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MONTANA SELF INSURERS' ASSOCIATION

December 2023 Update

  • DOLI Red Tape Initiative DRAFT Rule Changes
  • Medicare Reporting – Civil Monetary Penalties, CMS Data Report & Webinar 1/18
  • WC Benchmarking Survey – MSIA Member Input Requested
  • Time to First Medical Service – WCRI Report
  • 20 Issues to Watch – 2024 - 1/9
  • Comp Laude Recognition – The Montana Connection
  • Nat’l Council of Self Insurers – Annual Mtg June 2 - 5

DOLI Red Tape Initiative DRAFT Rule Changes

MSIA members were among the first to learn that an exposure draft of the Red Tape Initiative workers’ compensation rule changes was coming with the announcement at our September Annual Meeting. The 125 page exposure draft has been released, DOLI has provided some distribution and a copy is attached. 

MSIA applauds DOLI for some exhaustive work. Most of the changes will streamline the rules and regulations in the state and will avoid duplicating statutory language. Within those changes there are some which may require further review and potential change. The advantage of this exposure draft is to be able to provide input and suggestions prior to going through the formal rule making process. We also applaud DOLI for seeking input in this manner. 

Among the changes is a proposal for carriers and self-insurers to report unpaid case reserves for claims seeking SIF reimbursement. This is new language and is purportedly needed to assist the Department in generating reports to the legislature. The remaining changes eliminate (among other things):  

the requirements to be over the age of 18 and have a HS diploma or equivalent to sit for and become licensed to manage WC claims in Montana, rule language regarding the Purpose of the Montana Utilization and Treatment Guidelines, and

Language regarding definitions within the rules that may be duplicative of the language in statute. 

MSIA has an informal meeting with DOLI representatives starting today regarding our initial review. While some of our concerns may well be put aside based on greater understanding of why the language is no longer necessary, the requirement for reporting case reserves on SIF claims and permitting someone who has not reached a legal age to have access to and manage private medical information are areas MSIA is less willing to accept. As well, MSIA will be sharing our thoughts with the industry and business leaders to make sure as broad a spectrum of interested parties is involved in the potential changes. Our goal is not to stop the effort, but to provide the best thoughts possible by bringing in more perspectives on the changes.

Workers’ Compensation Benchmarking Survey – Respond by 1/19

The eleventh annual Workers’ Compensation Benchmarking Study’s industrywide survey is currently underway. I have participated in the past, and have found the Survey provides a thought provoking and worthwhile exercise for my management of our company’s claims efforts. The Survey results reflect the best of our industry and identifies goals for claims professionals and organizations to shoot for. The Survey is sponsored, in part, by MSIA member Rising Medical Solutions. 

For only the second time, the Survey seeks input from the frontline claims professionals (versus claims executives) to ascertain alignment between industry leadership and those who directly handle workers' compensation claims and have an immediate impact on financials and injured worker outcomes. The study will also identify any substantial changes since last surveying frontline professionals in 2019. We will learn what impact the pandemic’s changes in our personal and professional lives have had. As the industry’s largest talent constituency, with the greatest influence on financial and injured worker outcomes, visibility into their views will highlight advancement opportunities for the entire industry. Survey leadership includes Montana representation. 

MSIA encourages members to participate as a valuable opportunity for members to assess and enhance operational alignment within your claims organizations.

  • If you are a Claims Leader (e.g., C-Suite through Supervisor) – please forward the confidential survey link to your frontline claims staff
  • If you are a Frontline Claims Professional (e.g., claims adjuster, claims examiner) – please share your insights by taking the confidential survey 

Please note, all confidential data will be aggregated, and no individual or organization will be identified in any way in study findings.

In return for completing the brief 10-minute survey, all frontline participants will receive the Annual Report which can be used to validate operational alignment, verify existing strategies, advocate for resources in support-challenged areas, and identify opportunities to impact claim outcomes.

Here is the confidential survey link. MSIA encourages members to share this survey link with your frontline colleagues.

Time to First Medical Service – WCRI Report

Last month the Workers’ Compensation Research Institute (WCRI) issued their FlashReport, Time to First Medical Service, which reviewed data from 17 states for claims made from 2016 – 2021, with claim experience through March 2022 (Montana is not one of the states in the WCRI database). Even though Montana data is not included, our system is not so different from other states in this area. The report provides a reasonable comparison between Pre-Pandemic and Post-Pandemic experience in the time from injury to ‘entry’ medical services and first surgeries or further physical medical care. Research verifies that shorter time to medical treatment from injury results in faster physical recover, faster return to life (work) and better injury outcomes. 

