State of the States November 18, 2023

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A California-based nationwide insurance broker announced they expect favorable developments for workers’ compensation insurance going into 2023

NationalCalifornia-based insurance brokers Woodruff Sawyer announced they expect favorable developments for workers’ compensation insurance going into 2023. In their annual statement, the brokerage sees that “workers’ compensation remains the best-performing casualty line of insurance. It is increasingly vital to organizations’ overall insurance program structures, as many risk managers continue to leverage their workers’ compensation programs to generate insurer competition on tougher lines of insurance.” In response to profitable underwriting results, insurers cut rates on average of 1.2 percent; however, in many states, these rate reductions are much higher. Although long-term covid uncertainty does show some cause for concern, Woodruff-Sawyer emphasized that “the pandemic barely impacted insurers’ underwriting results.” While it is likely that rate decreases continue, turnover from the great resignation prompting greater numbers of new employees could increase the injury rate as previous studies show a higher risk of workplace injuries for employees in the first year on the job. 

National Council on Compensation Insurance (NCCI) researchers estimate that the average covid claim incurred a cost of $9,600

NationalNCCI researchers estimate that the average covid case incurred a cost of $9,600. Covid claim counts and losses decreased by more than half, with covid claim counts falling to 4% of all claims in 2021 from 11% in the prior year and total payments declining to 1% from 2%. These numbers include all covid related claims with a paid and/or paid+case benefit component for private carriers and state funds. The analysis does not include experience from self-insured employers or denial and expense-only claims. NCCI utilized data from 45 states and approximately 117,000 claim cases. Covid claims affected the healthcare sector heavily accounting for nearly 50% of all lost time claims and more than 20% of paid+case losses.

State lawmakers are looking to increase physician evaluation fees in the state workers’ compensation system


 injured-workers-pharmacy-blog-new-jerseyState lawmakers are looking to increase physician evaluation fees in the state workers’ compensation system. Via S3309 & 4832, legislators hope to increase physician evaluation fees from the current $600 reimbursement to $1000. If passed, the bills will take immediate effect. SS309 would also include a clause adding that psychologists, nurse practitioners, or licensed clinical social workers who provide psychological treatment may be compensated for generating a report or delivering testimony concerning treatment of the injured worker in their role as a treatment provider. The legislature is scheduled to convene in January of 2023. 

The Bureau of Workers’ Compensation updated their fee schedule as part of their annual review

injured-workers-pharmacy-blog-tennesseeAs part of its annual review, the state Department of Labor & Workforce Development - Bureau of Workers’ Compensation is tasked with updating the state workers’ compensation fee schedule. While no significant changes were observed in the fee schedule, the Bureau announced that it is now partnered with FAIR Health to assist in the analysis of their fee schedules. FAIR Health will provide rate tables, including rates for codes valued by Medicare and rates gap-filled for many services not priced by Medicare but have a formula set in the Bureau’s regulations. Officials with the Bureau emphasize that these updated codes should eliminate almost all calculations and confusion, ultimately reducing the volume of questions and disputes for the Medical Payment Committee. Comments regarding the proposed changes can be forwarded to the Bureau by November 22, 2022 at 4:30pm CST. 

 Legislators are working to extend workers’ compensation presumptions to members of the state’s national guard


injured-workers-pharmacy-blog-texas Legislators are working to extend workers’ compensation presumptions to members of the state’s national guard via HB90/SB155. Rep. Jared Patterson and Senator Joan Huffman pre-filed legislation which would reclassify national guard members as designated first responders in the Lone Star state. This move would allow national guard personnel to receive workers’ compensation presumptions, including PTSD and death benefits. In addition, the legislative proposals would require the Division of Workers’ Compensation (DWC) to expedite claims of national guard members. The reasoning for this initiative comes after a guardsman perished on duty, and no state benefits were available to the soldier’s family. While federal deployment to the border covers guardsmen in the event of injury or death, those on state-related deployment, where the Governor of Texas sends troops to the border, do not enjoy similar benefits. As such, Patterson and Huffman hope these proposals can close this benefit gap and provide for members of the national guard and their families. 

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