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MONTANA SELF INSURERS' ASSOCIATION

MSIA Update / Leg. Week 4

  • Legislative Week 4 – Still Slow – See Attached Spreadsheet
  • HB 143 – PAs as Treating Physicians – Passes House
  • HB 197 - ‘Rainey’ Passes House
  • SB 109 – PTs as Treating Physicians – Passes Committee
  • LC 1353 – MSIA Transportation Bill – Language Available

The Senate continues its’ struggles. An Ethics Committee has been appointed to review Senator Jason Ellsworths’(R-Hamilton) actions in the closing days of his term as Senate President at the end of last year. Ellsworth awarded a no-bid contract to a business associate to perform work that is typically done by legislative staff. When the issues first came to light, the contractor has walked away from the contract. No work was performed and no payments have been made.

Ellsworth was the Republican leader of the revolt on the first day of the session in teaming up with the Democrats to adopt rules different than those agreed to by the Majority prior to the session. Nine Republican Senators teamed up with the Democrat minority members to change a Committee status and Committee representation – a significant blow to the desire of the more conservative members of the legislature (not just the Senate).

The Chair of the Ethics Committee, Sen. Sue Vinton (R-BIL), was replaced by Sen. Forrest Mandeville (R-Columbus) allegedly based on public comments Vinton had made about Ellsworths’ actions in awarding the contract. Senate President Matt Regier (R-Kalispell) at first retained Matthew Monforton, a known conservative operative and former legislator, as counsel to the committee. That selection drew some fire based on Monforton’s social media posts also commenting on Ellsworths’ actions. A new counsel has been appointed who apparently does not use social media.

The Ethics Committee is made up of four members of Leadership - two each from the majority and minority. An audit of Ellsworths’ actions has already been issued and determined he acted inappropriately in awarding the contract.

In some of the Committees as well, there appear to remain some hard feelings between the majority, minority and individuals in the majority – getting down to placement of seats during the Committee meetings. It seems to me, still, that Senate Committee bill hearing schedules and bill drafting is lighter than it has been in prior years.

The Medicaid Expansion bill everyone expected as the vehicle for debate, HB 245 (Buttrey R-GTF) passed the House Human Services Committee with all the Democrats and five Republican votes (14 – 7). The more conservative members of the Committee – including House Speaker Brandon Ler (R-Savage) voted against the bill.

Here’s this week’s run-down of legislation we’re interested in (for a full list of bills of interest and more comments – see the attached spreadsheet):

 

HB 143 / Etchart / R-BIL

This bill permits PAs to be treating physicians. The bill passed the House 98 – 0 this week and will be assigned to a Senate Committee. MSIA supports this proposal. Business, PAs, Primary Care providers, insurers and AFL/CIO-MFT supported the bill in the House Committee. The only opponent was the Trial Lawyers Association.

 

HB 197 / Nicastro / R-BIL

This bill addresses the Rainey Workers Comp Court decision (Nat'l Union-Rainey_2021MTWCC10.pdf) where the judge determined that even with a full duty release, the insurer had to go through a job analysis and 14 day notice before terminating TTD benefits. This bill passed the passed the House on 1/27, on a party-line vote. It will now go to the Senate where it will be assigned to a Committee. MSIA supports this bill.

 

SB 109 / Hertz / R-Polson

This bill would allow Physical Therapists to be Treating Physicians. PTs have alleged that about 12 other states allow for ‘Direct Access’ to PTs for workers’ compensation claims. That may be, but the requirements for a ‘Treating Physician’ in the Montana WC system require them to make a diagnosis, be the gatekeeper for treatment – referring to other specialists as needed, provide the release to return to work, determine maximum medical improvement and provide impairment ratings – few of which a licensed PT in Montana can do. In our opinion, this proposal takes access to health care providers too far. The bill passed  the Senate Bus, Labor & Economic Affairs Committee 11-0 on 1/29. MSIA was the lead opponent on this bill. Importantly MSF was an informational witness – neither supporting nor opposing the bill, which carried some weight with the Committee members.

 

SB 202 / L. Smith / D-HLN

This bill provides the WC Court Judge with the authority to appoint, or terminate an Guardian ad Litem. The WC Court Judge was asked to appoint a new Guardian ad Litem and he ruled he could not, as the statutory language does not provide him that ability. Although this has been done for the 100 years or so of the WC system in Montana, the statutory language to support it was not there. MSIA supports this bill.

 

LC 458 / J. Kassmier / R-Ft Benton

This bill is the Department of Labor ‘clean up’ bill. It provides a clarification of “employer” in a borrowed employee situation, provides for annual instead of quarterly reporting of losses for Administrative Fund assessments and changes the medical status form so that only one form would be needed, rather than two with the second providing medical information not permitted to be shared with the insurer. MSIA supports this bill.   

 

LC 660 / A. Olsen / D-MSO

This bill would change the choice of physician back to the employee choice, versus the current employer choice (see discussion above). While language has not yet been released, and it exists in title form only, MSIA expects to oppose this bill.   

 

LC 1353 / Buttrey / R-GTF

This is an MSIA bill to limit coverage when an employer provides or pays for vehicle use. The goal is to limit exposure to when an employee is in course and scope of work, rather than anytime they are in a vehicle furnished or paid for by the employer. Language is now available (see spreadsheet for the link).

 

LC 1564 / Reavis / D-BIL

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. In so doing, it likely creates an equal protection violation of constitutional language. That argument, which will be made, could lead to a proposal that everyone have access to mental-mental claim benefits. There are only about 12 states which continue to exclude mental-mental claims in their WC systems. And, the trend across the country has been to provide presumptive coverage for first responders. MSIA opposes this bill.

 

LC 1836 / Harvey / D-Butte

This bill eliminates the benefit cap based on State Average Weekly Wage, which will have a significant impact on benefits for higher wage earners. NCCI has been notified of the language and has been asked to estimate the cost impact to the system. MSIA opposes this proposal.