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MONTANA SELF INSURERS' ASSOCIATION

MSIA Update / Leg. Week 15

  • Legislative UPDATE - SB 345 Passes House Committee !!!
  • Get Ready for the Floor Fight! – We Still Need Your Help
  • SB 394 – PTSD for First Responders Also Passes – Another Floor Fight
  • HB 740 – Family Pharmacy w/MSIA Amendment – On to Governor
  • HB 516 – Transfer WC Court to Judiciary – On to Governor
  • Easter Break – When Will They Go Home?

Legislative UPDATE - SB 345 Passes House Committee !!!

  • Get Ready for the Floor Fight! – We Still Need Your Help
  • SB 394 – PTSD for First Responders Also Passes – Another Floor Fight
  • HB 740 – Family Pharmacy w/MSIA Amendment – On to Governor
  • HB 516 – Transfer WC Court to Judiciary – On to Governor
  • Easter Break – When Will They Go Home?

SB 345 – the MSIA requested bill to end the automatic deference to treating physicians and to make IMEs somewhat easier to get - - passed the House Business & Labor Committee this morning 11-9. All the Representatives we needed to support the bill, did so, and the Committee Chair, Ed Buttrey (R-GTF) will carry the bill on the House floor. 

We still have a fight to get the bill passed - - and continue to need your help with ANY House majority (R) member. They need to hear from YOU that this bill is important. MSIA is preparing a message to every member for delivery to the floor next week, and we will be making contact with the business community to rally as much support as possible for the bill. However, they need to hear from the folks at home that this is important. Email addresses are Firstname.Lastname@legmt.gov. Attached is a DRAFT letter we are preparing for the House floor which makes the points that are important. For SB 345,you can simplify the message by using the top bullet points.

The reason we have to keep at it is because the opponents, labor and plaintiff attorneys have made this their number 1 target and are pulling out all the stops to try to defeat it. Assume they will leave no stone unturned - - and we have to at least match their efforts. We need you. 

SB 394 – the PTSD for First Responders also passed the House Business & Labor Committee this morning. MSIA has been the lead opponent to this proposal – mostly because it will add costs, but it also opens the gate for everyone else to get mental-mental benefits in our system. Montana is not alone in excluding mental-mental benefits – we are one of 11 or 12 states who exclude those claims. However, this is an emotional issue and - - it is a tough one.

While that’s true – there may be a better alternative and MSIA has been asking the legislature to come up with a more substantial and substantive answer. This is a big problem in our society and requires a bigger solution than this bill. Georgia has recently enacted a law which specifically addresses the problem and provides needed benefits to our first responder heros who are suffering. At the least, we should look at its’ application to Montana. This issue is too important not to. 

Also attached is a DRAFT letter to the House floor with reasons to endorse a study, instead of the current language of the bill. Here too – members of the House need to hear from everyone about the alternative. 

Happy Easter Break. The legislature went home this afternoon and will be gone for the Easter break through to Tuesday morning. 

This is the silly-er part of the silly season, although there’s an argument to be made that it’s all been the silly-er part this year. Bills start flying all over the place, amendments get adopted before being written and bills move from Committee to floor and floor action to make a deadline. 

We’ve talked about how bills can move forward after a transmittal deadline if they include either revenue or an appropriation. As an example, Senator Daniel Zolnikov (R-BIL) carried SB 553 that has nothing to do with our issues but was heard this week in House Business & Labor. Among the list of different things the bill did – and there is a laundry list of things the bill will do – it included a $1 assessment for all airline tickets sold in Montana, creating revenue for the state. Zolnikov needed more time to get his bill through, so he created revenue for the state to meet a later transmittal date. As an aside, the House Business & Labor Committee agreed to an amendment to strip that out of the bill. 

Taxes, taxes, taxes. The bottom line is there is no clear path regarding property or income taxes. Enough people dislike the Governor’s property tax proposal (HB 231); enough people dislike the House Democrats property tax proposal (HB 155); enough people dislike the Senate leadership alternative (SB 90) which would take most of the money from the tourism taxes on hotel rooms and rental cars to subsidize property tax; and, no one wants to enact what is ultimately Plan B – another $400 rebate on property taxes this year (SB 434). Late this week the Senate Tax Committee passed a modified version of both the Governor’s proposal (HB 231) and the House Democrats proposal (HB 155). The ultimate point is to keep the bills alive so maybe something can be agreed to. Maybe. All of the bills, other than SB 90, increase taxes somewhere within the property tax realm – either on second homes, more expensive homes or commercial properties, or a combination of all three. The result is in shifting the tax burdens, each bill has enough of a coalition to gum up the works on any of them.

