O F F I C E O F L E G I S L A T I V E R E S E A R C H
P U B L I C A C T S U M M A R Y
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PA 23-32—sHB 6797
Judiciary Committee
AN ACT CONCERNING PL ANS FOR THE TREATMEN T OF
WORKPLACE INJURIES A ND ILLNESSES AND EST ABLISHING
WORKING GROUPS TO RE VIEW ACCESS TO MEDICAL RE CORDS
AND PARTIAL DISABILI TY PAYMENTS UNDER TH E WORKERS'
COMPENSATION ACT
SUMMARY: This act makes various changes affecting workers’ compensation
and related matters.
It requires the Workers’ Compensation Commission (WCC) chairperson, in
setting standards for approving employer or insurer medical plans, to include
whether the plan has an administrative process allowing employees to seek certain
information about the medical and health care services recommended by the plan’s
providers (e.g., their appropriateness and payment).
The act also requires the Judiciary Committee chairpersons or their designees,
by August 15, 2023, to convene two working groups. One group must review
medical records-related statutes and develop legislative recommendations on (1)
streamlining third-party record requests to health care providers in order to timely
get record copies and (2) setting reasonable fees for expenses when responding to
these requests, including requests for electronic records.
The second group must review the level of partial permanent disability
payments available to injured employees under the workers’ compensation laws.
This review must assess whether (1) existing laws adequately protect all injured
employees in the state and (2) the laws on benefit levels should change.
EFFECTIVE DATE: October 1, 2023, except the working group provisions are
effective upon passage.
§ 1 — WORKERS’ COMPEN SATION MEDICAL PLANS
Existing law allows employers or insurers acting for them to set up medical
plans to provide treatment for job-related injuries and illnesses for employees
receiving workers’ compensation. The plans must be approved by the WCC
chairperson, based on standards the chairperson sets in consultation with a medical
advisory panel.
The act requires these standards to include whether the plan has an
administrative process allowing employees, without limit, to seek a determination
on the (1) need for, or appropriateness of, the medical and health care services
recommended by the plan’s providers and (2) payment for these services.
Existing law also requires the standards to include, among other things, the
plan’s (1) ability to provide required services in a way that is timely, effective, and
convenient for employees and (2) inclusion of all service categories and enough O L R P U B L I C A C T S U M M A R Y
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providers for each type in accessible locations to ensure employees have adequate
choice.
§§ 2 & 3 — WORKING GROUPS
Under the act, the Judiciary Committee chairpersons, or their designees, serve
as both working groups’ chairpersons. Each group must meet at least monthly, and
at other times as necessary upon the call of the group’s chairpersons.
For both groups, member appointments (see below) must be made by July 12,
2023.
Medical Records Working Group Membership
Under the act, the medical records working group includes the chairpersons and
ranking members of the Judiciary and Public Health committees and the WCC’s
legal director, or their designees. The working group also includes the following
eight members, jointly appointed by the Judiciary Committee chairpersons or their
designees:
1. a representative of a national third-party medical records provider;
2. a representative of a national association representing third-party medical
records providers;
3. an attorney specializing in personal injury law;
4. an attorney specializing in workers’ compensation law;
5. a representative of a statewide bar association, representing attorneys; and
6. one representative each from three statewide medical-related associations,
representing hospitals, physicians, and medical specialty providers.
Partial Permanent Disability Benefits Working Group Membership
Under the act, this working group includes the chairpersons and ranking
members of the Judiciary and Labor and Public Employees committees and the
WCC’s legal director, or their designees. The group also includes the following five
members, jointly appointed by the Judiciary Committee chairpersons or their
designees:
1. two attorneys who specialize in representing clients appearing before the
WCC, one for claimants and one for respondents;
2. two representatives of attorney groups, one for a statewide bar association
and one for a statewide trial lawyers association; and
3. a representative of a statewide association representing in-state workers’
compensation insurers.
Reporting Requirement
By February 1, 2024, each working group must report on its findings and
recommendations. The medical records group must report to the Judiciary and
Public Health committees, and the other group must report to the Judiciary and O L R P U B L I C A C T S U M M A R Y
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Labor and Public Employees committees. Each group terminates when it submits
its report or on February 1, 2024, whichever is later.