BEFORE THE DEPARTMENT OF LABOR AND INDUSTRY

                                          OF THE STATE OF MONTANA 

 

In the matter of the amendment of ARM 24.29.1433, 24.29.1534, and 24.29.1538 pertaining to medical fee schedules for workers' compensation purposes

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO: All Concerned Persons

 

            1. On May 11, 2021, at 10:00 a.m., the Department of Labor and Industry (department) will hold a public hearing via remote conferencing to consider the proposed amendment of the above-stated rules. Because there currently exists a state of emergency in Montana due to the public health crisis caused by the novel coronavirus, there will be no in-person hearing. Interested parties may access the remote conferencing platform in the following ways:

 

            (a) Join Zoom Meeting, https://mt-gov.zoom.us/j/96061827447

                    Meeting ID: 960 6182 7447

                    -OR-

            (b) Dial by telephone, +1 646 558 8656 or +1 406 444 9999

                    Meeting ID: 960 6182 7447

 

            The hearing will begin with a brief introduction by department staff to explain the use of the videoconference and telephonic platform.  All participants will be muted except when it is their time to speak.

 

            2. The department will make reasonable accommodations for persons with disabilities who wish to participate in this public hearing or need an alternative accessible format of this notice. If you require an accommodation, contact the department no later than 5:00 p.m., on May 3, 2021, to advise us of the nature of the accommodation that you need. Please contact Celeste Ackerman, Employment Relations Division, P.O. Box 8011, Helena, Montana 59604-8011; telephone (406) 444-6604; facsimile (406) 444-4140; Montana TTD (406) 444-5549; or e-mail [email protected].

 

            3. General Statement of Reasonable Necessity: There is reasonable necessity to amend ARM 24.29.1433, 24.29.1534, and 24.29.1538 to incorporate the annually updated medical fee schedules and related materials to comply with the provisions of 39-71-704(2), MCA, that require the department annually establish a medical fee schedule. Each year, the department takes into consideration factors including the historical paid reimbursement as a percentage of Medicare, comparison with the region, and the western medical price index.

 

            4.  The rules proposed to be amended are as follows, stricken matter interlined, new matter underlined:

 

            24.29.1433 FACILITY SERVICE RULES AND RATES FOR SERVICES PROVIDED ON OR AFTER JULY 1, 2013 (1) through (1)(c)(vi) remain the same.

            (vii) The "Montana Workers' Compensation Facility Fee Schedule Instruction Set Effective July 1, 2019," for services provided from July 1, 2019, through June 30, 2020; and

            (viii) The "Montana Workers' Compensation Facility Fee Schedule Instruction Set Effective July 1, 2020.," for services provided from July 1, 2020, through June 30, 2021; and

            (ix) The "Montana Workers' Compensation Facility Fee Schedule Instruction Set Effective July 1, 2021."

            (2) through (11)(a)(vii) remain the same.

            (viii) Effective July 1, 2020, through June 30, 2021, the base rate is $8,909.

            (ix) Effective July 1, 2021, the base rate is $9,435.

            (b) Payments for inpatient acute care hospital services must be calculated using the base rate multiplied by the Montana MS-DRG weight. For example, if the MS-DRG weight is 0.5, the amount payable is $4,454.50 $4,717.50, which is the base rate of $8,909 $9,435 multiplied by 0.5.

            (c) through (12)(a)(vi) remain the same.

            (vii) $119, from July 1, 2019, through June 30, 2020; and

            (viii) $123, on or after from July 1, 2020., through June 30, 2021; and

            (ix)  $130, on or after July 1, 2021.

            (b) through (b)(vi) remain the same.

            (vii) $89, from July 1, 2019, through June 30, 2020; and

            (viii) $92, on or after from July 1, 2020., through June 30, 2021; and

            (ix)  $98, on or after July 1, 2021.

            (c) through (g) remain the same.

