Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB724 Compare Versions

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Version 2 (New)

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31	28		STATE OF OKLAHOMA
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33	30		1st Session of the 58th Legislature (2021)
34	31
35	32		COMMITTEE SUBSTITUTE
36	33		FOR ENGROSSED
37	34		SENATE BILL NO. 724 By: Dahm of the Senate
38	35
39	36		and
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41	38		Gann of the House
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47	44		COMMITTEE SUBSTITUTE
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49	46		An Act relating to the Physician Advisory Committee;
50	47		amending Section 50, Chapter 208, O.S.L. 2013, as
51	48		last amended by Section 1, Chapter 34, O.S.L. 2020
52	49		(85A O.S. Supp. 2020, Section 50), which relates to
53	50		medical examination and treatment; removing authority
54	51		to establish parameters for certain maintenance or
55	52		treatment; repealing Section 17, Chapter 208, O.S.L.
56	53		2013 (85A O.S. Supp. 2020, Section 17), which relates
57	54		to appointment and duties; repealing Section 60,
58	55		Chapter 208, O.S.L. 2013, as amended by Section 22,
59	56		Chapter 476, O.S.L. 2019 (85A O.S. Supp. 2020,
60	57		Section 60), which relates to adoption of alternative
61	58		method to evaluate permanent disability; and
62	59		providing an effective date.
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67	64		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
68	65		SECTION 1. AMENDATORY Section 50, Chapter 208, O. S.L.
69	66		2013, as last amended by Section 1, Chapter 34, O.S.L. 2020 (85A
70	67		O.S. Supp. 2020, Section 50), is amended to read as follows:
	68	+	Section 50. A. The employer shall promptly provide an injured
	69	+	employee with medical, surgical, hospital, optometric, podiat ric,
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72		-	SB724 HFLR Page 2
73		-	BOLD FACE denotes Committee Amendments. 1
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98		-	Section 50. A. The employer shall promptly provide an injured
99		-	employee with medical, surgical, hospital, optometric, podiatric,
100	96		chiropractic and nursing services, along with any medicine,
101	97		crutches, ambulatory devices, artificial limbs, eyeglasses, contact
102	98		lenses, hearing aids , and other apparatus as may be reasonably
103	99		necessary in connection with the injury received by the empl oyee.
104	100		The employer shall have the right to choose the treating physician
105	101		or chiropractor.
106	102		B. If the employer fails or neglects to provide medical
107	103		treatment within five (5) days after actual knowledge is received of
108	104		an injury, the injured employee may sel ect a physician or
109	105		chiropractor to provide medical treatment at the expense of the
110	106		employer; provided, however, that the injured employee, or another
111	107		in the employee’s behalf, may obtain emergency treatment at the
112	108		expense of the employer where such emergen cy treatment is not
113	109		provided by the employer.
114	110		C. Diagnostic tests shall not be repeated sooner than six (6)
115	111		months from the date of the test unless agreed to by the parties or
116	112		ordered by the Commission for good cause shown.
117	113		D. Unless recommended by the t reating doctor or chiropractor at
118	114		the time claimant reaches maximum medical improvement or by an
119	115		independent medical examiner, continuing medical maintenance shall
120	116		not be awarded by the Commission. The employer or insurance carrier
121	117		shall not be responsibl e for continuing medical maintenance or pain
	118	+	management treatment that is outside the parameters established by
	119	+	the Physician Advisory Committee or Official Disability Guidelines
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123		-	SB724 HFLR Page 3
124		-	BOLD FACE denotes Committee Amendments. 1
	121	+	Req. No. 8098 Page 3 1
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149		-	management treatment that is outside the parameters established by
150		-	the Physician Advisory Committee or Official Disability Guidelines
151	146		(ODG). The employer or insurance carrier shall not be responsible
152	147		for continuing medical maintenance or pain management treatment not
153	148		previously ordered by the Commission or approved in advance by the
154	149		employer or insurance carrier.
155	150		E. An employee claiming or entitled to benefits under the
156	151		Administrative Workers’ Compensation Act, shall, if ordered by the
157	152		Commission or requested by the employer or insurance carrier, submit
158	153		himself or herself for medical examination. If an employee refuses
159	154		to submit himself or herself to examination, his or her right to
160	155		prosecute any proceeding und er the Administrative Workers’
161	156		Compensation Act shall be suspended, and no compensation shall be
162	157		payable for the period of such refusal.
