HF 2248

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to workers' compensation; adopting recommendations of the Workers'
Compensation Advisory Council; amending Minnesota Statutes 2006, sections
176.101, subdivision 1; 176.102, subdivision 11; 176.136, subdivisions 1a, 1b;
176.275, subdivision 1; repealing Minnesota Statutes 2006, section 176.669.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2006, section 176.101, subdivision 1, is amended to read:

Subdivision 1.

Temporary total disability.

(a) For injury producing temporary total
disability, the compensation is 66-2/3 percent of the weekly wage at the time of injury.

(b)(1) Commencing on October 1, deleted text begin 2000 deleted text end new text begin 2007 new text end , the maximum weekly compensation
payable is deleted text begin $750 deleted text end new text begin $850 new text end per week.

(2) The Workers' Compensation Advisory Council may consider adjustment
increases and make recommendations to the legislature.

(c) The minimum weekly compensation payable is $130 per week or the injured
employee's actual weekly wage, whichever is less.

(d) Temporary total compensation shall be paid during the period of disability
subject to the cessation and recommencement conditions in paragraphs (e) to (l).

(e) Temporary total disability compensation shall cease when the employee returns
to work. Except as otherwise provided in section 176.102, subdivision 11, temporary
total disability compensation may only be recommenced following cessation under this
paragraph, paragraph (h), or paragraph (j) prior to payment of deleted text begin 104 deleted text end new text begin 130 new text end weeks of temporary
total disability compensation and only as follows:

(1) if temporary total disability compensation ceased because the employee returned
to work, it may be recommenced if the employee is laid off or terminated for reasons other
than misconduct if the layoff or termination occurs prior to 90 days after the employee
has reached maximum medical improvement. Recommenced temporary total disability
compensation under this clause ceases when any of the cessation events in paragraphs
(e) to (l) occurs; or

(2) if temporary total disability compensation ceased because the employee returned
to work or ceased under paragraph (h) or (j), it may be recommenced if the employee is
medically unable to continue at a job due to the injury. Where the employee is medically
unable to continue working due to the injury, temporary total disability compensation
may continue until any of the cessation events in paragraphs (e) to (l) occurs following
recommencement. If an employee who has not yet received temporary total disability
compensation becomes medically unable to continue working due to the injury after
reaching maximum medical improvement, temporary total disability compensation shall
commence and shall continue until any of the events in paragraphs (e) to (l) occurs
following commencement. For purposes of commencement or recommencement under
this clause only, a new period of maximum medical improvement under paragraph
(j) begins when the employee becomes medically unable to continue working due to
the injury. Temporary total disability compensation may not be recommenced under
this clause and a new period of maximum medical improvement does not begin if the
employee is not actively employed when the employee becomes medically unable to
work. All periods of initial and recommenced temporary total disability compensation are
included in the deleted text begin 104-week deleted text end new text begin 130-week new text end limitation specified in paragraph (k).

(f) Temporary total disability compensation shall cease if the employee withdraws
from the labor market. Temporary total disability compensation may be recommenced
following cessation under this paragraph only if the employee reenters the labor market
prior to 90 days after the employee reached maximum medical improvement and
prior to payment of deleted text begin 104 deleted text end new text begin 130 new text end weeks of temporary total disability compensation. Once
recommenced, temporary total disability ceases when any of the cessation events in
paragraphs (e) to (l) occurs.

(g) Temporary total disability compensation shall cease if the total disability ends
and the employee fails to diligently search for appropriate work within the employee's
physical restrictions. Temporary total disability compensation may be recommenced
following cessation under this paragraph only if the employee begins diligently searching
for appropriate work within the employee's physical restrictions prior to 90 days after
maximum medical improvement and prior to payment of deleted text begin 104 deleted text end new text begin 130 new text end weeks of temporary total
disability compensation. Once recommenced, temporary total disability compensation
ceases when any of the cessation events in paragraphs (e) to (l) occurs.

(h) Temporary total disability compensation shall cease if the employee has been
released to work without any physical restrictions caused by the work injury.

(i) Temporary total disability compensation shall cease if the employee refuses an
offer of work that is consistent with a plan of rehabilitation filed with the commissioner
which meets the requirements of section 176.102, subdivision 4, or, if no plan has been
filed, the employee refuses an offer of gainful employment that the employee can do in the
employee's physical condition. Once temporary total disability compensation has ceased
under this paragraph, it may not be recommenced.

