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CLIENT ALERT: Bureau of Workers' Compensation Budget Amends Law

Client Alert
December 20, 2017

As we head into 2018, you should be aware of some recent changes made in Ohio’s laws concerning Workers’ Compensation. These changes became effective September 29, 2017.   Some will affect business more than others, but these are changes you should really know about. 

>A notice of intent to settle can be filed by the Injured Worker or Employer within thirty (30) days of receipt of an order being appealed (or, apparently which could be appealed), or the Industrial Commission’s refusal to hear an appeal. If filed, this filing extends the time for filing an appeal to Court to one-hundred and fifty (150) days (unless the other party files an objection to the notice within fourteen (14) days of receipt). This provision may assist parties in settling claims before invoking judicial machinery.

>Changes increased Injured Worker Attorney fees from $4,500.00 to $5,000.00.

>The BWC medical section is required to schedule a medical examination to determine the employee’s continued entitlement to initial compensation no later than thirty (30) days following the initial consecutive ninety (90) day period.   While the BWC may waive the scheduling of a medical examination for “good cause,” if the employee’s employer objects to the waiver, then the administrator will refer the employee to the bureau medical section to schedule the examination or the administrator will schedule the examination.

>Section 4123.56(E) provides that if an injured worker is awarded temporary total disability compensation before the full weekly wage is determined, s/he will be compensated at the statewide average weekly wage rate.  Discrepancies will be accounted for and adjusted once the full weekly wage is calculated.

>A Permanent Partial Disability Application (C92) will be dismissed (without prejudice, which means it can be refiled if the statute has not already run) if the injured worker fails to respond to an attempt to schedule an examination by the bureau medical section or fails to attend a scheduled medical exam without notice or explanation.

>Various provisions amend sections which address fire fighter cancer presumption.  Changes to this the section, among other things, amend the fire fighter cancer presumption to permit rebutting the presumption by demonstrating that exposure to the carcinogen could not have caused that type of cancer.  Changes to this section also limit the presumption to situations where the fire fighter has not worked in hazardous duty for more than fifteen (15) years.  Other changes  permit a fire fighter to receive working wage loss if s/he has a scheduled claim for cancer contracted by a fire fighter.

>The time limit for filing a claim is reduced from two years to one year.  It is important to note, however, that the statute of limitations for occupational disease claims has apparently not changed.

>Also, while not a legislative change, an important new medical rule goes into effect January 1, 2018.  A section of the Ohio Administrative Code will be enacted, which covers Lumbar Fusions.  Under this new rule, before approving lumbar fusion surgery, certain medical criteria generally must be met.

For more information about the law changes or other employment, labor and workers' compensation matters, contact Richard L. Williger

Workers' Compensation
Client Alert

The Ohio Board of Pharmacy’s Latest Batch of Rules: What Providers Should Know

January 15, 2024The Ohio Board of Pharmacy released several new rules and proposed amendments to existing rules over the past month that will significantly impact pharmacy operations. Topics range from updates to the Terminal Distributor of Dangerous Drugs license to mobile clinics to mandatory rest breaks for pharmacists of outpatient pharmacies. A summary of the proposed changes is below, along with instructions for commenting on the rules. Your BMD healthcare attorney can help write comment letters and submit the comments on your behalf as well.Client Alert

Employee or Independent Contractor? New Guidance Issued by the Department of Labor

January 10, 2024On January 9, 2024, the U.S. Department of Labor (DOL) issued its long-awaited final rule — effective March 11, 2024 — revising its prior interpretation of worker classifications under the federal Fair Labor Standards Act (FLSA). The new final rule rescinds the standard previously established in 2021, in turn, shifting the analysis of whether a worker is an employee (versus an independent contractor) of a business from a more streamlined “economic reality” test to a more complex “totality of the circumstances” standard.Client Alert

Increased Medicaid Rates to Take Effect This Month for Ohio Providers

January 5, 2024As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024.Client Alert

Corporate Transparency Act Update

December 27, 2023The Corporate Transparency Act (“CTA”), with an effective date of January 1, 2024, is set to impose strict reporting guidelines on business owners throughout the country. The following provides a brief update on two aspects of the CTA ahead of its effectiveness next week.Client Alert

The Second Wave of UnitedHealthcare's Prior Authorization Cuts Started in November

December 11, 2023In August 2023, UnitedHealthcare released its plan to eliminate roughly one-fifth of its then-current prior authorization requirements. The first round of prior authorization cuts took effect on September 1, 2023. In that round, UnitedHealthcare eliminated the necessity for some prior authorizations for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plan members. The second and final round of prior authorization cuts began on November 1, 2023. The November 2023 Prior Authorization Cuts apply to the same plans as well as community plans (i.e., Medicaid managed care plans).
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