163	158		F. For compensable injuries resulting in the use of a medical
164	159		device, ongoing service for the medical device shall be provided in
165	160		situations including, but not limited to, medical device battery
166	161		replacement, ongoing medication refills related to the medical
167	162		device, medical device repair, or medical device replacement.
168	163		G. The employer shall reimburse the employee for the actual
169	164		mileage in excess of twenty (20) miles round trip to and from the
170	165		employee’s home to the location of a medical service provider for
171	166		all reasonable and necessary treatment, for an evaluation of an
172	167		independent medical examiner and for any evaluation m ade at the
	168	+	request of the employer or insurance carrier. The rate of
	169	+	reimbursement for such travel expense shall be the official
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174		-	SB724 HFLR Page 4
175		-	BOLD FACE denotes Committee Amendments. 1
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200		-	request of the employer or insurance carrier. The rate of
201		-	reimbursement for such travel expense shall be the official
202	196		reimbursement rate as established by the State Travel Reimbursement
203	197		Act. In no event shall the reimbursement of travel for me dical
204	198		treatment or evaluation exceed six hundred (600) miles round trip.
205	199		H. Fee Schedule.
206	200		1. The Commission shall conduct a review and update of the
207	201		Current Procedural Terminology (CPT) in the Fee Schedule every two
208	202		(2) years pursuant to the provisions o f paragraph 14 of this
209	203		subsection. The Fee Schedule shall establish the maximum rates that
210	204		medical providers shall be reimbursed for medical care provided to
211	205		injured employees including, but not limited to, charges by
212	206		physicians, chiropractors, dentists, counselors, hospitals,
213	207		ambulatory and outpatient facilities, clinical laboratory services,
214	208		diagnostic testing services, and ambulance services, and charges for
215	209		durable medical equipment, prosthetics, orthotics, and supplies.
216	210		The most current Fee Schedule established by the Administrator of
217	211		the Workers’ Compensation Court prior to February 1, 2014, shall
218	212		remain in effect, unless or until the Legislature approves the
219	213		Commission’s proposed Fee Schedule.
220	214		2. Reimbursement for medical care shall be prescribed a nd
221	215		limited by the Fee Schedule. The director of the Employees Group
222	216		Insurance Division of the Office of Management and Enterprise
223	217		Services shall provide the Commission such information as may be
	218	+	relevant for the development of the Fee Schedule. The Commi ssion
	219	+	shall develop the Fee Schedule in a manner in which quality of
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225		-	SB724 HFLR Page 5
226		-	BOLD FACE denotes Committee Amendments. 1
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251		-	relevant for the development of the Fee Schedule. The Commission
252		-	shall develop the Fee Schedule in a manner in which quality of
253	246		medical care is assured and maintained for injured employees. The
254	247		Commission shall give due consideration to additional requirements
255	248		for physicians treating an injured worker under the A dministrative
256	249		Workers’ Compensation Act , including, but not limited to,
257	250		communication with claims representatives, case managers, attorneys ,
258	251		and representatives of employers, and the additional time required
259	252		to complete forms for the Commission, insurance carriers, and
260	253		employers.
261	254		3. In making adjustments to the Fee Schedule, the Commission
262	255		shall use, as a benchmark, the reimbursement rate for each Current
263	256		Procedural Terminology (CPT) code provided for in the fee schedule
264	257		published by the Centers for Medica re and Medicaid Services of the
265	258		U.S. Department of Health and Human Services for use in Oklahoma
266	259		(Medicare Fee Schedule) on the effective date of this section,
267	260		workers’ compensation fee schedules employed by neighboring states,
268	261		the latest edition of "Relat ive Values for Physicians" (RVP), usual,
269	262		customary and reasonable medical payments to workers’ compensation
270	263		health care providers in the same trade area for comparable
271	264		treatment of a person with similar injuries, and all other data the
272	265		Commission deems rel evant. For services not valued by CMS, the
273	266		Commission shall establish values based on the usual, customary and
274	267		reasonable medical payments to health care providers in the same
	268	+	trade area for comparable treatment of a person with similar
	269	+	injuries.
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276		-	SB724 HFLR Page 6
277		-	BOLD FACE denotes Committee Amendments. 1
	271	+	Req. No. 8098 Page 6 1
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302		-	trade area for comparable treatment o f a person with similar
303		-	injuries.
