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Summary of 2011 Pending Legistlation

By Douglas Meagher - Kopka Pinkus Dolan & Eads
| Date: 03/01/2012

The following is a summary of bills pertaining to the Indiana Worker’s Compensation system that have been introduced in this session of the General Assembly. The most notable provisions of the legislation address provider fee claim issues and are included in this summary. Action by the originating body of the General Assembly must be completed by March 1, 2011 so that the opposite body may consider the legislation.

2011 Worker’s Compensation Legislation

Senate Bill No. 576

    Requires that all members of the Worker’s Compensation Board (Board) be attorneys in good standing admitted to the practice of law in Indiana.

  • Renames the position of executive secretary executive administrator.
  • Requires a health care provider to file a claim for payment with the Board not later than one year after the last date the provider provided services to an injured or disabled employee.
  • Requires the Board to establish a schedule of fees and charges for the resolution of health care provider claims.
  • Allows the second injury fund to be used to pay certain fund liabilities.
  • Authorizes the Board to resolve claims using mediation.
  • Requires an employer to provide a copy of an injury report to the Board upon request.
  • Requires an injury report within seven days after the first day of a disability arising from a work place injury (rather than the occurrence of the injury).
  • Increase civil penalties for failure to: (1) post certain notices; (2) file certain records; and (3) determine liability for claims in a timely manner.
  • Permits the Board to request evidence of worker’s compensation and occupational diseases compensation coverage from an employer.
  • Establishes a civil penalty of $50 per employee per day for an employer’s failure to provide proof of coverage.
  • Requires the Board to waive a civil penalty assessed whenever an employer provides proof of coverage by the twentieth day after the Board provides written notice of the employer’s failure to provide evidence of the coverage.
  • Allows the Board, after notice and a hearing, to post on the Board’s web site the name of an employer who fails or refuses to provide proof of coverage or pay a civil penalty assessed for the failure or refusal to provide coverage.
  • Provides that an employer’s name may not be removed from the Board’s web site until the employer provides proof of coverage and pays the civil penalties assessed.
  • Requires that civil penalties be deposited in the worker’s compensation supplemental administrative fund, instead of the state general fund.
  • Removes outdated references to infractions and criminal penalties. Makes confirming and technical corrections.

Senate Bill No. 574

  • Requires a health care provider to file a claim for payment with the Worker’s Compensation Board (Board) not later than two years after the last date the provider provided services to an injured or disabled employee.
  • Amends the definition of “pecuniary liability” applying to the responsibility of an employer or insurance carrier to recognize that the charge for services or products provided after June 30, 2011, by a medical services facility is equal to 200% of the amount determined using the Medicare program reimbursement methodologies, models, and values or weights, including the coding, billing, and reporting payment policies in effect on the date a service or product is provided.
  • Increases benefit amounts for injuries and disablements occurring on and after July 1, 2011.
1-10 $1,540.00
1-35 $1,760.00
36-50 $2,970.00
50-100 $3,850.00

 

Maximum AWW: $1,075.00
Maximum TTD: $716.70
Maximum Award: $360,000.00

House Bill No. 1485

  • Sets limitations on the pecuniary liability for a medical services facility for purposes of the worker’s compensation law.
  • Prohibits a medical service facility from collecting payment for medical care.
  • Requires the Worker’s Compensation Board to annually approve the most recent Medicare fee schedule, not later than December 31 each year, to determine the pecuniary liability of a medical services facility.
  • Allows a medical services facility to request an explanation from a billing review service if the medical services facility’s bill has been reduced as a result of the application of a Medicare coding change.
  • Requires an employer required to carry worker’s compensation insurance to pay an annual $2 filing fee.
  • Makes a technical correction.
  • Removes an outdated reference.

Senate Bill No. 164

  • Provides than an employee who knowingly or intentionally makes a false statement of independent contractor status to the department of state revenue commits a Class D felony.
  • Provides that an employer or employee shall not classify an employee as an independent contractor for the sole or primary purpose of avoiding the worker’s compensation law, and that a violation is a Class A infraction.
  • Provides that a person who makes a false representation that an employee is an independent contractor for the purpose of avoiding the unemployment compensation law commits a Class C misdemeanor.
  • Makes technical corrections.
  • Makes confirming amendments.

Senate Bill No. 170

  • Requires a local government unit that employs an individual as a police officer, county police officer, or sheriff who is disabled in the line of duty to offer to provide and pay for certain health coverage for the individual and the individual’s spouse, surviving spouse, and certain children.

Senate Bill No. 370

  • Exempts worker’s compensation benefits received from other states from the claims of creditors. Increases the bankruptcy exemption for intangible personal property from $300 to $1,200.