There were no delays in the first ‘entry’ (emergency room or initial evaluation and management – office – visits) medical services as a result of COVID. These ‘entry’ services are provided to almost all injured workers. The report strongly suggests that the rise in the use of telemedicine likely had an impact in the similar length of time to initial visit pre, during and post pandemic time periods. However, as you might suspect, the length of time from injury to first surgery increased during the pandemic period in 2020. That trend began to reverse in 2021. Interestingly, as well, initial physical medicine service occurred sooner in non-hospital physical/occupational therapy situations as opposed to when it was provided in a hospital outpatient setting. 

MSIA, through one of our members, is a member of WCRI and has access to WCRI reports. 

20 Issues to Watch in 2024 – Free Webinar Jan 9 @ 10a MST

Featuring Mark Walls of MSIA member Safety National and Kimberly George of Sedgwick, this webinar has become an annual favorite. Walls and George go through what they see coming up and how the issues may manifest themselves in the workers’ compensation world. The webinar is free and advance registration is required, Issues to Watch 2024 – January 9 at 10a MST. 

Discussion topics will include: 

  • Trends impacting frequency of severity rates in catastrophic claims.
  • Effects of legal system abuse in liability verdicts.
  • Expectations for evolving employee benefits.
  • Industries facing increasing workplace violence.

Register here: Issues to Watch 2024 (safetynational.com)

Comp Laude Recognition – The Montana Connection

Work Comp Central sponsors the Annual Comp Laude awards, recognizing leadership in our industry and designed to change the narrative of workers’ compensation . For the first time in memory, Montana had a number of connections to both nominees and winners. 

Jason Swant, Workers Compensation Section Manager with the Employment Standards Division of the Montana Department of Labor and Industry was recognized as the Regulator of the Year. Swant has risen through the ranks at what is now ESD (formerly ERD) and has become known to everyone he works with as earnest, honest and highly customer service oriented. MSIA thanks Swant for his contributions to the Montana workers’ compensation system and for working with us, regardless of the issue. Comp Laude got right, Swant is an outstanding regulator. It is a pleasure to work with him. 

Debra Livingston with ReEmployAbility, and the MSIA Annual Meeting guest speaker was recognized as a Magna Comp Laude, Claim Professional of the Year and ReEmployAbility was named the Most Innovative Service Provider. Livingston, in her presentation to MSIA members and guests, showed us how her innovative program helps injured workers return to life (and work) after an accident when their time of injury employer does not have light duty opportunities. ReEmployAbility places people in non-profits – helping them, and helping the injured worker get back to life, community and providing greater sense purpose to them, after significant and life altering injuries. Her program has had great successes. Livingston’s presentation at the MSIA Annual Meeting is available to members at MSIA.org/annual-meetings/2023.

Michael Marsh, MSIA Secretary/Treasuer and owner of Midland Claims Service in Billings was nominated for Workers’ Compensation Philanthropist of the Year. 

Dr. Gerry Stanley – a friend of MSIA - was recognized as the Doctor/Physician of the Year. Stanley’s company, Harvard MedTech, helps people recover through the use of virtual reality. Stanley has been a speaker at the Governor’s Conference in Bozeman and at the National Council of Self Insurers. 

National Council of Self Insurers – Annual Mtg June 2 - 5

Registration for the 2024 National Council of Self Insurers Annual Meeting at the beautiful Don Cesar Hotel in St. Petersburg Beach, Florida. MSIA is on the Executive Committee of the National Council of Self Insurers. 

Yes, it’s December and the meeting is in June – however rooms are limited and going fast! This is an exciting year for NCSI and this Conference promises to be one of the best. Employer members are already signing up and we’re expecting to hear from some provocative and well respected leaders in workers’ compensation. This is a Conference you don’t want to delay registering for! 2024 Annual Meeting (natcouncil.com)


A final note for the year – Thank you for your support, encouragement and membership in MSIA this year. Our best wishes, from our family to you and yours for a Happy, Healthy and Safe Christmas and New Year!