304	296		a. No reimbursement shall be allowed for any magnetic
305	297		resonance imaging (MRI) unless the MRI is provided by
306	298		an entity that meets Medicare requirements for the
307	299		payment of MRI services or is accredited by the
308	300		American College of Radiology, the Intersocietal
309	301		Accreditation Commission or the Joint Commission on
310	302		Accreditation of Healthcare Organizations. For all
311	303		other radiology procedures, the reimbursement rate
312	304		shall be the lesser of the reimbursement rate allowed
313	305		by the 2010 Oklahoma Fee Schedule and two hundred
314	306		seven percent (207%) of the Medicare Fee Schedule.
315	307		b. For reimbursement of medical services for Evaluation
316	308		and Management of injured employees as defined in the
317	309		Fee Schedule adopted by the Commission, the
318	310		reimbursement rate shall not be less than one hundred
319	311		fifty percent (150%) of the Medicare Fee Schedule.
320	312		c. Any entity providing durable medical equipment,
321	313		prosthetics, orthotics or supplies shall be accredited
322	314		by a CMS-approved accreditation organization. If a
323	315		physician provides durable medical equipment,
324	316		prosthetics, orthotics, prescription drugs , or
325	317		supplies to a patient ancillary to the patient’s
	318	+	visit, reimbursement shall be no more than ten percent
	319	+	(10%) above cost.
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327		-	SB724 HFLR Page 7
328		-	BOLD FACE denotes Committee Amendments. 1
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353		-	visit, reimbursement shall be no more than ten percent
354		-	(10%) above cost.
355	346		d. The Commission shall develop a reasonable stop -loss
356	347		provision of the Fee Schedule to pr ovide for adequate
357	348		reimbursement for treatment for major burns, severe
358	349		head and neurological injuries, multiple system
359	350		injuries, and other catastrophic injuries requiring
360	351		extended periods of intensive care. An employer or
361	352		insurance carrier shall have the right to audit the
362	353		charges and question the reasonableness and necessity
363	354		of medical treatment contained in a bill for treatment
364	355		covered by the stop-loss provision.
365	356		4. The right to recover charges for every type of medical care
366	357		for injuries arising out of and in the course of covered employment
367	358		as defined in the Administrative Workers’ Compensation Act shall lie
368	359		solely with the Commission. When a medical care provider has
369	360		brought a claim to the Commission to obtain payment for services, a
370	361		party who prevails in full on the claim shall be entitled to
371	362		reasonable attorney fees.
372	363		5. Nothing in this section shall prevent an employer, insurance
373	364		carrier, group self-insurance association, or certified workplace
374	365		medical plan from contracting with a provider of medica l care for a
375	366		reimbursement rate that is greater than or less than limits
376	367		established by the Fee Schedule.
	368	+	6. A treating physician may not charge more than Four Hundred
	369	+	Dollars ($400.00) per hour for preparation for or testimony at a
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378		-	SB724 HFLR Page 8
379		-	BOLD FACE denotes Committee Amendments. 1
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404		-	6. A treating physician may not charge more than Four Hundred
405		-	Dollars ($400.00) per hour for preparation fo r or testimony at a
406	396		deposition or appearan ce before the Commission in connection with a
407	397		claim covered by the Administrative Workers’ Compensation Act.
408	398		7. The Commission’s review of medical and treatment charges
409	399		pursuant to this section shall be conducted pursuant to the Fee
410	400		Schedule in existence at the time the medical care or treatment was
411	401		provided. The judgment approving the medical and treatment charges
412	402		pursuant to this section shall be enforceable by the Commission in
413	403		the same manner as provided in the Administrative Workers’
414	404		Compensation Act for the enforcement of other compensation payments.
415	405		8. Charges for prescription drugs dispensed by a pharmacy shall
416	406		be limited to ninety percent (90%) of the average wholesale price of
417	407		the prescription, plus a dispensing fee of Five Dollars ($5.00) per
418	408		prescription. "Average wholesale price" means the amount determined
419	409		from the latest publication designated by the Commission.
420	410		Physicians shall prescribe and pharmacies shall dispense generic
421	411		equivalent drugs when available. If the National Drug Code, or
422	412		"NDC", for the drug product dispensed is for a repackaged drug, then
423	413		the maximum reimbursement shall be the lesser of the original
424	414		labeler’s NDC and the lowest -cost therapeutic equivalent drug
425	415		product. Compounded medications shall be billed by the compoun ding
426	416		pharmacy at the ingredient level, with each ingredient identified
427	417		using the applicable NDC of the drug product, and the corresponding
	418	+	quantity. Ingredients with no NDC area are not separately
	419	+	reimbursable. Payment shall be based on a sum of the allo wable fee
428	420
429		-	SB724 HFLR Page 9
430		-	BOLD FACE denotes Committee Amendments. 1
	421	+	Req. No. 8098 Page 9 1
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455		-	quantity. Ingredients with no NDC area are not separately
456		-	reimbursable. Payment shall be based on a sum of the allowable fee
457	446		for each ingredient plus a dispensing fee of Five Dollars ($5.00)
458	447		per prescription.
