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Work Comp News

Check back here frequently because workers comp is like Texas weather - it will change every 5 minutes!


TEXAS

Texas Department of Insurance Office of Workers Compensation changes the medical dispute resolution process.  Effective June 1, 2012, you will now have to utilize the benefit review conference/contested case hearing process.  Watch for notifications from TDI on when your hospital's training is scheduled. 


COLORADO

The new guidelines for COWC fees are in effect beginning January 1, 2011. The new rules incorporate the unit values posted in the 2010 Relative Values for Physicians (RVP) dataset which is authored by Relative Value Studies, Inc.

Specific rules established by the Colorado Division of Workers Compensation are published in RULE 18 and override any guidelines put forth by Relative Value Studies, Inc. herein. RULE 18 may be downloaded from:
http://www.coworkforce.com/dwc/Rules/Rules%20of%20procedure.asp.

Click on Proposed/Adopted Rules/Notices of Rule Hearings link. You will find the updated Rule 18 located under the Adopted Rules heading.


NEVADA

Nevada’s new fee schedule effective February 1, 2011

http://dirweb.state.nv.us/WCS/2011mfs.pdf

The 2011 MFS includes increases per the 2010 medical consumer price index (up 3.4%) and also includes a new trauma activation fee.


CALIFORNIA

The new California rules require payers to be able to accept electronic medical bills and their related attachments in 18 months. The rules also mandate changes to paper billing practices and data capture requirements within 6 months of the effective date, or October 15, 2011.

Start your process now.  In Texas, many providers had challenges meeting the deadlines and being able to attach documentation to their initial billing which resulting in not being able to bill electronically.  Because Texas took the stance all you had to do was be “able” to bill electronically, providers were exempt from penalties for not conforming to the rule.  It has yet to be determined how California will address this issue assuming there are the same challenges.

http://www.dir.ca.gov/dwc/DWCPropRegs/Ebilling/Guide_CompanionGuide/MedicalBillingPaymentGuideFinal_Final.pdf