Sept. 1

L&I also announced that effective Oct. 1, negative pressure wound therapy for home use will only be covered for care of a condition accepted on or related to a claim.

In addition, L&I’s medical treatment guidelines for foot and ankle diagnosis/treatment have been updated and expanded. The new guidelines take effect Oct. 1.


WATCHLIST: The state is proposing an update to its medical fee schedule, which includes clarification of reimbursement rules for repackaged and compound prescription drugs as well as increases in ambulance service rates. If adopted, these changes will be retroactively effective July 1.


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