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Montana Self Insurers' Association

MSIA Update May 2024


Re-Scheduling Marijuana

MSIA first reported on the potential of the federal government re-scheduling marijuana in our February 2024 UPDATE. Since then, not only has the Department of Health and Human Services (HHS) recommended re-scheduling (hhs-marijuana-rescheduling), it has become a directive of the Biden administration. The Drug Enforcement Agency of the Department of justice (DEA) will be putting forth a proposal to move marijuana from a Schedule I drug (no medical value and highly susceptible to abuse) to a Schedule III drug. This would permit marijuana to be available by prescription in states where it is legal to do so. Where marijuana remains illegal, there is no impact based on this change, but adds to the pressure to change the drugs’ status. This marks the first time, since marijuana was assigned as a Schedule I drug, where the federal government has recognized there may be medical advantages to using marijuana. This also helps remove some of the roadblocks to medical and other research regarding the medical application of marijuana. 

Of course, the issue is not simple nor is the process. Once the DEA approves of the HHS recommendation, the proposal must be go through the administrative adoption process. After publication in the Federal Register, there is a 60-day public comment period and the action may be subject to a public hearing. Alternatively, Congress could take action on their own and direct, by law, to make changes to marijuana criminal, medical and taxation laws. While Congress is aware of the state level changes and has debated marijuana legislation, those proposals have never passed more than one chamber. Even with the re-scheduling, there would remain significant financial hurdles to banks for dealing with cannabis businesses, and therefore this is only the first step at the federal level. 

Again, this is the first time the federal government has formally acknowledged there may be medical benefits of marijuana, and this would permit serious study of the drug in this country. This could also permit pharmaceutical companies to get involved in the sale and distribution of medical marijuana where it is legal. Re-scheduling would not make cannabis legal but would remove many of the obstacles to medical research. 38 states have made medical marijuana legal, and almost half have de-criminalized its’ recreational use. 

Our thanks to MSIA member Health-e-Systems for first identifying the HHS recommendation. 


St. Vincent’s Hospital in Billings Designated a Level 1 Trauma Center

St. Vincent Regional Hospital, part of Intermountain Health (an MSIA member), was designated a Level 1 Trauma Center last month. Level 1 Trauma care is the highest level of emergency care designation recognized by the American College of Surgeons. Billings Clinic became a Level 1 Trauma Center in August last year. Both hospitals in Billings are the only Level 1 Trauma Centers in MT, WY, ID or SD. The closest other centers are either Denver, Salt Lake or Seattle. 

A Level 1 Trauma Center must be able to deliver comprehensive care to the most critically injured patients, 24 hours a day, every day. 


Dept of Labor Final Red Tape Rules Adoption & More Red Tape Changes to Med Fee Schedule Rules 

Public Hearing June 4 – 9a MDT

The Montana Secretary of State will be publishing on Friday, May 10 the final adoption of the Department of Labor’s initial Red Tape Rules changes. MSIA comments at the public hearing on March 28 were the only comments provided during the hearing. All of our comments received a response, although none of our concerns resulted in amending the proposed language. The Department had released an ‘exposure draft’ earlier in the winter and our most significant concerns were addressed prior to the formal publication of the proposed change, and we supported the changes amended as we had sought. The remaining suggestions MSIA provided, to retain specific language regarding balance billing, choice of provider and minimum age to be a claims examiner were reviewed and regretfully, rejected. The soon to be adopted proposed changes would, in our opinion, make the rules less clear and leave some to interpret the rules differently than intended by the laws. 

The Department has also recently submitted Red Tape Initiative updates applicable specifically to the medical fee schedules along with new conversion factors to be used for the various medical fee schedules. These proposed changes are also attached. Included in this package is an update to the Dental fee schedule to apply 100% of the usual and customary charge for dental services and to provide for the American Dental Association Dental Claim Form for billing. 

A public hearing on these proposed rules (also attached) will be held on June 4 at 9a MDT. The public is invited to attend via Zoom or telephone,  

Join Zoom Meeting, https://mt-gov.zoom.us/j/88376081707 , or Dial by telephone, +1 406 444 9999 or +1 646 558 8656

Meeting ID: 883 7608 1707, Passcode: 569883 

MSIA will be reviewing the new Medical Fee Schedule Red Tape Initiative rules change proposals. MSIA member comments are appreciated and welcome. Please contact us if you have perspectives on these changes you would like to have considered by the Department. 


