Washington regulators weigh public input on medical networks, settlements

Medical providers can begin enrolling in Washington's new medical network. Meanwhile, the Department of Labor and Industries is finalizing rules to implement structured settlement agreements. Both changes came as a result of separate legislation enacted in 2011.

H.B. 2123 allows workers, employers, or regulators to initiate and negotiate structured settlements to resolve claims for certain injured workers age 55 and older. L&I recently held public hearings concerning rules to implement the legislation.

L&I is responsible for leading negotiations with State Fund employers who insure with L&I and their injured workers. Washington's State Fund is the seventh largest workers' comp insurer in the country, according to L&I.

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Next year, regulators will implement a workers' comp medical network, a result of Substitute S.B. 5801. Enrollment has just begun for physicians, chiropractors, naturopathic physicians, podiatric doctors, advanced registered nurse practitioners, physician assistants, dentists, and optometrists. Other provider types and those out-of-state can continue treating injured workers until they are invited to join the network.

Once the network has launched, injured workers may see a nonnetwork provider only for an initial visit. After that they must see a network provider, according to L&I officials. Providers outside the network cannot receive payment beyond the first treatment.

Regulators recently held a hearing to get public input on proposed rules developed in consultation with a special advisory group comprised of worker, employer, and provider representatives. The rules cover visits to nonnetwork providers -- what L&I can pay for and who can decide to reopen a claim.

Read more at the WorkersComp Forum homepage.

March 15, 2012

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