Client Alerts, News Articles & Blog Posts

Everything you need to know about BMD and the industry.

CLIENT ALERT: Bureau of Workers' Compensation Budget Amends Law

As we head into 2018, you should be aware of some recent changes made in Ohio’s laws concerning Workers’ Compensation. These changes became effective September 29, 2017.   Some will affect business more than others, but these are changes you should really know about. 

>A notice of intent to settle can be filed by the Injured Worker or Employer within thirty (30) days of receipt of an order being appealed (or, apparently which could be appealed), or the Industrial Commission’s refusal to hear an appeal. If filed, this filing extends the time for filing an appeal to Court to one-hundred and fifty (150) days (unless the other party files an objection to the notice within fourteen (14) days of receipt). This provision may assist parties in settling claims before invoking judicial machinery.

>Changes increased Injured Worker Attorney fees from $4,500.00 to $5,000.00.

>The BWC medical section is required to schedule a medical examination to determine the employee’s continued entitlement to initial compensation no later than thirty (30) days following the initial consecutive ninety (90) day period.   While the BWC may waive the scheduling of a medical examination for “good cause,” if the employee’s employer objects to the waiver, then the administrator will refer the employee to the bureau medical section to schedule the examination or the administrator will schedule the examination.

>Section 4123.56(E) provides that if an injured worker is awarded temporary total disability compensation before the full weekly wage is determined, s/he will be compensated at the statewide average weekly wage rate.  Discrepancies will be accounted for and adjusted once the full weekly wage is calculated.

>A Permanent Partial Disability Application (C92) will be dismissed (without prejudice, which means it can be refiled if the statute has not already run) if the injured worker fails to respond to an attempt to schedule an examination by the bureau medical section or fails to attend a scheduled medical exam without notice or explanation.

>Various provisions amend sections which address fire fighter cancer presumption.  Changes to this the section, among other things, amend the fire fighter cancer presumption to permit rebutting the presumption by demonstrating that exposure to the carcinogen could not have caused that type of cancer.  Changes to this section also limit the presumption to situations where the fire fighter has not worked in hazardous duty for more than fifteen (15) years.  Other changes  permit a fire fighter to receive working wage loss if s/he has a scheduled claim for cancer contracted by a fire fighter.

>The time limit for filing a claim is reduced from two years to one year.  It is important to note, however, that the statute of limitations for occupational disease claims has apparently not changed.

>Also, while not a legislative change, an important new medical rule goes into effect January 1, 2018.  A section of the Ohio Administrative Code will be enacted, which covers Lumbar Fusions.  Under this new rule, before approving lumbar fusion surgery, certain medical criteria generally must be met.

For more information about the law changes or other employment, labor and workers' compensation matters, contact Richard L. Williger

Investment Training for the Second and Third Generations

Consider this scenario. Mom and Dad started the business from the ground up. Over the decades it has expanded into a money-making machine. They are able to sell the business and it results in a multimillion-dollar payday for their labors. The excess money has allowed Mom and Dad to invest with various financial advising firms, several fund management groups, and directly with new startups and joint ventures. Their experience has made them savvy investors, with a detailed understanding of how much to invest, when, and where. They cannot justify formation of a full family office with dedicated investors to manage the funds, but Mom and Dad have set up a trust fund for the children to allow these investments to continue to grow over the years. Eventually, Mom and Dad pass. Their children enjoy the fruits of their labors, and, by the time the grandchildren are adults, Mom and Dad's savvy investments are gone.

Provider Relief Funds – Continued Confusion Regarding Reporting Requirements and Lost Revenues

In Fall 2020, HHS issued multiple rounds of guidance and FAQs regarding the reporting requirements for the Provider Relief Funds, the most recently published notice being November 2, 2020 and December 11, 2020. Specifically, the reporting portal for the use of the funds in 2020 was scheduled to open on January 15, 2021. Although there was much speculation as to whether this would occur. And, as of the date of this article, the portal was not opened.

Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.

HHS Issues Opinion Regarding Illegal Attempts by Drug Manufacturers to Deny 340B Discounts under Contract Pharmacy Arrangements

The federal 340B discount drug program is a safety net for many federally qualified health centers, disproportionate share hospitals, and other covered entities. This program allows these providers to obtain discount pricing on drugs which in turn allows the providers to better serve their patient populations and provide their patients with access to vital health care services. Over the years, the 340B program has undergone intense scrutiny, particularly by drug manufacturers who are required by federal law to provide the discounted pricing.

S.B. 263 Protects 340B Covered Entities from Predatory Practices in Ohio

Just before the end of calendar year 2020 and at the end of its two-year legislative session, the Ohio General Assembly passed Senate Bill 263, which prohibits insurance companies and pharmacy benefit managers (“PBMs”) from imposing on 340B Covered Entities discriminatory pricing and other contract terms. This is a win for safety net providers and the people they serve, as 340B savings are crucial to their ability to provide high quality, affordable programs and services to patients.