(j) Temporary total disability compensation shall cease 90 days after the employee
has reached maximum medical improvement, except as provided in section 176.102,
subdivision 11, paragraph (b). For purposes of this subdivision, the 90-day period after
maximum medical improvement commences on the earlier of: (1) the date that the
employee receives a written medical report indicating that the employee has reached
maximum medical improvement; or (2) the date that the employer or insurer serves the
report on the employee and the employee's attorney, if any. Once temporary total disability
compensation has ceased under this paragraph, it may not be recommenced except if the
employee returns to work and is subsequently medically unable to continue working
as provided in paragraph (e), clause (2).

(k) Temporary total disability compensation shall cease entirely when deleted text begin 104 deleted text end new text begin 130 new text end weeks
of temporary total disability compensation have been paid, except as provided in section
176.102, subdivision 11, paragraph (b). Notwithstanding anything in this section to the
contrary, initial and recommenced temporary total disability compensation combined shall
not be paid for more than deleted text begin 104 deleted text end new text begin 130 new text end weeks, regardless of the number of weeks that have
elapsed since the injury, except that if the employee is in a retraining plan approved under
section 176.102, subdivision 11, the deleted text begin 104 week deleted text end new text begin 130-week new text end limitation shall not apply during
the retraining, but is subject to the limitation before the plan begins and after the plan ends.

(l) Paragraphs (e) to (k) do not limit other grounds under law to suspend or
discontinue temporary total disability compensation provided under this chapter.

(m) Once an employee has been paid 52 weeks of temporary total compensation,
the employer or insurer must notify the employee in writing of the deleted text begin 104-week deleted text end new text begin 130-week
new text end limitation on payment of temporary total compensation. A copy of this notice must also
be filed with the department.

Sec. 2.

Minnesota Statutes 2006, section 176.102, subdivision 11, is amended to read:

Subd. 11.

Retraining; compensation.

(a) Retraining is limited to 156 weeks.
An employee who has been approved for retraining may petition the commissioner
or compensation judge for additional compensation not to exceed 25 percent of the
compensation otherwise payable. If the commissioner or compensation judge determines
that this additional compensation is warranted due to unusual or unique circumstances of
the employee's retraining plan, the commissioner may award additional compensation in
an amount not to exceed the employee's request. This additional compensation shall cease
at any time the commissioner or compensation judge determines the special circumstances
are no longer present.

(b) If the employee is not employed during a retraining plan that has been
specifically approved under this section, temporary total compensation is payable for up
to 90 days after the end of the retraining plan; except that, payment during the 90-day
period is subject to cessation in accordance with section 176.101. If the employee is
employed during the retraining plan but earning less than at the time of injury, temporary
partial compensation is payable at the rate of 66-2/3 percent of the difference between
the employee's weekly wage at the time of injury and the weekly wage the employee is
able to earn in the employee's partially disabled condition, subject to the maximum rate
for temporary total compensation. Temporary partial compensation is not subject to the
225-week or 450-week limitations provided by section 176.101, subdivision 2, during the
retraining plan, but is subject to those limitations before and after the plan.

(c) Any request for retraining shall be filed with the commissioner before deleted text begin 156 deleted text end new text begin 208
new text end weeks of any combination of temporary total or temporary partial compensation have
been paid. Retraining shall not be available after deleted text begin 156 deleted text end new text begin 208 new text end weeks of any combination of
temporary total or temporary partial compensation benefits have been paid unless the
request for the retraining has been filed with the commissioner prior to the time the deleted text begin 156 deleted text end
new text begin 208 new text end weeks of compensation have been paid.

(d) The employer or insurer must notify the employee in writing of the deleted text begin 156-week deleted text end
new text begin 208-week new text end limitation for filing a request for retraining with the commissioner. This notice
must be given before 80 weeks of temporary total disability or temporary partial disability
compensation have been paid, regardless of the number of weeks that have elapsed since
the date of injury. If the notice is not given before the 80 weeks, the period of time within
which to file a request for retraining is extended by the number of days the notice is late,
but in no event may a request be filed later than 225 weeks after any combination of
temporary total disability or temporary partial disability compensation have been paid. The
commissioner may assess a penalty of $25 per day that the notice is late, up to a maximum
penalty of $2,000, against an employer or insurer for failure to provide the notice. The
penalty is payable to the commissioner for deposit in the assigned risk safety account.

