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MONTANA SELF INSURERS' ASSOCIATION

MSIA Update / Leg. Week 9

  • Transmittal Day!! – Legislature on Break until Mar 14
  • Rep Ron Marshall (R-Hamilton) Resigns Suddenly
  • SB 346 – Limit DOLI Benefit Awards & Clarify Reservation of Rights Medical Benefits – Pulled at MSIA Request - DEAD
  • SB 295 – Choice of Provider - DEAD
  • SB 308 – Eliminate the Cap on Benefits –  to Sen Finance & Claims
  • HB 552 – PTSD Coverage for First Responders – DEAD but…SB 394
  • SB 394 – PTSD Coverage for First Responders – to Sen Finance & Claims
  • SB 345 – Eliminate Treating Provider Deference & Make IMEs Easier – to Sen Finance & Claims
  • SB 338 – Guardian ad Litem – Passes Senate
  • HB 516 – Transfer WC Court to Judiciary – Passes House
  • HB 727 – Plan 2 & 3 Competition Measures – House Bus & Labor 3/1
  • HB 805 – Terminate Benefits for Illegal Aliens – House Bus & Labor 3/3
  • HB 740 – PBM Changes – Passes House

Rep. Ron Marshall (R-Hamilton) Resigns Suddenly

In what came as a surprise to the business community, Representative Ron Marshall (R-Hamilton) has resigned effective noon on Monday 3/3. He has taken a beating this year from the tobacco lobby (he personally owns and runs at least two vape shops) and has had a difficult session. He resigned with a bitter message about how the lobbyists are running the capitol and the elected representatives can no longer represent the people. Marshall was the Chair of the House Human Services Committee, and was a member of the House Busines & Labor Committee. The latter is more important to us, as his departure eliminates a majority caucus vote from that committee. Typically in that committee, it is not an issue, but we need to keep track of each of the votes. The Ravalli County Republican Committee will submit three names to the County Commissioners and they will make an appointment to fill the unexpired term. It is not clear whether that will happen prior to the end of the session.

Transmittal Day is the mid-point of the session and the traditional demarcation for bills that will die and those that will be considered in the latter half of the session. Transmittal day is the point by which a bill must pass the chamber of origin, or else the bill is likely to be dead. While there are exceptions – they are rare. One way to get around the transmittal deadline is to move the bill to Appropriations, Revenue or Finance and Claims committees. That is what has happened to at least three bills we care about, SB 345 - an MSIA requested bill to end the automatic deference to the treating physician and make it easier to get IMEs, SB 308 – proposing to effectively eliminate the cap on benefits and SB 394 – providing PTSD for first responders. So, those bills are still viable, but have not passed the Senate yet.

For our purposes, assume that bills are not dead enough - - until the day after session ends.

With the legislature on break until next Friday, 3/14, we will see what we can find out about why that action was taken.

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. The more important bills/proposals are closer to the top:

SB 346 / Hertz / R-Polson

This bill was an MSIA requested bill to limit the ability of the Department of Labor to order the continuation of benefits and to clarify that benefits provided under the medical benefits reservation of rights cannot include indemnity benefits. This bill was scheduled to be heard in Sen Bus & Labor on 3/3, when we received some data requested earlier from the Department of Labor which indicated that the bill might impact about 14 claims per year, across all three plans, self insured, commercial carriers, MSF and the Uninsured Employers Fund. With that data, we reviewed our request to the sponsor to push the bill and put his credibility and our credibility to the test. We decided that our solution, just did not have a significant enough problem to try to change the balance in the WC system, and respectfully requested the sponsor pull the bill from further consideration.


SB 308 / Harvey / D-BTE

This bill would remove the SAWW cap on benefits. MSIA was the lead opponent to this proposal as it un-balances the workers’ comp system, which is supposed to provide benefits with a reasonable approach to actual wages at a reasonable cost to employers. This proposal, according to NCCI, would result in a system cost increase of between 6.5 – 7.7% the day it became law. Our current cap on benefits is part of a national standard and 30 states have the same – or a lower – cap. There is a rumor that an attempt to appease some opposition by putting a $150,000 cap would be made. In effect, there is no difference. The bill has been referred to Senate Finance & Claims for consideration. MSIA opposes this bill. The bill was re-referred to the Senate Finance & Claims Committee by a 25-24 vote.


HB 552 / 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 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. The bill was heard in House Bus & Labor committee on 2/26. An amendment to clarify the definition of ‘first responders’, usage of the DSM-5 and an effective date was added on 2/28 and the bill passed committee 15-5 on 2/28. The bill was sent to House Appropriations for further consideration and tabled there 13-10. Most of the time, that action kills a bill, but based on legislative rule, a ‘Blast’ motion on the floor, if it gets 60 votes, can pull a bill directly from Committee to the floor for consideration. A BLAST motion was attempted on this bill and failed 51-47 on 3/3. This bill is DEAD – however, it’s companion bill, SB 394 was heard in Sen Bus & Labor the following day. The Governor’s office does not oppose this bill.  MSIA was the lead opponent to this bill.


SB 394 / Neumann / D-BZN

This bill started as being similar to HB 552 (above) and has been amended to have the same language. The bill was heard in Senate Bus & Labor on 3/4 and MSIA was the lead opponent. The bill passed from that Committee 7-5 later that day. It was then re-referred to Senate Finance & Claims for further consideration (as was SB 308 and SB 345). MSIA members MCCF and the MT School Boards Group, and the Plan 2 private carriers, along with the MT Chamber of Commerce also testified in opposition to the bill. The night before the hearing we identified 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. We will continue to try to defeat this bill, or find an alternative solution, rather than pushing all these costs onto employers.


SB 345 / Hertz / R-Polson

This is another 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 Sen Bus & Labor on 2/28. The bill passed Committee 12-0 on 3/4 and was re-referred to Senate Finance & Claims for further consideration. MSIA was the lead proponent on this bill and was joined by the Plan 2 carriers, businesses, as well as MSIA members MCCF and MSGIA and MSF.


SB 338 / Hertz / R-Polson

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. This bill was heard in Sen Bus & Labor on 2/26 and passed 12-0. MSIA supports this bill. We do not anticipate an issue with this bill passing and becoming law.

 

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. MSIA supports this bill.


HB 727 / Nicol / R-BIL

This is the perennial ‘kill MSF’ bill. The bill requires an annual measure of competition of Plan 2 and Plan 3 carriers and if none is found to exist, after a hearing, the Commissioner of Securities and Insurance shall take action to promote new insurers to the market, limit large mergers of insurers, promote consumer education and prohibit or limit by at least 50% the premium written by producer agencies to MSF. The bill was heard and tabled (killed) in House Bus & Labor on 3/1. MSIA will not take a position on this bill.


HB 805 / Nicol / R-BIL

This bill permits termination of benefits for illegal aliens and was intended to terminate benefits for legal aliens who leave the country while collecting workers’ compensation benefits. (even if they are legally required to do so). The bill was drafted so that anyone leaving the US, while on benefits would have their benefits terminated – anyone. The bill was heard and tabled (killed) in House Bus & Labor on 3/3. MSIA will not take a position on 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.