459	448		9. When medical care includes prescription drugs dispensed by a
460	449		physician or other medical care provider and the NDC for the drug
461	450		product dispensed is for a repa ckaged drug, then the maximum
462	451		reimbursement shall be the lesser of the original labeler’s NDC and
463	452		the lowest-cost therapeutic equivalent drug product. Payment shall
464	453		be based upon a sum of the allowable fee for each ingredient plus a
465	454		dispensing fee of Five Dollars ($5.00) per prescription. Compounded
466	455		medications shall be billed by the compounding pharmacy.
467	456		10. Implantables are paid in addition to procedural
468	457		reimbursement paid for medical or surgical services. A
469	458		manufacturer’s invoice for the actual cost to a physician, hospital
470	459		or other entity of an implantable device shall be adjusted by the
471	460		physician, hospital or other entity to reflect, at the time
472	461		implanted, all applicable discounts, rebates, considerations and
473	462		product replacement programs and shall b e provided to the payer by
474	463		the physician or hospital as a condition of payment for the
475	464		implantable device. If the physician, or an entity in which the
476	465		physician has a financial interest other than an ownership interest
477	466		of less than five percent (5%) in a publically publicly traded
478	467		company, provides implantable devices, this relationship shall be
	468	+	disclosed to patient, employer, insurance company, third -party
	469	+	commission, certified workplace medical plan, case managers , and
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480		-	SB724 HFLR Page 10
481		-	BOLD FACE denotes Committee Amendments. 1
	471	+	Req. No. 8098 Page 10 1
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506		-	disclosed to patient, employer, insurance company, third -party
507		-	commission, certified workplace medical plan, case manager s, and
508	496		attorneys representing claimant and defendant. If the physician, or
509	497		an entity in which the physician has a financial interest other than
510	498		an ownership interest of less than five percent (5%) in a publicly
511	499		traded company, buys and resells implantable devices to a hospital
512	500		or another physician, the markup shall be limited to ten percent
513	501		(10%) above cost.
514	502		11. Payment for medical care as required by the Administrative
515	503		Workers’ Compensation Act shall be due within forty -five (45) days
516	504		of the receipt by the employer or insurance carrier of a comp lete
517	505		and accurate invoice, unless the employer or insurance carrier has a
518	506		good-faith reason to request additional information about such
519	507		invoice. Thereafter, the Commission may assess a penalty up to
520	508		twenty-five percent (25%) for any amount due under the Fee Schedule
521	509		that remains unpaid on the finding by the Commission that no good -
522	510		faith reason existed for the delay in payment. If the Commission
523	511		finds a pattern of an employer or insurance carrier willfully and
524	512		knowingly delaying payments for medical care, the Commission may
525	513		assess a civil penalty of not more than Five Thousand Dollars
526	514		($5,000.00) per occurrence.
527	515		12. If an employee fails to appear for a scheduled appointment
528	516		with a physician or chiropractor, the employer or insurance company
529	517		shall pay to the physician or chiropractor a reasonable charge, to
	518	+	be determined by the Commission, for the missed appointment. In the
	519	+	absence of a good-faith reason for missing the appointment, the
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531		-	SB724 HFLR Page 11
532		-	BOLD FACE denotes Committee Amendments. 1
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557		-	be determined by the Commission, for the missed appointment. In the
558		-	absence of a good-faith reason for missing the appointment, the
559	546		Commission shall order the employee to reimburse the employer or
560	547		insurance company for the charge.
561	548		13. Physicians or chiropractors providing treatment under the
562	549		Administrative Workers’ Compensation Act shall disclose under
563	550		penalty of perjury to the Commission, on a form prescribed by the
564	551		Commission, any ownership or interes t in any health care facility,
565	552		business, or diagnostic center that is not the physician’s or
566	553		chiropractor’s primary place of business. The disclosure shall
567	554		include any employee leasing arrangement between the physician or
568	555		chiropractor and any health care facility that is not the
569	556		physician’s or chiropractor’s primary place of business. A
570	557		physician’s or chiropractor’s failure to disclose as required by
571	558		this section shall be grounds for the Commission to disqualify the
572	559		physician or chiropractor from providin g treatment under the
573	560		Administrative Workers’ Compensation Act.
