Contents october 2013 I. Executive orders
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- Poverty Statement
- FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES RULE TITLE: Fee Schedule Update
- NOTICE OF INTENT Workforce Commission Office of Workers Compensation
- Title 40 LABOR AND EMPLOYMENT Part I. Workers Compensation Administration Subpart 3. Hearing Rules
- NOTICE OF PAYMENT, MODIFICATION, SUSPENSION, TERMINATION OR CONTROVERSION OF COMPENSATION OR MEDICAL BENEFITS
- FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES
| Family Impact Statement
Implementation of this proposed Rule should not have any known or foreseeable impact on any family as defined by R.S. 49:972(D) or on any family formation, stability, and autonomy. This proposed Rule shall not have any impact on the six criteria set out in R.S. 49:972(D). Poverty Statement Implementation of this proposed Rule should not have any known or foreseeable impact on poverty as defined by R.S. 49:973. Small Business Statement The impact of the proposed Rule on small business has been considered and it is estimated that the proposed action is not expected to have a significant adverse impact on small business as defined in the Regulatory Flexibility Act. The agency, consistent with health, safety, environmental and economic welfare factors has considered and, where possible, utilized regulatory methods in the drafting of the proposed Rule that will accomplish the objectives of applicable statutes while minimizing the adverse impact of the proposed Rule on small businesses. Public Comments Inquiries concerning the proposed amendments may be directed to: Director, Office of Workers’ Compensation Administration, Louisiana Workforce Commission, P.O. Box 94040, Baton Rouge, Louisiana 70804-9040. Interested parties may submit data, views, arguments, information or comments on the proposed amendment in writing to the Louisiana Workforce Commission, Office of Workers’ Compensation, P.O. Box 94040, Baton Rouge, Louisiana 70804-9040., Attention: Director, Office of Workers’ Compensation Administration. Written comments must be submitted and received by the Department within 20 days from the publication of this notice. A request pursuant to R.S. 49:953(A)(2) for oral presentation, argument or public hearing must be made in writing and received by the Department within 20 days of the publication of this notice. Public Hearing A public hearing will be held on Monday, November 25, 2013, at 9:30 AM at the Louisiana Workforce Commission Training Center, 2155 Fuqua St., Baton Rouge, LA 70802. Curt Eysink Executive Director FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES RULE TITLE: Fee Schedule Update I. ESTIMATED IMPLEMENTATION COSTS (SAVINGS) TO STATE OR LOCAL GOVERNMENT UNITS (Summary) In July of 2013, in accordance with LSA - R.S. 23:1034.2 and 1291, the Office of Workers' Compensation (OWC), Louisiana Workforce Commission (LWC) updated the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes in order to be consistent with the American Medical Association (AMA). In doing so, numerous codes were added and deleted. However, the rules associated with the Current Dental Terminology (CDT) and Physical Medicine (which references physical and occupational therapist codes) were omitted in the updates. The proposed rule will replace the obsolete rules and guidelines associated with the CDT and Physical Medicine codes. Also, in order to be consistent with the AMA, the proposed rule will delete duplicate codes, fix codes with incorrect pricing and add inadvertently omitted codes. The proposed rule change will have no impact on state or local government expenditures. All implementation costs associated with the proposed rule change have been factored into the department’s operating budget. II. ESTIMATED EFFECT ON REVENUE COLLECTIONS OF STATE OR LOCAL GOVERNMENTAL UNITS (Summary) There is no anticipated revenue impact on state or local government units. III. ESTIMATED COSTS AND/OR ECONOMIC BENEFITS TO DIRECTLY AFFECTED PERSONS OR NONGOVERNMENTAL GROUPS (Summary) The LWC anticipates that implementation of the proposed omitted codes, prices, and rules will provide for a more accurate account of what services were provided and allow billings according to a more precise medical determination. The department cannot determine whether workers' compensation costs will be higher or lower due to the proposed rule. IV. ESTIMATED EFFECT ON COMPETITION AND EMPLOYMENT (Summary) There is no anticipated direct effect on competition and employment.