 

            AUTH: 39-71-203, MCA

            IMP:     39-71-704, MCA

 

            24.29.1534 PROFESSIONAL FEE SCHEDULE FOR SERVICES PROVIDED ON OR AFTER JULY 1, 2013 (1) remains the same.

            (a) the instruction set for the fee schedule as adopted in this subsection. All the definitions, guidelines, RVUs, procedure codes, modifiers, and other explanations provided in the instruction set affecting the determination of individual fees apply. A copy of the Copies of the current fee schedule and the instruction set may also be obtained at no charge from the Montana Department of Labor and Industry, P.O. Box 8011, Helena, Montana 59604-8011 on the Employment Relations Division website;

            (i) through (1)(a)(vi) remain the same.

            (vii) The "Montana Workers' Compensation Professional Fee Schedule Instruction Set Effective July 1, 2019" applies to services provided from July 1, 2019, through June 30, 2020; and

            (viii) The "Montana Workers' Compensation Professional Fee Schedule Instruction Set Effective July 1, 2020" applies to services provided on or after from July 1, 2020., through June 30, 2021; and

            (ix) The "Montana Workers' Compensation Professional Fee Schedule Instruction Set Effective July 1, 2021" applies to services provided on or after July 1, 2021.

            (b) through (10) remain the same.

 

            AUTH: 39-71-203, MCA

            IMP:     39-71-704, MCA

 

            24.29.1538 CONVERSION FACTORS FOR SERVICES PROVIDED ON OR AFTER JANUARY 1, 2008 (1) through (2)(h) remain the same.

            (i) $64.04 from July 1, 2019, through June 30, 2020; and

            (j) $63.41 on or after from July 1, 2020., through June 30, 2021; and

            (k)  $61.05 on or after July 1, 2021.

            (3) through (3)(i) remain the same.

            (j) $69.58 from July 1, 2019, through June 30, 2020; and

            (k) $67.32 on or after from July 1, 2020., through June 30, 2021; and

            (l) $64.84 on or after July 1, 2021.

            (4) and (5) remain the same.

 

            AUTH: 39-71-203, MCA

            IMP:     39-71-704, MCA

 

REASON:  There is reasonable necessity to amend ARM 24.29.1433, 24.29.1534, and 24.29.1538 to incorporate the annually updated medical fee schedules and related materials to comply with the provisions of 39-71-704(2), MCA, that require the department to annually establish a medical fee schedule.

 

            5. Copies of the proposed 2021 publication are available and can be accessed at http://erd.dli.mt.gov/work-comp-claims/medical-regulations.

 

            6. A printed version of the proposed 2021 publication is also available by contacting Celeste Ackerman at the address, e-mail, or telephone numbers listed in paragraph 2 of this notice.

 

            7. Concerned persons may present their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to Celeste Ackerman, Employment Relations Division, P.O. Box 8011, Helena, MT 59604-8011; fax (406) 444-4140; or e-mail to [email protected] and must be received no later than 5:00 p.m., on May 17, 2021.

 

            8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request, which includes the name and e-mail or mailing address of the person to receive notices and specifies the particular subject matter or matters regarding which the person wishes to receive notices. Such written request may be mailed or delivered to the Department of Labor and Industry, attention:  Laura Ducolon, 1315 E. Lockey Avenue, P.O. Box 1728, Helena, Montana 59624-1728, faxed to the department at (406) 444-4493, or e-mailed to [email protected].

 

            9. An electronic copy of this notice of public hearing is available through the department's web site at http://dli.mt.gov/events/calendar.asp, under the Calendar of Events, Administrative Rules Hearings Section. In addition, although the department strives to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems, and that a person's difficulties in sending an e-mail do not excuse late submission of comments.

 

            10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

            11. Pursuant to 2-4-111, MCA, the department has determined that the rule changes proposed in this notice will not have a significant and direct impact upon small businesses.

 

            12. The department's Office of Administrative Hearings has been designated to preside over and conduct this hearing.

 

/s/ QUINLAN L. O'CONNOR Quinlan L. O'Connor Alternate Rule Reviewer	/s/ LAURIE ESAU Laurie Esau, Commissioner DEPARTMENT OF LABOR AND INDUSTRY

 

 

            Certified to the Secretary of State April 6, 2021.