There’s only one thing that everyone seems agree on – income taxes will not subsidize property tax relief. Maybe there’s two things that people agree on – that and we have to do something on property taxes. But, so far, no one knows what we will be doing. 

This time of year/session also brings out the “when are they going home” question. In prior sessions, it was somewhat predictable. Last session however, Senate Minority Leader Pat Flowers (D-BZN) surprised everyone when he called for session to end, well before anyone expected it and got enough votes to pull it off. The move surprised most of us and left the House with no choice but to pack up as well, since anything they did that needed Senate concurrence, was dead. This year, of course with ‘the Nine’ who knows? Some speculation has them going home next Friday 4/25. 

That seems a bit too early for me to buy it. However, with the current calendar going to May 5 – I would be surprised if they went past Wednesday, 4/30. That feels about right to me – just based on my gut – and avoids another month’s rent for anyone not in the Helena area. That makes sense - - although in fairness, in every week’s message I have warned us about trying to apply logic or sense to the session…..

There’s another change to the spreadsheet this week. In the bill title column, I have indicated whether the bill is going to the Governor or to Conference Committee. The legislature and the Governor’s office have an unwritten agreement that rather than bombard the Governor with bills all at once at the end of the session, the legislature holds bills back and releases them so that the Governor has time to actually think about them rather than a mass signing or mass veto based on deadlines. Typically the Governor has 10 days to determine what to do with a bill before it is vetoed based on inaction. To avoid that, the legislature agrees to hold up delivery. So, when I say the bill is on its’ way to the Governor, it can be a while before he actually gets it. A Conference Committee is created when the House and Senate disagree on final language on a bill and pull together a small number of members to hammer out the details. Among the “joys” of a legislative session, is that a Conference Committee only has to stay within the title of the bill (thus so many bills are introduced as, “Generally Revising Workers’ Compensation Laws”). They do not have to address the original purpose of the bill, nor the amended version – as long as they stay within the title, they can do anything they want. Conference Committee reports are voted up or down – they do not get to change the ultimate language presented to the floors.  

And, for the record, bills that do not have an enactment date within the language, are effective October 1 of the legislative year. 

It’s been a wild week – in a wild year; Happy Easter. It’s also the last weekend of the ski season – on behalf of your local ski patrol, please keep the black side of your skis or snowboard down! 

 

SB 345 / Hertz (R-Polson)

This is a MSIA requested bill to end the deference to treating physicians in litigated cases and ask the Judge to provide credibility on testimony and experience, make it easier to secure an IME and provide some ancillary benefits to support an IME when travel is involved. The bill was heard in House Bus & Labor on 3/31 with MSIA as the lead proponent joined by the Plan 2 carriers, businesses, as well as MSIA members MCCF and MSGIA and MSF. This bill is the subject of significant grass-roots efforts by MSIA, business groups, as well as labor and plaintiff attorneys. The bill passed House Bus & Labor 11-9 on 4/18 and we expect it will be addressed on the floor next week. Thank you for your support of our efforts to get this bill passed. MSIA members made a significant difference in moving commitments from individual legislators – we still need you!

 

SB 394 / Neumann (D-BZN)

This bill provides for PTSD claim opportunities for law enforcement and first responders. Rather than provide a presumption, the language requires claims to go through the WC process for compensability determination. However, it provides a carve out from the existing prohibition on ‘mental-mental’ claims. There are only 12 states which continue to exclude mental-mental claims in their WC systems. And the trend across the country has been to provide presumptive PTSD coverage for first responders. MSIA was the lead opponent to the bill, as was MSIA members MCCF and MSGIA. MSIA offered what may be a unique program in Georgia, which may be a better approach to addressing the issue by creating a special program within municipalities’ health care programs for PTSD for first responders. The bill passed Finance & Claims 12-10, with all members of the nine voting with the Democrats. The bill then moved to the Senate floor for its first vote. MSIA organized businesses and authored a letter in opposition from a broader business community, including MSIA members MCCF. MSBGIA, MT Electric Co-Ops’ Assoc, MMIA, the Plan 2 carriers, APCIA, the MT Chamber of Commerce, the MCA and the Helena Chamber of Commerce and distributed the letter to each Senate desk and handed them out in the hall. The bill passed the Senate 29-20 on 4/4. We will continue to try to defeat this bill, or find an alternative solution, rather than pushing all these costs onto employers. The bill also pssed the Committee today 12-8. The Governor’s office does not oppose this bill.  MSIA will be the lead opponent to this bill – and we need your help to re-focus the legislature onto the idea that this is a big problem and needs a bigger solution than this bill. 

