S-I Administrative Assessment Going Up 25% for FY 2007!

WSIA Successfully Fought to Limit the Assessment

The Department of Labor & Industries announced that the Self-Insurance Administrative Assessment for FY 2007 (July 1, 2006 to June 30, 2007) will be increasing by a whopping 21.7% (17.6% for those companies paying the adjusted rate).  The reason?  The Department is changing cost allocations for all services and attributing them to different programs, including self-insurance.  The Department claims that self-insurers have not been paying their proportionate share of all Department services that we utilize.  The major components of the increase are: $1.2 million in direct costs associated with services provided by Health Services Analysis and the Medical Director’s Office, and $2.9 million in indirect costs associated with Information Services ($1.5 million) and Administrative Services ($1.25 million.)  The Department also wanted to charge self-insurers $3 million for HSA and indirect costs from FY 2005.  WSIA successfully argued against these charges, and challenged the charges associated with the ORCA scanned-document project.  If that $3 million was included, the increase in the Administrative Assessment would have been nearly 39%!  Also, WSIA has demanded the justification for all costs associated with the Assessment, and may challenge those for next year’s allocation.  The Annual memorandum outlining the Administrative Assessment will be sent out shortly.  If you have specific questions, please contact WSIA Executive Director Dave Kaplan at dave.kaplan@wsiassn.org or at 800.736.7296.

Second Injury Fund Assessment to Drop for FY 2007

Department to Hold Back Part of Credit at WSIA Request

The Department will soon announce the Second Injury Fund Assessment for FY 2007.  The good news is that the assessment rate is going to drop significantly.  However, the reason for the drop was the delay and backlog of Pension Claims for FY 2005 carrying over into FY 2006.  Because of this artificial decrease in Second Injury Fund costs, WSIA has asked the Department to only apply half of the overpayment for FY 2005 and FY 2006 to the rate reduction for FY 2007, and to retain the other half of the overpayment to apply against the FY 2008 Second Injury Fund assessment.  This is will help mitigate a likely rate increase that will occur in FY 2008.  As a reminder, the three-year experience rating period for the Second Injury Fund began July 1, 2006.  Assessments based on this experience will begin July 1, 2009, with half of the cost of the Second Injury Fund pension socialized among all self-insured employers, and the other half of the cost allocated among those firms having Second Injury Fund pensions.

Help Expedite Your Own Claims,

Use Self-Insured Claims Related Checklists

Frustrated with delays at the Department on pension requests, vocational rehabilitation determinations, etc, etc, etc?  The Department has developed a series of “checklists” that will help make certain you’re submitting all of the information necessary to get more timely decisions.  Go to the WSIA website at www.wsiassn.org and click on the link on the home page that says “Claims Facilitation Checklists.”

Self-Insured Employer Notice of Denial (SIF-4) Now Available Online

You can now access a fillable SIF-4 template online at the Department of Labor & Industries’ website at http://www.lni.wa.gov/Forms/pdf/207163af.pdf.  Please remember that while you can use the template, you cannot change or delete text, font size, layout or headings.  It must remain substantially similar, and must contain all legal language as provided by statute or rule.  You can find other forms at the Department’s website by going to the homepage, click on “Get a Form or Publication,” and search for forms using key words or the form number.

SIEDRS Project Progress Report, Voluntary Participation Encouraged

The Self-Insurance Electronic Data Reporting System (SIEDRS) project is proceeding as planned.  A number of organizations have already volunteered to gear up for the January 1, 2007 implementation date for voluntary submittal of data.  It is important to note that after June 29, 2007, there will be fewer technical support staff dedicated solely to the SIEDRS project.  Your organization does not need to be ready by January to participate voluntarily.  You can prepare your system any time, and test when you are ready.  Mandatory participation will occur July 1, 2008, so it is very important that you budget and plan ahead to be in compliance.  This is particularly important for public entity self-insured employers that must budget and plan far ahead.  To get an enrollment package, contact the Department at SIEDRS@lni.wa.gov.  Note your name, email address, telephone number, and name of the self-insured employer or third party administrator that you represent.

