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Regulatory Review
Alaska
Annual Reports, SIF Contributions
Alaska Statute 23.30.155(m) requires that each insurer or adjuster file an annual report with the Alaska Workers’ Compensation Board providing all compensation activity for the previous year. The report is due on or before March 1. Insurers (or their claims adjusters), uninsured employers, or self insured employers must also submit payment of their Second Injury Fund contributions and their Workers’ Safety and Compensation Administration Account fees.
SIF contributions are assessed against each claim, based on the year of the injury and the SIF contribution rate in effect at that time. SIF contributions are paid on all claims, irrespective of whether SIF reimbursement is currently being received on the claim. No SIF payment should be submitted for a claim where the SIF assessed amount due is $20 or less.
Benefits Calculator
Pursuant to AS 23.30.220(b), the Division of Workers’ Compensation has updated its online benefit calculator to include payroll deductions for calendar year 2015.
Mileage
The Division of Workers’ Compensation increased the mileage reimbursement rate when a claimant is using a privately owned vehicle to obtain medical treatment within Alaska to $0.575 per mile. The change was effective Jan. 1. The revised POV rate table is available online. For out-of-state mileage reimbursement, parties should use the U.S. General Services Administration POV Rate Table.
COLAs
The Department of Labor and Workforce Development issued a COLA list for the period of Jan. 1, 2014 to Dec. 31, 2016. The cost of living for Alaska is the average cost of living for Anchorage, Juneau, and Fairbanks. If a recipient does not reside in a location listed on the COLA ratio list, the cost-of-living ration for the location nearest the recipient’s residence must be used. If the recipient lives in a location equidistant from two published locations, the ratio that results in the higher compensation rate must be used. The Division of Workers’ Compensation has contracted with Northern Economic Research Associates to produce COLA survey for locations outside of the United States. For an out-of-country COLA determination, requests should be sent to Division of Workers’ Compensation, Attn: Administrative Manager, 3301 Eagle Street, Suite 304, Anchorage, AK 99503-4149. If an employer or recipient wishes to dispute a COLA rate, it may petition the Alaska Workers’ Compensation Board for a hearing, in accordance with AS 23.30.110 and 8 AAC 45.138(g).
Compensation Rates
The Division of Workers’ Compensation announced new maximum and minimum compensation rates for 2015. The maximum compensation rate under AS 23.30.175(a) is 120 percent of the Alaska AWW, which is $1,159. The minimum compensation rate under AS 23.30.175(a) is 22 percent of the maximum compensation rate, which is $255. The maximum compensation rate under AS 23.30.041(k) is 105 percent of the Alaska AWW, which is $1,014.
Rate Tables
The Division of Workers’ Compensation announced that it will no longer be producing rate tables but will post a manual worksheet for 2015 on its website.
California
Ambulance Services
The Division of Workers’ Compensation adopted an order adjusting the ambulance services section of the official medical fee schedule to conform to changes in the Medicare payment system as required by Labor Code Section 5307.1.
The changes were effective Jan. 15 for ambulance services paid for under the California workers’ compensation official medical fee schedule. The adjustment incorporates the 2015 ambulance inflation factor which has been announced by the Centers for Medicare and Medicaid Services. The ambulance inflation factor for calendar year 2015 is 1.50 percent.
Qualified Medical Evaluators
The Division of Workers’ Compensation is accepting applications for the qualified medical evaluator examination on April 25. QMEs are independent physicians certified by the DWC Medical Unit to conduct medical evaluations of injured workers. Applications for the QME exam may be downloaded from the DWC website. Applicants may also contact the Medical Unit at 510-286-3700 to request an application via U.S. mail, email or fax. The deadline for filing the exam applications is March 12. For more information, contact the Medical Unit at (510) 286-3700 or by email at [email protected].
Connecticut
Fee Schedules
The Workers’ Compensation Commission issued a new facility fee schedule for the treatment of injured workers. The schedule is effective April 1. The hospital inpatient rate is set at 174 percent of the Medicare rate payable to that facility on the date of service. The hospital outpatient and hospital-based ambulatory surgery rate is set at 210 percent of the Medicare rate payable to that facility on the date of service. The non-hospital based ambulatory surgery rate is set at 195 percent of the hospital-based outpatient Medicare rate payable in the same Core Based Statistical Area on the date of service. Where there is no Medicare rate for the procedure in an outpatient hospital setting, the parties must negotiate the reimbursement rate.
If negotiation is not successful, the parties may request a hearing with the commission; however, treatment shall proceed while the matter is pending.
Mileage
The Workers’ Compensation Commission increased the mileage reimbursement rate for all travel expenses incurred on or after Jan. 1 to 57.5 cents per mile. The rate change applies to all claimants, regardless of injury date, and coincides with the federal mileage reimbursement rate pursuant to Section 31-312(a) of the Workers’ Compensation Act.