574	561		14. a. Beginning on May 28, 2019, the Commission shall
575	562		conduct an evaluation of the Fee Schedule, which shall
576	563		include an update of the list of Current Procedural
577	564		Terminology (CPT) codes, a l ine item adjustment or
578	565		renewal of all rates, and amendment as needed to the
579	566		rules applicable to the Fee Schedule.
	567	+	b. The Commission shall contract with an external
	568	+	consultant with knowledge of workers’ compensation fee
	569	+	schedules to review regional and nati onwide
580	570
581		-	SB724 HFLR Page 12
582		-	BOLD FACE denotes Committee Amendments. 1
	571	+	Req. No. 8098 Page 12 1
583	572		2
584	573		3
585	574		4
586	575		5
587	576		6
588	577		7
589	578		8
590	579		9
591	580		10
592	581		11
593	582		12
594	583		13
595	584		14
596	585		15
597	586		16
598	587		17
599	588		18
600	589		19
601	590		20
602	591		21
603	592		22
604	593		23
605	594		24
606	595
607		-	b. The Commission shall contract with an external
608		-	consultant with knowledge of workers’ compensation fee
609		-	schedules to review regional and nationwide
610	596		comparisons of Oklahoma’s Fee Schedule rates and date
611	597		and market for medical services. The consultant shall
612	598		receive written and oral comment from employers,
613	599		workers’ compensation medical service and insurance
614	600		providers, self-insureds, group self -insurance
615	601		associations of this state and the public. The
616	602		consultant shall submit a report of its findings and a
617	603		proposed amended Fee Schedule to the Commission.
618	604		c. The Commission shall adopt the proposed amended Fee
619	605		Schedule in whole or in part and make any additional
620	606		updates or adjustments. The Commission shall submit a
621	607		proposed updated and adjusted Fee Schedule to the
622	608		President Pro Tempore of the Senate, the Speaker of
623	609		the House of Representatives and the Governor. The
624	610		proposed Fee Schedule shall become effective on July 1
625	611		following the legislative session, if approved by
626	612		Joint Resolution of the Legislature during the session
627	613		in which a proposed Fee Schedule is submitted.
628	614		d. Beginning on May 28, 2019, an external evaluation
629	615		shall be conducted and a propos ed amended Fee Schedule
630	616		shall be submitted to the Legislature for approval
	617	+	during the 2020 legislative session. Thereafter, an
	618	+	external evaluation shall be conducted and a proposed
631	619
632		-	SB724 HFLR Page 13
633		-	BOLD FACE denotes Committee Amendments. 1
	620	+	Req. No. 8098 Page 13 1
634	621		2
635	622		3
636	623		4
637	624		5
638	625		6
639	626		7
640	627		8
641	628		9
642	629		10
643	630		11
644	631		12
645	632		13
646	633		14
647	634		15
648	635		16
649	636		17
650	637		18
651	638		19
652	639		20
653	640		21
654	641		22
655	642		23
656	643		24
657	644
658		-	during the 2020 legislative session. Thereafter, an
659		-	external evaluation shall be conducted and a proposed
660	645		amended Fee Schedule shall be submitted to the
661	646		Legislature for approval ev ery two (2) years.
662	647		I. Formulary. The Commission by rule shall adopt a closed
663	648		formulary. Rules adopted by the Commission shall allow an appeals
664	649		process for claims in which a treating doctor determines and
665	650		documents that a drug not included in the formula ry is necessary to
666	651		treat an injured employee’s compensable injury. The Commission by
667	652		rule shall require the use of generic pharmaceutical medications and
668	653		clinically appropriate over -the-counter alternatives to prescription
669	654		medications unless otherwise spe cified by the prescribing doctor, in
670	655		accordance with applicable state law.
671	656		SECTION 2. REPEALER Section 17, Chapter 208, O.S.L. 2013
672	657		(85A O.S. Supp. 2020, Section 17), is hereby repealed.
673	658		SECTION 3. REPEALER S ection 60, Chapter 208, O.S.L.
674	659		2013, as amended by Section 22, Chapter 476, O.S.L. 2019 (85A O.S.
675	660		Supp. 2020, Section 60), is hereby repealed.
676	661		SECTION 4. This act shall become effective November 1, 2021.
677	662
678		-	COMMITTEE REPORT BY: COMMITTEE ON PUBLIC HEALTH, dated 04/08/2021 -
679		-	DO PASS, As Amended.
	663	+	58-1-8098 AB 04/08/21
	664	+
	665	+