NOTICE OF INTENT Workforce Commission Office of Workers' Compensation Notice of Payment, Modification, Suspension, Termination or Controversion of Compensation or Medical Benefits (LAC 40:I.6631) Notice is hereby given, in accordance with R.S. 49:950 et seq., that the Louisiana Workforce Commission, Office of Workers' Compensation, pursuant to the authority vested in the director of the Office of Workers' Compensation by R.S. 23:1310.1 and in accordance with applicable provisions of the Administrative provisions Act, proposes to amend LAC 40:I:6631. The proposed amendments alter the existing form LWC-WC-1002, which is the form by which payors currently report a Notice of Payment to the injured worker and the Office of Workers’ Compensation Administration (“OWCA”). The amendments to the current LWC-WC-1002 are made in accordance with La. R.S. 23:1201.1 (Act 337 of the 2013 Legislative Session). The new LWC-WC-1002 is more expansive and payors will use the form to report any initial payment, modification, suspension, termination or controversion of compensation or medical benefits to the injured worker and the OWCA. Title 40 LABOR AND EMPLOYMENT Part I. Workers' Compensation Administration Subpart 3. Hearing Rules Chapter 66. Miscellaneous Subchapter E. Forms §6631. Notice of Payment, Modification, Suspension, Termination or Controversion of Compensation or Medical Benefits EMPLOYER/PAYOR MAIL TO: 1. Employee Social Security No. ______ -_____-_______ OFFICE OF WORKERS' COMPENSATION 2. Payor Claim No.: POST OFFICE BOX 94040 3. Date of Injury/Illness BATON ROUGE, LA 70804-9040 4. Date of Notice: NOTICE OF PAYMENT, MODIFICATION, SUSPENSION, TERMINATION OR CONTROVERSION OF COMPENSATION OR MEDICAL BENEFITS 5. Purpose of Form (check one): Initial Payment ____ Modification ____ Suspension ____ Termination____ Controversion ____ 6. (a) Employee Name: Address: ______________________________________________ Telephone: ______________________________________________
Address: ____________________________________________________ Telephone: ___________________________________________________ Facsimile: ____________________________________________________ (c) Employer Name: ________________________________ Address: ____________________________________________________ _____________________________________________________ Telephone: ___________________________________________________ Facsimile: ____________________________________________________
employee each month; C. Reduced PTD___ TTD____ SEB_____ (check one) at the rate of $___________ due to employee’s receipt of (check applicable item): _____ Social Security Benefits at the rate of $______________ per _____________; _____ Other Workers' Compensation Benefits at the rate of $__________ per _________’ _____ Employer Funded Disability Benefits at the rate of $___________ per __________; _____ Unemployment Insurance Benefits _____ Third Party Recovery in the amount of $_______________ _____ 50% reduction of compensation based on Employee’s refusal to cooperate with Vocational Rehabilitation _____ Reduction due to child support order _____ Other (Describe): _____________________________________________________________________________________________________ D. Permanent Partial Disability (PPD) Benefits of $______________ per week payable for ____________ weeks. E. Death Benefits have begun in the amount of $ _________ per week, representing ______% of AWW. Employee Name __________________ Date of injury/illness________________ 11. Suspension/Termination Indemnity and/or Medical Benefits have been suspended/terminated due to: _____ Employee’s refusal to submit to a medical examination; _____ Employee’s refusal to execute a Choice of Physician form; _____ Fraud _____ Dispute over Compensability (Describe): _____ Employee’s refusal to return the form LWC-WC-1025 or LWC-WC-1020; _____ Released to return to work full duty; _____ Employee able to earn 90% of pre-accident average weekly wage; or ____ Other (Describe): 12. Controversion Employee’s rights to Indemnity and/or Medical Benefits are disputed and have been denied because Employer/Payor disputes: _____ Compensable Work Accident; _____ Compensable Injury; _____ Employment Relationship; _____ Causation; _____ Disability; _____ Fraud; _____ Jurisdiction; or ____ Other (Describe): 13. Notice Submitted By: Signature of Preparer: Printed name: Position/Affiliation: Telephone: Facsimile: Address: 14. Please provide the following information: Payor/Self Insured Employer Name: Telephone: Facsimile: Address: NOTICE OF DISAGREEMENT (to be completed by Employee/Employee Representative) MAIL TO: Employee Social Security No.: _______-____-________ The preparer for Employer/Payor Payor Claim No. (if known): at the address listed in Section 13 Date of Injury/Illness: of the LWC-WC-1002. Date of Notice of Disagreement: BASIS OF DISAGREEMENT 1. Average Weekly Wage is incorrect. The correct AWW amount is $______________. 2. The type of workers’ compensation indemnity benefits is incorrect. The correct type is PTD/TTD/SEB/PPD (circle one). 3. The amount/rate of workers’ compensation indemnity benefits is incorrect. The correct amount is $_________ per __________. 4. The basis for Employer/Payor’s suspension/termination/controversion of benefits is incorrect because (describe): ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________ 6. Notice Submitted By:
