PREPROPOSAL STATEMENT OF INQUIRY
LABOR AND INDUSTRIES
Subject of Possible Rule Making: (1) Workers' compensation employer, worker, and health care provider fraud and abuse following the enactment of chapter 243, Laws of 2004 (ESHB 3188). Possible rules include those elaborating (a) liability of general construction contractors for workers' compensation premiums owed by their subcontractors; (b) liability of individuals for the unpaid workers' compensation premiums of a dissolved company's workers' compensation premiums; (c) when a person or entity is a successor to an employer who owes workers' compensation premiums, (d) defining terms necessary to implement to "willful misrepresentation by a workers' compensation claimant or beneficiary that could result in penalties"; and (e) when liens would be imposed on health care providers that have not repaid an overpayment after a final order;
(2) Immediate suspensions of health care providers following the enactment of chapter 259, Laws of 2004 (SSB 6428); and
(3) The department may also update rules regarding employer audits and recordkeeping and how premiums are estimated when employers fail to maintain adequate records or cooperate with department auditors.
The department may promulgate rules implementing the two statutes separately, but every effort will be made to coordinate the hearings and comment periods to facilitate participation by those affected.
Statutes Authorizing the Agency to Adopt Rules on this Subject: Rules implementing chapter 243, Laws of 2004 (ESHB 3188) are authorized by section 10 of the act; rules implementing chapter 259, Laws of 2004 (SSB 6428) are authorized by RCW 51.04.030(1).
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: This rule making would assist in the implementation of ESHB 3188 and SSB 6428 passed by the legislature in the 2004 session.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Board of Industrial Insurance Appeals (BIIA), while the BIIA does not "regulate this subject" it reviews L&I's decision upon appeal. L&I will keep the BIIA informed of the rule-making developments.
Department of Health (DOH) licensing and disciplinary boards. L&I will keep DOH informed of rule-making developments related to provider immediate suspensions.
Process for Developing New Rule: Parties interested in participating in the development of these rules may contact the person listed below. The public may also participate by providing written comments during the comment period or giving oral testimony at public hearings.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Doric Olson, Department of Labor and Industries, Insurance Services Division, P.O. Box 44100, Olympia, WA 98504-4100, e-mail OLSD235@LNI.wa.gov, phone (360) 902-6639, fax (360) 902-4940.
April 30, 2004
Paul Trause
Director