Gary Weeks Resigns as DLI Director, Judy Schurke Named Interim Director

October 13th was the last day of Gary Weeks as Director of the Department of Labor & Industries.  He left after only 18 months in the position, citing personal reasons.  Gary was a fair and thoughtful leader, and his presence will be missed.  However sad Gary’s departure, Judy Schurke has been named Interim Director.  Well-known in the self-insured community, Judy has served as Deputy Director for Operations at the Department for the past few years.  Prior to that she served as the Business Representative on the Board of Industrial Insurance Appeals, and as head of workers’ compensation for the Boeing Company.  We wish Judy good luck in her new and difficult role.  The Department has begun a national search to find a new director.  WSIA told the Governor’s Chief of Staff that we want a director that is open-minded, free from the on-going political struggles of the past few decades, and isn’t afraid to pursue legislative changes that are in the best interests of the system – whether labor or business likes the proposals or not.  We hope the Governor find someone who fits the bill.

Guidelines Being Developed on Narcotics

Used for Chronic, Non-Cancer Pain

The medical directors from a number of state agencies are developing guidelines to limit the dosage of narcotics or opioids used to treat chronic, non-cancer pain among patients of state agency programs – including the Department of Labor & Industries.  While the guidelines do not require it, a hearing was held on October 23rd to take into consideration public input in the setting of these dosage guidelines.  This should help reduce the number of fatalities and overdoses by injured workers.  WSIA supports the efforts to help physicians control and prevent opioid medication abuse.

Electronic Filing of Claims Appeals

At the Board of Industrial Insurance Appeals

Did you know you can file your claims appeals electronically, online?  You can!  Go to the Board of Industrial Insurance Appeals website at www.biia.wa.gov and click on the E-filing logo.  Your appeal is submitted instantly, saving time and postage.  You are able to print a copy for your records, and a receipt showing that your submittal was received.  Give it a try!

Updated Self-Insurance Section Phone Contact Listing

Need an updated list of Self-Insurance section phone numbers?  Here’s the link to the latest and greatest list, http://www.lni.wa.gov/ClaimsIns/Files/SelfIns/SelfInsPhoneList.pdf, updated October 6, 2006.  Check back at the link periodically for updated information.

Provider Bulletins No Longer Printed,

Only Available Electronically at the Department’s Website

The Department will no longer be providing hardcopies of Provider Bulletins to customers.  Instead, notification of new Bulletins will be sent on a postcard.  The postcard will include the Bulletin's title, purpose, and where the Bulletin can be found at the Department's website,

http://www.lni.wa.gov/ClaimsIns/Providers/Billing/ProvBulletins/default.asp.

Spokane COHE Expanding, Pushing for Self-Insured Participation

The Spokane Center of Occupational Health & Education (COHE), located at St. Luke’s Hospital & Medical Center, is in the process of recruiting self-insured employers to participate in the project.  A small number of self-insured employers have signed up to participate, with a number of other self-insured employers considering participation.  The COHE projects were formed to help facilitate three party communication in claims (particularly with State Fund claims), educate attending physicians about prompt filing of Reports of Accident (ROA) and the value and importance of Return to Work to the injured worker, and to help provide claim coordination so that claims won’t fall through the cracks.  Both the Renton COHE and Spokane COHE have had some measurable success in increasing the number of ROA’s filed within 2 days of the date of the worker seeking treatment (over 80% for Renton, over 60% for Spokane).  There are also some measurable positive results from the Renton COHE on carpal tunnel claims.  The Spokane COHE has not shared the same success in that area.  Additionally, the State Fund employer community has some concerns regarding the lack of substantive, measurable results in general beyond the Hawthorn Effect, and regarding the administration of the Spokane COHE.

The WSIA Board of Directors has reflected on COHE projects for 8 years.  After consideration of the benefits for the additional costs involved ($8.18 for every time loss claim the employer has – whether the claim goes through COHE or not, and the higher reimbursement rates in the fee schedule for activities already being compensated for best practices), the Board has agreed that WSIA cannot recommend participation in the program, but would not discourage participation by those self-insured employers who wish to take advantage of the emphasis on prompt filing of Physician’s Initial Reports.