Workers Compensation Committee
Albany Update

Staff Contact: Ken Pokalsky
December 31, 2008

Executive Budget Issues

The proposed state Executive Budget for Fiscal 2010 contained no significant initiatives regarding the Workers Compensation Board or the states comp system. Overall, the budget proposes :

Also, as part of the proposed deficit reduction plan for the current fiscal year, the Administration has proposed to reconcile statutory language on how assessments are collected by carriers, and how these assessments are remitted to the Board. This clarification, which has been supported by some members of the insurance industry, would result in a one-time increase in state revenues of $50 million, with these funds to support the Boards reform efforts and to provide General Fund gap relief. (see S.249/A.162, Part K, pp.39 to 44).

Please feel free to contact me with any questions or comments regarding these or other Executive Budget issues.

WCB Forms

As reminder, the WCB is mandating use of revised C-2s (employer notice of injury) and C-3s (employee claim form) effective 1/1/09. However, the Board has delayed mandatory use of new C-4s by doctors until 4/1/09, to allow more time for integration of this new data requirement into their practices.

A list of all recently revised WCB forms are available on the Boards web site.

Proposed Dental Fee Schedule

The WCB has proposed a new fee schedule for dental care provided to workers compensation claimants, as required by the 2007 reform act. The 12/24/08 State Register notice, and proposed fee schedule, is available here. Comments are due February 9, 2009.

The fee schedule, which would be incorporated by reference into the Boards regulations, is separate and distinct from the states Medicaid dental fee schedules, with fees generally higher than state Medicaid rates. In effect, it will also replace the states no-fault fee schedule.

If adopted, the fees schedule would apply to treatments and procedures performed on or after March 1, 2009, regardless of when the claim was filed. Similar to the Boards pharmacy fee schedule, this proposal would allow a premiumof 25 percent above the adopted fee schedulefor services provided where a carrier has filed a notice of controversy regarding the claim. The proposed rule also would adopt a 45 day prompt payment requirement for undisputed bills submitted to a carrier.

Please contact me if you would like to discuss this proposal, or provide input to our rule review and comment effort.