Get These 2021 Workers’ Comp Legal and Regulatory Trends on Your Radar Today

The National Comp panel on workers' comp legal and regulatory trends is sure to shed a light on what's in store for the industry in 2021 and beyond.
By: | October 13, 2020

From drug formularies, presumption laws and opioids, to telemedicine, gig workers and more, the legal/regulatory landscape is always changing for the workers’ compensation industry.

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In the tumultuous year that has been 2020, never has the question of “What comes next?” been more prevalent. Workers’ comp teams across the country have had to pivot as the need to protect workers and provide solutions for the COVID-19 pandemic rose in priority.

So, what comes next? How will 2020’s events and regulations impact the legal landscape of tomorrow?

Lisa Anne Bickford, director of government relations for Coventry; Mark Pew, senior vice president, product development & marketing for Preferred Medical; and Don Lipsy, AVP, managed care government relations for Sedgwick Claims Management Services, Inc. aim to look at the trends that should be on every comp professional’s radar. 

On Oct. 21, the virtual National Workers’ Compensation and Disability Conference will present the session, “Workers’ Comp Regulatory and Legislative Trends that Belong on Your Radar for 2021,” in which these three workers’ comp leaders will detail some of the key items to watch as we move into next year.

In the one-hour discussion, attendees will gain actionable knowledge about core issues the industry is trying to tackle or will have to tackle in the years to come.

“For those that don’t closely follow trends or cannot pay attention to the constant legislative and regulatory churn, I’m confident our dialogue will help prepare everyone for some broad and challenging subjects going into 2021,” Pew said.

“My hope is that session attendees can use that knowledge as a springboard to start a conversation in their organizations about what’s next and how they will address these topics,” added Lipsy.

Here’s a preview of what the speakers will have to say:

A Top 2021 Trend: Telemedicine

It goes without saying that 2020 has certainly driven up the need for telecommunication. As businesses shut down and workers moved to home offices, Zoom calls and video conferencing became the norm.

So, too, did telemedicine.

Mark Pew, senior vice president of product development and marketing, Preferred Medical

“Work comp, and in reality all of health care around the planet, have seen an exponential acceptance of telehealth due to COVID-19. That goes from payers being willing to pay for it, to providers willing to be part of it, to patients being willing to do it,” Pew said.

That has made “telemedicine the trend to watch,” Bickford added.

She explained that, at Coventry, the company’s bill review volume during COVID skyrocketed. The team saw bills rise from 230 telemedicine bills per day in March to 5,300 bills per day in May. That, Bickford said, represented an increase of 3,433%.

Moving into 2021, the panelists agree that the acceptance of telemedicine is likely to grow, despite previous hesitations.

“One of the key reasons why broad acceptance was not as robust pre-COVID was questions as to its efficacy. Could treatment being provided virtually be as clinically and cost-effective as in-person? Nobody knew,” Pew said.

Now, there is more insight into the effectiveness of such care. Telemedicine is being used to fill the gap of a traditional workers’ comp visit as injured workers choose to avoid in-person contact to prevent the spread of COVID-19. This is one trend that many in the workers’ comp industry will want to keep a pulse on, especially as the regulations around it update to match its growing popularity.

“We are already seeing many states move from emergency regulations that broadened the scope of telehealth/telemedicine to codify those expanded allowances through work comp regulation or legislation,” Lipsy said.

Other Areas to Keep an Eye On

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In addition to telemedicine, the National Comp panelists are excited to discuss several other legal/regulatory hot topics that are sure to become top-of-mind in 2021.

“Many have said, ‘as California goes, so goes the nation,’ and workers’ comp is no exception,” Bickford said. Attendees can expect a deeper dive on some of the key issues that have surfaced in California and are also being seen in other states.

For instance, the issue of COVID-19 presumptions will be a big one the panelists will address. “California’s recently-passed presumption statute, SB 1159, which was just enacted on September 17, takes a novel approach to determining whether a presumption of work-relatedness exists for COVID exposure by statutorily defining an ‘outbreak,’ ” Bickford explained.

Additionally, she expects more industry focus will be placed on California’s ABC test, which determines whether a worker is an employee or an independent contractor, as we move into 2021.

Don Lipsy, AVP, managed care government relations, Sedgwick Claims Management Services, Inc.

The biopsychosocial model is another area to watch as its popularity continues to grow in workers’ comp. The idea behind this model is that injured worker should be looked at holistically, from a biological, psychological and social standpoint.

“I’ve seen gradual, generational and geographical acceptance of the biopsychosocial model in workers’ comp,” said Pew, who has been advocating for adoption since as early as 2011. For him, the personalization of mental health and mental resilience encourages a focus on whole-person treatment. During the session, he will expand on this idea, as well as discuss why he believes this is the case.

“Where biopsychosocial is going to evolve to in 2021 and beyond is going to provide the most long-term excitement,” Lipsy added. “When we talk about anything behavioral health, we are not only touching on something that impacts everyone, we are talking about conditions that are the anthesis of what workers’ comp was built to address and has managed successfully for decades.”

So… What Comes Next?

With an eye on the future, the workers’ comp industry must keep abreast of the legal/regulatory changes coming its way.

“As with all of our other subjects, COVID-19 has made agility one of the key differentiators for business leaders. Those that can embrace the ‘new normal’ — there is no return to the ‘old normal’ — will thrive,” Pew said.

Looking forward, the comp industry must have an eye toward innovation in order to meet the needs of legal/regulatory changes. As one example, Pew said “the battle over employee classification, regardless of final decisions, will be an opportunity for innovation in work comp.”

Likewise, comp professionals wanting to keep in tune should continue to read and listen to their local government affairs and compliance liaisons.

“Lisa Anne, Mark and so many other incredibly sharp people are at the forefront of our industry in terms of helping shape the conversation and (eventually) the laws around what makes up the short- and long-term of workers’ compensation,” Lipsy said.

Lisa Anne Bickford, director of government relations, Coventry

“The issues have a habit of changing or being cyclical, but being watchful of what legislative and regulatory activity is ongoing and participating in that activity is a great way for people to help drive our industry forward.”

Bickford agreed: “Get involved with what is happening in the states!” she emphatically said. “The topics we discuss in the session are all impactful.”

She anticipates attendees will leave this session with a better understanding of the explosive growth of telemedicine, as well as an understanding of recent developments in the pharmacy sector and the concurrent rise in the adoption of the biopsychosocial model. &

Autumn Heisler is the content strategist at Risk & Insurance®. She can be reached at [email protected]

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The R&I Editorial Team can be reached at [email protected]