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Home > Agendas > 2008-2009 > Workers' Compensation Board

2008-2009 Regulatory Agendas

90-351
Workers' Compensation Board

AGENCY UMBRELLA-UNIT NUMBER: 90-351
AGENCY NAME: Workers’ Compensation Board

CONTACT PERSON: John C. Rohde, General Counsel, 27 State House Station, Augusta, Maine 04333-0027. Tel.: (207)287-7086

EMERGENCY RULES ADOPTED SINCE THE LAST REGULATORY AGENDA: None

EXPECTED 2008-09 RULE-MAKING ACTIVITY:

CHAPTER 1: Payment of Benefits
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §152(2-A)
PURPOSE: Update procedures regarding Board forms impacted by electronic filing of information.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 1: Payment of Benefits
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §152(2-A)
PURPOSE: Clarify coverage notification requirements.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 2: Section 213 Compensation for Partial Incapacity
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §213(2)
PURPOSE: To address the permanent impairment threshold.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 2: Section 213 Compensation for Partial Incapacity
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §213(4)
PURPOSE: To address the partial incapacity benefit limitation.
ANTICIPATED SCHEDULE: Fall 2008; Spring 2009
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 2: Section 213 Compensation for Partial Incapacity
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §213(2)
PURPOSE: To clarify the procedures for collecting permanent impairment data.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 2: Section 213 Compensation for Partial Incapacity
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §213(1)
PURPOSE: To clarify the procedures regarding extensions of benefits due to extreme financial hardship.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 3: Form Filing
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §152(2-A), §303
PURPOSE: To require electronic filing of payment and related information.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 4: Independent Medical Examiner
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §312
PURPOSE: To clarify procedural issues.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 4: Independent Medical Examiner
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §312
PURPOSE: To update fees and expenses and procedures.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 5: Medical Fee Schedule
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §209
PURPOSE: To update the medical fee schedule.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 5: Medical Fee Schedule
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §209
PURPOSE: To update facility fee section.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 6: Rehabilitation
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §217
PURPOSE: To update/clarify procedures related to rehabilitation.
ANTICIPATED SCHEDULE: Winter 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 7: Utilization Review, Treatment Protocols, Permanent Impairment
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §210
PURPOSE: Update utilization review procedures and guidelines.
ANTICIPATED SCHEDULE: Winter 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 7: Utilization Review, Treatment Protocols, Permanent Impairment
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §153(8)
PURPOSE: Establish a schedule for determining permanent impairment.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 8: Procedures for Payment
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §152(2-A)
PURPOSE: Update to conform with electronic filing requirements.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 9: Procedure for Coordination of Benefits
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §152(2-A)
PURPOSE: Update to conform with electronic filing requirements.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 12: Formal Hearings
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2); §315
PURPOSE: Update expenses.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 12: Formal Hearings
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2)
PURPOSE: Clarify procedures related to filing of Joint Scheduling Memo and Exchange of Information.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 14: Review By Full Board
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §320
PURPOSE: Update procedure for Board review of hearing officer decisions.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 15: Penalties
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2)
PURPOSE: Update process/procedure regarding section 324(2) penalties.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER 18: Examinations by Impartial Physicians Pursuant to 39-A M.R.S.A. §611
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §611
PURPOSE: Update expenses and fees.
ANTICIPATED SCHEDULE: Fall 2008
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys

CHAPTER ?: Worker Advocates
STATUTORY AUTHORITY: 39-A M.R.S.A. §152(2), §153-A(7)
PURPOSE: Worker advocate case management authority.
ANTICIPATED SCHEDULE: Winter 2008-09
AFFECTED PARTIES: Injured employees, employers, self-insured employers, insurance companies, third-party administrators, health care providers, attorneys