Telephone Address:
Employee Representative La. Bar Roll No. Address: Telephone: Facsimile: Signature Printed name:
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1310.1. HISTORICAL NOTE: Promulgated by the Department of Labor, Office of Workers' Compensation Administration, LR 25:286 (February 1999), amended by the Workforce Commission, Office of Workers Compensation, LR 40: Family Impact Statement Implementation of this proposed Rule should not have any known or foreseeable impact on any family as defined by R.S. 49:972(D) or on any family formation, stability, and autonomy. This proposed Rule shall not have any impact on the six criteria set out in R.S. 49:972(D). Poverty Statement Implementation of this proposed Rule should not have any known or foreseeable impact on poverty as defined by R.S. 49:973. Small Business Statement The impact of the proposed Rule on small business has been considered and it is estimated that the proposed action is not expected to have a significant adverse impact on small business as defined in the Regulatory Flexibility Act. The agency, consistent with health, safety, environmental and economic welfare factors has considered and, where possible, utilized regulatory methods in the drafting of the proposed Rule that will accomplish the objectives of applicable statutes while minimizing the adverse impact of the proposed Rule on small businesses. Public Comments Inquiries concerning the proposed amendments may be directed to: Director, Office of Workers’ Compensation Administration, Louisiana Workforce Commission, P.O. Box 94040, Baton Rouge, LA 70804-9040. Interested parties may submit data, views, arguments, information or comments on the proposed amendment in writing to the Louisiana Workforce Commission, Office of Workers’ Compensation, P.O. Box 94040, Baton Rouge, LA 70804-9040, Attention: Director, Office of Workers’ Compensation Administration. Written comments must be submitted and received by the department within 20 days from the publication of this notice. A request pursuant to R.S. 49:953(A)(2) for oral presentation, argument or public hearing must be made in writing and received by the department within 20 days of the publication of this notice.
A public hearing will be held on Monday, November 25, 2013, at 10 a.m. at the Louisiana Workforce Commission Training Center, 2155 Fuqua St., Baton Rouge, LA 70802. Curt Eysink Executive Director FISCAL AND ECONOMIC IMPACT STATEMENT FOR ADMINISTRATIVE RULES RULE TITLE: Notice of Payment, Modification, Suspension, Termination or Controversion of Compensation or Medical Benefits I. ESTIMATED IMPLEMENTATION COSTS (SAVINGS) TO STATE OR LOCAL GOVERNMENT UNITS (Summary) The proposed amendments alter the existing form LWC-WC-1002, which is the form that Payors (employers or entities responsible for payment of benefits by a claimant as a result of a work related injury) currently report a Notice of Payment, Modification or Suspension to the injured worker and the Office of Workers’ Compensation Administration (OWCA). The amendments to the existing LWC-WC-1002 are made in accordance with La. R.S. 23:1201.1 (Act 337 of the 2013 Regular Legislative Session). The new LWC-WC-1002 is more expansive so Payors will use the form to report any initial payment, modification, suspension, termination or controversion of compensation or medical benefits to the injured worker and the OWCA. The OWCA will not experience any additional expense due to the alteration of the form, including the capturing of expanded information, nor will it experience material savings from the use of the new form. The proposed form LWC-WC-1002 will be made available online, therefore no re-printing of the forms will be necessary. The Division of Administration indicates that the proposed rule will have no fiscal impact on the Office of Risk Management. II. ESTIMATED EFFECT ON REVENUE COLLECTIONS OF STATE OR LOCAL GOVERNMENTAL UNITS (Summary) The implementation of the new form LWC-WC-1002 will have no anticipated effect on revenue collections of state or local governmental units. III. ESTIMATED COSTS AND/OR ECONOMIC BENEFITS TO DIRECTLY AFFECTED PERSONS OR NONGOVERNMENTAL GROUPS (Summary) The proposed amendments update the existing LWC-WC-1002 form and no additional costs are anticipated. The Payor will be required to use the new LWC-WC-1002 form when there is any initial payment, modification, suspension, termination or controversion of compensation or medical benefits. The new form will require more detailed information than is required by the existing form. As a result, the new form may be more time consuming for Payors to complete. IV. ESTIMATED EFFECT ON COMPETITION AND EMPLOYMENT (Summary) There is no anticipated direct effect on competition and employment.
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