Sec. 3.

Minnesota Statutes 2006, section 176.136, subdivision 1a, is amended to read:

Subd. 1a.

Relative value fee schedule.

(a) The liability of an employer for services
included in the medical fee schedule is limited to the maximum fee allowed by the
schedule in effect on the date of the medical service, or the provider's actual fee, whichever
is lower. deleted text begin The medical fee schedule effective on October 1, 1991, remains in effect until
the commissioner adopts a new schedule by permanent rule. deleted text end The commissioner shall
adopt permanent rules regulating fees allowable for medical, chiropractic, podiatric,
surgical, and other health care provider treatment or service, including those provided
to hospital outpatients, by implementing a relative value fee schedule deleted text begin to be effective
on October 1, 1993 deleted text end . The commissioner may adopt by reference new text begin , according to the
procedures in paragraph (h), clause (2), new text end the relative value fee schedule new text begin tables new text end adopted for
the federal Medicare program deleted text begin or a relative value fee schedule adopted by other federal
or state agencies deleted text end . The relative value fee schedule must contain reasonable classifications
including, but not limited to, classifications that differentiate among health care provider
disciplines. The conversion factors for the original relative value fee schedule must
reasonably reflect a 15 percent overall reduction from the medical fee schedule most
recently in effect. The reduction need not be applied equally to all treatment or services,
but must represent a gross 15 percent reduction.

(b) Effective October 1, 2005, the commissioner shall remove all scaling factors
from the relative value units and establish four separate conversion factors according to
paragraphs (c) and (d) for each of the following parts of Minnesota Rules:

(1) Medical/surgical services in Minnesota Rules, part 5221.4030, as defined in part
5221.0700, subpart 3, item C, subitem (2);

(2) Pathology and laboratory services in Minnesota Rules, part 5221.4040, as
defined in part 5221.0700, subpart 3, item C, subitem (3);

(3) Physical medicine and rehabilitation services in Minnesota Rules, part
5221.4050, as defined in part 5221.0700, subpart 3, item C, subitem (4); and

(4) Chiropractic services in Minnesota Rules, part 5221.4060, as defined in part
5221.0700, subpart 3, item C, subitem (5).

(c) The four conversion factors established under paragraph (b) shall be calculated
so that there is no change in each maximum fee for each service under the current fee
schedule, except as provided in paragraphs (d) and (e).

(d) By October 1, 2006, the conversion factor for chiropractic services described in
paragraph (b), clause (4), shall be increased to equal 72 percent of the conversion factor
for medical/surgical services described in paragraph (b), clause (1). Beginning October 1,
2005, the increase in chiropractic conversion factor shall be phased in over two years by
approximately equal percentage point increases.

(e) When adjusting the conversion factors in accordance with paragraph (g) on
October 1, 2005, and October 1, 2006, the commissioner may adjust by no less than zero,
all of the conversion factors as necessary to offset any overall increase in payments under
the fee schedule resulting from the increase in the chiropractic conversion factor.

(f) The commissioner shall give notice of the relative value units and conversion
factors established under paragraphs (b), (c), and (d) according to the procedures in
section 14.386, paragraph (a). The relative value units and conversion factors established
under paragraphs (b), (c), and (d) are not subject to expiration under section 14.386,
paragraph (b).

(g) new text begin The conversion factors shall be adjusted as follows:
new text end

new text begin (1) new text end After permanent rules have been adopted to implement this section, the
conversion factors must be adjusted annually on October 1 by no more than the percentage
change computed under section 176.645, but without the annual cap provided by that
section.