 

HB 740 / Bertoligio (R-Clancy)

This bill is aimed at providing more control over PBM relationships by independent pharmacies. While an initial amendment eliminated the reference to application to the workers’ compensation statutes, there remained a reference to the PBM statutory language which would have increased pharmacy costs to WC carriers (including self insurers). MSIA is working with others to make a final amendment to eliminate that reference so there is no impact to WC coverage. First, WC is a minimal payer to pharmacies, in comparison to health coverage and there is already a WC pharmacy fee schedule. At the least, not making this change would result in a conflict within the statutory language. The bill has passed the House 98-1 on 3/7. MSIA is working on an amendment to this language to eliminate reference to the WC statutory language. The bill was heard on 4/1 in the Senate Judiciary Committee and passed out, with our amendment 5-3 on 4/8. It then passed Senate Finance & Claims and ultimately the Senate, today 63-35. The bill will next go to the Governor for his decision.  

 

HB 516 / Walsh (R-Twin Bridges)

This bill would move the WC Court from the Department of Labor to the Judiciary. The bill was heard in House Bus & Labor on 2/25 and passed 20-0. The bill passed the House 95-2 on 3/3 and was heard in Sen Bus & Labor on 3/20 where it passed 8-4 on the same day. There is a clarification needed on this bill to continue the funding through the DOLI Administrative assessment to workers’ compensation insurers (including Plan 1, self-insurers). That amendment, adopted by and the passed the Senate. The House concurred in the Senate amendments and passed the final version 98-1 on 4/17. The bill will next go to the Governor, where he is expected to sign it. MSIA supports this bill.

 

For a full list of legislation we are following – and the bills that are currently dead, see the attached spreadsheet for more details and access to links to the language, fiscal notes or amendments.



DOLI Releases Exposure Draft Rules Updates

 

The Department of Labor and Industry, Employment Standard Division (ESD – the workers’ compensation regulator) last week released an exposure draft of rules updates. MSIA sent a copy of the drafts to members on Wednesday 4/9 – they are also attached. The changes propose to do four things:

  • Correct what are basically scribner’s’ errors to the rules as adopted last year as part of the Red Tape Initiative. Last year’s efforts were so massive there were bound to be minor errors in references – and there were. These proposed rules make the appropriate corrections and do not make any substantive changes. 
  • Provide the annual updates to the fee schedules and formulary. It appears there are minor increases in prices, but not so much that NCCI will be making a filing to reflect that change.
  • Update the lodging rates used in calculating that portion of indemnity benefits. Under Montana law, if lodging is provided as part of the remuneration for the employee, the appropriate county lodging rate must be used in the calculation of benefits. Since last updated, Montana real estate values, and therefore lodging rates have changed by more than 20%. This update reflects those changes. 
  • Require that petitions to re-open benefits after the mandatory 5-year closure date be complete before they are accepted, and therefore start the 60 day decision process. Under law, the ESD has 60 days from the filing of a petition to make a determination of whether benefits should continue for another two years or not, based on the medical input and recovery of the injured worker. The law requires these benefits to be closed after five years, absent an agreement to continue the benefits, or such an order. 

There is no wiggle room in the deadline for ESD to make a determination on the petitions to re-open benefits. We have heard that some applications are incomplete, and require ESD to return those applications for additional required information. Absent this rule change, ESD has been in the position of waiting and burning days within the deadline for complete information on which to make a determination. This change permits ESD to request the required information and start tolling the number of days, based on a complete petition. 

MSIA supports these rule changes to make the necessary annual updates and to require the petitioner, whether the carrier or injured worker to submit a petition with the required information before starting to toll the number of days for a decision.