First Notice - - MSIA Webinar – MT & Countrywide WC System Results – 6/6 @ 10a MDT presented by NCCI

Sponsored by Midland Claims Service and  Injury Claims® and MyMatrixx by Evernorth 

As part of our commitment to the Montana workers’ compensation system and the people who are subject to it, or work with it, we have asked the National Council on Compensation Insurance (NCCI) to share their perspectives on the Montana & Countrywide WC System Results with ALL Montana system stakeholders. This Special Webinar is set for June 6 at 10a MDT and is FREE and available to everyone regardless of the role they play in our workers’ compensation system. 

We will hear from NCCI’s Executive Director & Actuary for Actuarial & Economic Services, John Deacon and Senior State Relations Executive Todd Johnson on NCCI’s latest information included in the NCCI filing which resulted in a -3% change in the overall average loss costs in our system. MSF took an overall average -10% change in their rates, in part based on this filing. 

  • Do you know the last time there was an increase in our NCCI filed loss costs?
  • What’s driving this change? 
  • How does Montana compare to other regional states or the country as a whole? 
  • Do we have more claims than other states? 

Continuing education credit is available for both the MT CSI Producer and the MT Department of Labor WC Claims Examiner license for this Montana & Countrywide WC System Results webinar. If you are seeking the CSI Producer license CE credit, you MUST provide your name as it appears on your license, your NPN number and your license number. Incomplete or inaccurate information will result in our not being able to apply your credit.

Advance registration is required - click on the links provided or contact the MSIA Office to register.



Governor’s Conference Registration Open – Safety Award Nominees Sought

Registration for the Governor’s Conference on Workers’ Compensation, September 11 – 13 at the Copper King Hotel in Butte, has officially opened. The theme this year is Better Medical, Better Outcomes and the Department of Labor has pulled out all the stops to put together an excellent list of both Montana based and nationally recognized speakers. 

Butte is the site of much of America’s business and labor history and is rich in stories and events. It is one of America’s historic seats for business and corporate leaders and one of the historic seats for America’s labor movement. Based on that, it is also where so much of the safety we take for granted today, was born and first put in place. Among the speakers expected to join us is Butte Historian and author Chris Fisk who will talk about the most deadly mining accident in American history – the Granite Mountaion/Speculator Mine disaster of 1917. This is a chilling and very moving tale about courage, resiliency, death and in the aftermath – changes in American business, labor and safety.  

The MSIA Annual Meeting is the first thing on the Governor’s Conference agenda. Our Business Meeting for members only will start at 8:15a and our Annual Meeting, open to all will start at 9a. The MSIA Annual Meeting guest speaker will be Amy Lee, nationally recognized for her leading issues research on workers’ compensation and a former Director of the Texas Workers’ Compensation Division. The MSIA Business & Annual Meeting is sponsored by Definiti Comp Solutions and Browning, Kaleczyc, Berry & Hoven.

Judge Thomas “Lee” Bruner was appointed by Governor Gianforte just prior to last year’s conference. Now with a year under his belt, he will be one of the featured speakers. This may be his first public speaking engagement since becoming Montana’s Workers Compensation Court Judge. Other speakers are set to include: 

  • Dr. John Schumpert – REOH, Missoula
  • Dr. Ethan Moses, CO Division of Workers Compensation Medical Director
  • Dr. Laura Kirsch – Clarus IME – an MSIA Member
  • Amanda Waltemach, PharmD and Silvia Sacalis, PharmD – Health-e-Systems – an MSIA Member
  • Kerri Poe – Arcadia Settlements – an MSIA Member
  • Hany Abelsayed – Tower Settlement 
  • Johnny Meyer – Ametros – an MSIA Member
  • Brian Allen – Optimized Outcome Solutions (MSIA Webinar presenter)

Register Today!


The Conference will also feature the annual Governor’s Safety Awards. Nominations are due by June 30.

The Governor’s Safety Achievement Award - This award recognizes Montana’s small, medium, and large employers and individuals in the public and private sectors committed to safety in the workplace. Through their commitment to safety, these employers and individuals are not only creating a safe place to work; they are reducing their workers’ compensation rate, making them leaders in their industry.

