HB 1240 Workers' Compensation
This 2006 workers' compensation bill comes from the State Board of Workers' Compensation Advisory Council's Legislative Committee. The Legislative Committee is comprised of leaders from all aspects of workers' compensation--insurance, labor, medical, legal, small business, and business.
The Advisory Council's Legislative Committee met on several occasions throughout the year and discussed a number of issues. The Committee came to a consensus on the following amendments:
Amend O.C.G.A. §34-9-104:
This section has been modified slightly to make its wording consistent with the wording found in other sections. The prior language provided that the employee shall receive notice from the employer. The new language provides that the employer shall send notice to the employee.
Amend O.C.G.A. §34-9-203:
This section has been amended to clarify existing law regarding the time limit for submitting requests for mileage reimbursement to make it clear that the injured worker has one year from the date incurred to submit mileage expenses, just as medical provider must submit charges to the employer/insurer within one year of the date of service.
Amend O.C.G.A. §34-9-265:
This section has been amended to increase the maximum cap on death benefits from $125,000.00 to $150,000.00 for the surviving spouse who is the sole dependent at the time of an employee's death. This cap had not been raised since July 1, 2000. (These benefits are paid in a weekly amount, based on the weekly rate the injured worker would receive for Temporary Total Disability.)
Delete O.C.G.A. §43-1B-7:
This deletion removed the workers' compensation exception from the Patient Self-referral Act of 1993. The purpose of that Act, as expressed by the General Assembly, was to remove the potential conflict of interest that is raised when one health care provider refers a patient to a second provider for other health services where the first provider has a financial interest in the second provider. The intent was to address referral practices which "may limit or eliminate competitive alternatives in the health care services market…result in over utilization…...increase costs to the health care system…and adversely affect the quality of health care."
All provisions of Title 43-1B have now been if effect for 10 years, and apply to all health care providers. These activities are also governed by federal law. There are a number of exceptions to the provisions, including rural areas and instances where there is not another suitable entity or facility in the community. Additionally, the provisions do not apply to group practices and self-contained facilities.
Workers' compensation providers had been subject to one part of the provisions of Title 43-1B, but not all. The recommendation was that there was no reason to continue the exemption and that the rules governing treatment of all other patients should also apply when the provider is treating a workers' compensation patient.
HB 1405 (Subsequent Injury Trust Fund)
Although this legislation was not requested by the Board's Advisory Council, it is included in this summary because of its impact on the workers' compensation system. This legislation was requested by the Trustees of the Subsequent Injury Trust Fund (SITF) and places time limits on the employer/insurer for perfecting a claim and obtaining a reimbursement agreement with the SITF.
Amend O.C.G.A. §34-9-362:
Under the new provisions, for those notices of claim that were filed with the SITF on or before July 1, 2006, the employer/insurer shall have until June 30, 2009 to obtain a reimbursement agreement issued by the SITF or the claim for reimbursement shall be deemed automatically denied.
For those notices of claim that are filed with the SITF after July 1, 2006, the employer/insurer shall have three years from the date the notice was received by the SITF to obtain a reimbursement agreement issued by the SITF or the claim for reimbursement shall be deemed automatically denied.
For those cases where the compensability of the underlying workers' compensation claim is at issue before the State Board of Workers' Compensation, the employer/insurer shall have three years from the date of final adjudication of compensability (by the State Board of Workers' Compensation or any appellate court) to obtain a reimbursement agreement issued by the SITF or the claim for reimbursement shall be deemed automatically denied.