Welcome New Member – Laird Cowley, PLLC

LairdCowley.com is a multi-faceted defense firm with offices in both Missoula and Helena, and our regional footprint covers a 5-state area. Laird Cowley’s practice areas include Workers’ Compensation, Commercial Litigation, Personal Injury, Insurance Litigation, Professional Negligence, Family Law, Employment Law, Construction Litigation, Business Law, and Immigration Law.  

Two attorneys at Laird Cowley, Tom Harrington and Tom Bell, dedicate their practices to workers’ compensation matters. The defense attorneys in Laird Cowley’s workers’ compensation department represent insurers and TPA’s across the State of Montana, and they have more than 50 years of combined legal experience. Laird Cowley is excited to join MSIA as an Associate Member! For more information contact Tom Harrington at THarrington@LairdCowley.com 406-541-7870 or Tom Bell at TBell@LairdCowley.com 406-541-7400.

National Council of Self Insurers Annual Conference – St Pete Beach, FLA 6/1-4

Featuring MSIA Members & Friends

The National Council of Self Insurers is hosting their next Annual Conference at the incredible Don CeSar Hotel on St Petersburg Beach, FLA June 1 – 4. Register here: National Council 2025 Annual Conference. 

This Annual Conference is one of the better conferences to learn what new approaches and programs are working in the workers’ compensation space - - and why. The conference focuses on Employers talking with Employers about what they are doing, how it is working and what they have learned. The Conference itself is relatively intimate – limited to about 250 people and is rich with Employer attendees. The employers who attend, tend to be the national names you know – Walmart, Walt Disney, Marriott, Ashley Furniture, JM Smucker, Dollar Tree/Family Dollar, Food Lion (Ahold Delhize), Fanatics, City of San Diego and more. 

I am looking forward to what I can learn. Why don’t you join me – at the MSIA discounted rate?  

Perhaps not surprisingly, since MSIA members are the industry leaders and experts, the Conference will also feature:

  • Ciara Koba of Allan Koba Compliance Solutions will be talking about MSAs and the changes CMS has instituted,
  • Amy Rolando of Minworx Health will be talking about their program regarding carpal tunnel and trigger finger,
  • Ron Carter of RxBridge will be talking about value from your TPA arrangement,
  • Cliff Belliveau of MyMatrixx by Evernorth will be talking about avoiding the potholes on the road to AI innovation,
  • Zebra Jahnke of EK Health will be talking about more effectively leveraging your manage care arrangements, 

Friends of MSIA Bob Wilson, President of WorkCompCollege.com and Yvonne Guibert, VP of the Institutes of Health will be speaking as well. Early bird registration is available until May 1 – AND – MSIA has access to some members only price registrations. Please contact us to secure those registrations. Otherwise sign up here – and we’ll see you in St Pete! National Council 2025 Annual Conference 

MSF Annual Medical Conference – Whitefish May 14 – 16 

Featuring MSIA Members - Challenges and Innovations: Solutions for a Changing Workers' Comp World

The MSF Annual Medical Conference brings together some of the country's top medical minds working in workers’ compensation to Montana to speak with claims professionals, Montana based medical providers and others. It is a unique opportunity to hear from leaders from across the country here in Montana. Registration information is here: Montana State Fund 23rd Annual Medical Conference. 

Since it focuses on the top medical voices in the country, it’s not a surprise the Conference also features three MSIA members. Here is the current lineup of speakers:

  • Kelly Stokes, Injured Employee, Montana State Fund
  • Dr. Lisa Fitzpatrick, DrOT, CHT, CAE, CEAS, President/CEO, XcelABLE – MSIA Member
  • Jonathan Lindsey, Claims Manager, CIGA
  • Terri Harrison, Director of Claims, CIGA
  • Kathleen Collins, Senior Clinical Pharmacist, Craig Hospital – MSIA Member
  • Kurt Hegmann, MD, MPH, Center Director, RMCOEH
  • Jan A. Saunders, CPO, LPO, Clinical Director, Prosthetics, Paradigm Care at Home – MSIA Member
  • Dean Blackaby, Attorney at Law, Montana Work Comp Solutions
  • Honorable Judge Lee Bruner, Montana Workers’ Compensation Court
  • Marcos Iglesias, MD, MMM, FAAFP, FACOEM, Chief Medical Director, Accident Fund Group