The Governor’s Achievement Award for Distinguished Workers’ Compensation - Trail Master - This award is given to a professional who works in the field of workers’ compensation in any capacity. The nominee should exhibit the ability to extend themselves beyond their professional life into their personal life representing the workers’ compensation field of employment. 

The Governor’s Achievement Award for Distinguished Workers’ Compensation - Trail Runner - This award is given to a professional in the field of workers’ compensation in any capacity. The nominee should exhibit the ability to extend themselves beyond their professional life into their personal life representing the workers’ compensation field of employment. This award goes to someone who has taken on the challenge of learning the workers’ compensation system in Montana. 



Welcome New MSIA Member – MinWorx Health 

Back to Work in Days, not Months. That’s the MinWorx pledge. Over 13 million people in the US suffer from Carpal Tunnel Syndrome or Trigger Finger Syndrome but only 5% have surgery. Why? No one is excited about the prospect of having surgery. Full recovery can be a long road and outcomes can be uncertain. Well, not anymore! If you have employees suffering with either CTS or TFS, now you can get them relief and back to work and life in days, while saving 80% on the total cost of the claim. Min (minimally invasive network) Worx (for work comp): bringing minimally invasive surgical bundles to work comp. 

As the Work Comp industry moves away from fee for service to condition specific care (safer, better outcomes, significant cost savings), MinWorx Health is uniquely positioned to bring the latest and best care for injured workers. We discover game-changing medical technologies, partner with those companies, and cut through barriers to allow access to injured workers years faster than usual. Oh, and we guarantee RTW and no revisions. This bold offering is possible because of the certainty of our outcomes. Sound too good to be true? Contact Amy Rolando at ARolando@MinworxHealth.com or 612-808-9870.


Welcome New MSIA Member – EK Health 

EK Health Services Inc. is a leading national workers’ compensation managed care organization. Partnering with companies, insurers, and healthcare professionals, we successfully resolve and simplify the complex issues surrounding workers' compensation. With a complete line of solutions, EK Health sets the gold standard for early intervention, medical case management, utilization and peer review, medical bill review, network management, clinical specialty programs, ergonomics, vocational rehabilitation, and Medicare set-aside.  

EK Health is focused on restoring the quality of life for injured workers through innovative, cost-effective solutions. Clients trust us to provide services with high-touch experiences, customizable and nimble solutions, lower costs, and proven results. Our holistic approach integrates the best people, processes, and technology to facilitate the best possible outcomes. With EK Health you can truly dream bigger and experience better managed care. For more information contact Kirra Gaudino at KGaudino@EKHealth.com or 1-877-861-1595 X-173.


2024 National Council of Self Insurers Annual Meeting 

June 2 – 5 - St. Pete Beach, FLA

There’s still time. MSIA members register at the membership rate – but you have to register soon to join us in fabulous St. Petersburg Beach, FLA. We’re meeting at the Don CeSar – holy cow, it can’t get much better than this! 2024 National Council Annual Meeting

The National Council Annual Conference is where employers talk to employers. The meeting agenda includes

  • Safety – What’s the Latest in Wearables and How Can We Learn From What They Tell Us?
  • MSA’s – The Employer’s and an Expert’s Perspectives
  • Humanizing the Workers Compensation Claims Process
  • Controlling Litigation Costs – the latest from a 50 state exposure employer
  • Unbundling TPA Programs for Customized Medical Management    
  • What To Do When OSHA Comes-A-Knockin’
  • AI in the Claims Process
  • Trolls, Bots, Truths & AI: Navigating the Muddy Waters of Social Media Investigations
  • New Opportunities for Old Dog Claims
  • Understanding the Language of Pharmacy
  • How to Hold Your Service Partners to Your Standards

The 2024 Election and What it Means for Our Business – We’ll get a state and federal legislative analysis and discuss the potential impact of this election year

We will hear from Stanley Steemer, Marriott, Chick-Fil-A, Publix Markets, Roto Rooter, our own Mike Marsh and Sibanye Stillwater Mining, Southern Legacy Waffles (Waffle House), Southern Glazers Wine & Spirits. American Electric Power and more. There will also be the annual meeting of state association executives, who openly share what’s working for them and what we’re all seeing on the legislative front. 

This is one of the few meetings where employers, share what they’re doing, what’s working and how they are making a difference – with other employers. Register now! 

2024 National Council Annual Meeting