new text begin (2) Each time the workers' compensation relative value fee schedule tables are
updated under paragraph (h), the commissioner shall adjust the conversion factors so that,
for services in both fee schedules, there is no difference between the overall payment in
each category of service listed in paragraph (b) under the new schedule and the overall
payment for that category under the workers' compensation fee schedule most recently
in effect. This adjustment shall be made before making any additional adjustment under
clause (1).
new text end

new text begin (h) The commissioner shall give notice of the adjusted conversion factors and
updates to the relative value fee schedule as follows:
new text end

new text begin (1) new text end The commissioner shall annually give notice in the State Register of the adjusted
conversion factors deleted text begin and may also give annual notice of any additions, deletions, or changes
to the relative value units or service codes adopted by the federal Medicare program. The
relative value units may be statistically adjusted in the same manner as for the original
workers' compensation relative value fee schedule deleted text end new text begin and any amendments to rules to
implement Medicare relative value tables incorporated by reference under this subdivision new text end .
The notices of the adjusted conversion factors deleted text begin and additions, deletions, or changes to the
relative value units and service codes is in lieu of the requirements of chapter 14. The
commissioner shall follow the deleted text end new text begin and amended rules to implement the relative value tables are
subject to the new text end requirements of section 14.386, paragraph (a). The annual adjustments to the
conversion factors and the medical fee schedules adopted under this section, including all
previous fee schedules, are not subject to expiration under section 14.386, paragraph (b).

new text begin (2) The commissioner may periodically update the workers' compensation relative
value tables by incorporating by reference the relative value tables in the national
physician fee schedule relative value file established by the Centers for Medicare and
Medicaid Services. The commissioner shall publish the notices of the incorporation by
reference in the State Register at least 60 days before the tables are to become effective for
purposes of payment under this section. Each notice of incorporation must state the date
the incorporated tables will become effective and must include information on how the
Medicare relative value tables may be obtained. The published notices of incorporation
by reference and the incorporated tables are not rules subject to section 14.386 or other
provision of chapter 14, but have the force and effect of law as of the date specified in
the notices.
new text end

Sec. 4.

Minnesota Statutes 2006, section 176.136, subdivision 1b, is amended to read:

Subd. 1b.

Limitation of liability.

(a) The liability of the employer for treatment,
articles, and supplies provided to an employee while an inpatient or outpatient at a small
hospital new text begin located outside the 11-county metropolitan area new text end shall be the hospital's usual and
customary charge, unless the charge is determined by the commissioner or a compensation
judge to be unreasonably excessive. A "small hospital," for purposes of this paragraph, is
a hospital which has 100 or fewer licensed beds.

new text begin (b) Except as provided in paragraph (c), the liability of the employer for the
treatment, articles, and supplies provided by a hospital located within the 11-county
metropolitan area, regardless of the number of licensed beds, shall be as follows:
new text end

new text begin (1) For outpatient treatment, articles, and supplies, the employer's liability is limited
to the maximum fee in the fee schedule adopted under subdivision 1a or rules adopted
under this section.
new text end

new text begin (2) For outpatient treatment, articles, and supplies that are not limited by clause (1),
and for all inpatient treatment, articles, and supplies that are not limited by a rule adopted
under this section, the employer's liability is limited to the hospital's usual and customary
charge multiplied by the "adjusted aggregate payment-to-charge ratio."
new text end

new text begin (i) The "aggregate payment-to-charge ratio" shall be determined on the basis of the
most recently available payment-to-charge data collected by the Department of Health as
of June 30 of each year. For purposes of this clause, the aggregate payment-to-charge ratio
equals the aggregate payments made for nonpublic program patients from commercial
insurers, nonprofit health plans, and private managed care to hospitals whose inpatient
facilities are located in the 11-county metropolitan area, divided by the aggregate charges
submitted by those hospitals to commercial insurers, nonprofit health plans, and private
managed care.
new text end

new text begin (ii) The "adjusted aggregate payment-to-charge ratio" is the aggregate
payment-to-charge ratio plus 15 percentage points (0.15) as a workers' compensation
premium.
new text end

new text begin (iii) For example, if a hospital's usual and customary charge is $10,000, and the
aggregate payment-to-charge ratio is 0.570, the adjusted aggregate payment-to-charge
ratio is 0.720 (0.570 plus 0.15). The maximum payment to the hospital would be $7,200
($10,000 multiplied by 0.720).
new text end

new text begin (iv) The commissioner shall annually publish in the State Register, no later than
October 1, notice of the adjusted aggregate payment-to-charge ratio as determined under
this paragraph. The published notice and ratio are not rules subject to section 14.386 or
other provision of chapter 14, but have the force and effect of law as of each October 1 for
purposes of payment under this paragraph.
new text end

