Legislative Session Concludes With No Agreement on Labor Omnibus Bill

As the Vermont legislative session came to a close a conference committee of the House and Senate failed to reach consensus on a labor omnibus bill.  The session ended with no action being taken.  The House and Senate each passed separate versions of a labor bill which included a change to the time allotted for notice to the injured worker for the discontinuance claims. Currently, when an employer or its carrier seeks to terminate benefits, it files a discontinuance (Form 27) and pursuant to 21 VSA 643(b), “The liability for the payments shall continue for seven days after the notice is received by the commissioner and the employee.”  The Senate version of the bill would have extended that to 14 days and added an additional seven-day extension to be granted upon approval of the Department of Labor Commissioner.  Additionally it mandated study committees on independent medical examinations and on lien recovery.  The Senate version of the bill is located at:

http://www.leg.state.vt.us/docs/2014/bills/Senate/S-129.pdf

The Vermont House’s version of the bill, included language that in the event of discontinuance a claimant may object to it and seek an additional seven day extension for benefits to continue. The extension needed to be specific as to a reason for the extension and the number of days of extension requested.  The bill also required that IME reports be sent to the employee at the same time it is sent to the employer. The House version of the bill is located at:

http://www.leg.state.vt.us/docs/2014/bills/House/S-129.pdf

 A number of groups, including the Vermont Chamber of Commerce cited the potential for increased cost to the entire workers' compensation system.  No agreement was reached before the session concluded but the bill will have further action next session.

Workers’ Compensation Benefits May be Paid by Direct Deposit or Prepaid Benefit Card Account

Effective July 1, 2013 if a claimant consents in writing, the carrier may pay the employee’s weekly temporary benefits by means of direct deposit or with an electronic prepaid benefit card account.  The statute states that prepaid benefit card accounts shall not be used to pay permanent impairment benefits or lump sum benefits.  The issuer of the card shall comply with consumer protection laws that apply to payroll account cards. 

The full text of the Act is located here: http://www.leg.state.vt.us/docs/2014/Acts/ACT006.pdf

Agency of Administration Submits Report on Integration of Workers’ Compensation With Health Care Reforms

 

The Agency of Administration Health Care Reform has submitted a report to the Vermont legislature on the Integration or Alignment of Vermont Workers’ Compensation System with Green Mountain Care. 

The report recommended that “Vermont should pursue greater administrative alignment of the workers’ compensation system with cost-reduction measures posed under the Vermont’s health care reform efforts and the Affordable Care Act. The research on the amount of potential savings through integration is conflicting, so integration should be considered only after a thorough analysis that is Vermont specific. Furthermore, integration would require Vermont to develop a monopolistic publicly funded workers’ compensation system, which it is not well-positioned to do at this time. Consideration of alignment is more appropriate after the new system is in place. In the meantime, administrative reform will preserve workers’ rights and the current workers’ compensation insurance market while potentially increasing savings for employers.” 

The text of the full report is here: http://hcr.vermont.gov/sites/hcr/files/2013/Act%2048%20Integration%20of%20Workers%27%20Compensation%201%2015%202013%20FINAL.pdf

Vermont Insurers Must Determine Existence of Medicaid Liens Starting July 1, 2013

 

Effective July 1, 2013, insurers shall take reasonable steps to discover whether the Department of Vermont Health Access has paid medical bills associated with workers’ compensation claims. 33 V.S.A. §1910 (b)(2). The legislation provides that the State of Vermont Human Service Agency has a lien against the insurer for monies paid for medical expenses on behalf of a person who has an injury, illness or disease and the person initiates a claim against an insurer for that injury, illness or disease. Additionally the legislation provides that “Payment to the recipient instead of the agency does not discharge the insurer from payment of the agency’s claim.” 33 V.S.A. §1910 (b)(2).  The statute is: http://www.leg.state.vt.us/statutes/fullsection.cfm?Title=33&Chapter=019&Section=01910

 

The Department of Vermont Health Access has written a memorandum on the insurer procedure for determining the existence of Medicaid Liens.  Most importantly the Department has noted that “the claim file should contain documentation (electronic, recorded language, typed or handwritten) to support the insurer's actions.”  The procedure sets forth that reasonable steps to determine the existence of such a lien include: (1) Asking the claimant or claimant’s representative at the beginning of the process by telephone, letter or electronic mail if he or she was a Medicaid recipient at the time of the injury.  If the answer is yes then the insurer should contact the Department of Vermont Health Access and refrain from payment until the lien is determined.  If the answer is no then the insurer must continue to review bills to determine if there is evidence that the Department of Vermont Health Access has paid bills on the claimant’s behalf and if so the insurer should determine the amount of the lien.  If not the insurer may proceed to resolve the claim; (2) An insurer may contact the Department of Vermont Health Access at any time to determine if a lien exists by contacting  the Department at: DVHATPLTeam@state.vt.us; by telephone at 802-879-5646; or by fax at 802-879-5959. The memorandum indicates that the insurer should document the claim files as to when and who was contacted at DVHA.  The memorandum concludes that if a lien exists the insurer must ensure reimbursement out of settlement proceeds by the claimant, the claimant’s representative, the insurer, or by naming Department of Vermont Health Access on monies paid to the claimant.  Then the claim may be closed and documentation of these actions protects the insurer from claims of bad faith or duplicate payment to the Department or the claimant.

The outreach document prepared by the Department of Vermont Health Access is located here: http://dvha.vermont.gov/budget-legislative/insurer-procedure-medicaid-liens.pdf