new text begin (c) The liability of the employer for surgical implants provided to an employee
while an inpatient or outpatient at a clinic, hospital, or other facility in the 11-county
metropolitan area is limited to the invoice cost of the implant to the entity that bills the
employer directly for the implant, plus the following:
new text end

new text begin (1) an additional 50 percent if the invoice cost is less than or equal to $500;
new text end

new text begin (2) an additional 30 percent if the invoice cost is from $500.01 to $1,000; or
new text end

new text begin (3) an additional 25 percent if the invoice cost is $1,000.01 or greater.
new text end

new text begin This reimbursement shall be paid to the billing clinic, hospital, other facility, or third-party
vendor.
new text end

deleted text begin (b) deleted text end new text begin (d) new text end The liability of the employer for the treatment, articles, and supplies new text begin that are
not limited by paragraph (a), (b), or (c), is as follows:
new text end

new text begin (1) For outpatient treatment, articles, and supplies provided by a hospital with
more than 100 licensed beds that is located outside the 11-county metropolitan area, the
employer's liability is limited to the maximum fee in the fee schedule adopted under
subdivision 1a or a rule adopted under this section, if applicable. If the treatment, articles,
and supplies are not limited by the fee schedule or rule, the employer's liability is as
provided in clause (2).
new text end

new text begin (2) For all treatment, articles, and supplies new text end that are not limited by new text begin the fee schedule
adopted under new text end subdivision 1a deleted text begin or 1c or paragraph (a) deleted text end new text begin , or a rule adopted under this section,
including all inpatient treatment, articles, and supplies provided by a hospital with more
than 100 licensed beds that is located outside the 11-county metropolitan area, the
employer's liability new text end shall be limited to 85 percent of the provider's usual and customary
charge, or 85 percent of the prevailing charges for similar treatment, articles, and supplies
furnished to an injured person when paid for by the injured person, whichever is lower. On
this basis, the commissioner or compensation judge may determine the reasonable value
of all treatment, services, and supplies, and the liability of the employer is limited to that
amount. The commissioner may by rule establish the reasonable value of a service, article,
or supply in lieu of the deleted text begin 85 percent limitation deleted text end new text begin limitations specified new text end in this deleted text begin paragraph deleted text end new text begin section new text end .

new text begin (f) For purposes of this subdivision, the 11-county metropolitan area consists
of Anoka, Carver, Chisago, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne,
Washington, and Wright Counties. A hospital's location is determined by the county
in which its inpatient facility is located.
new text end

new text begin (g) This section also governs the employer's liability for treatment, articles, and
supplies provided under this chapter by out-of-state providers.
new text end

deleted text begin (c) deleted text end new text begin (h) new text end The limitation of liability for charges provided by deleted text begin paragraph (b) deleted text end new text begin this
subdivision new text end does not apply to a nursing home that participates in the medical assistance
program and whose rates are established by the commissioner of human services.

Sec. 5.

Minnesota Statutes 2006, section 176.275, subdivision 1, is amended to read:

Subdivision 1.

Filing.

If a document is required to be filed by this chapter or any
rules adopted pursuant to authority granted by this chapter, the filing shall be completed by
the receipt of the document at the division, department, office, or the court of appeals. The
division, department, office, and the court of appeals shall accept any document which
has been delivered to it for legal filing immediately upon its receipt, but may refuse to
accept any form or document that lacks the name of the injured employee, employer, or
insurer, the date of injury, or the injured employee's Social Security number. new text begin If a workers'
compensation identification number has been assigned by the department it may be
substituted for the Social Security number on a form or document. new text end If the injured employee
has fewer than three days of lost time from work, the party submitting the required
document must attach to it, at the time of filing, a copy of the first report of injury.

A notice or other document required to be served or filed at either the department,
the office, or the court of appeals which is inadvertently served or filed at the wrong one
of these agencies shall be deemed to have been served or filed with the proper agency.
The receiving agency shall note the date of receipt of a document and shall forward the
documents to the proper agency no later than two working days following receipt.

Sec. 6. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, section 176.669, new text end new text begin is repealed.
new text end

Sec. 7. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 and 2 are effective for injuries occurring on or after October 1, 2007.
Section 3 is effective the day following final enactment. Section 4 is effective for
treatment, articles, and supplies provided on or after October 1, 2007.
new text end