WSR 10-05-097

PROPOSED RULES

DEPARTMENT OF

LABOR AND INDUSTRIES

[ Filed February 16, 2010, 11:18 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 10-01-169.

Title of Rule and Other Identifying Information: WAC 296-20-1103 Travel expense.

Hearing Location(s): Department of Labor and Industries, Room S117, 7273 Linderson Way S.W., Tumwater, WA 98501, on March 24, 2010, at 1:00 p.m.

Date of Intended Adoption: May 25, 2010.

Submit Written Comments to: Bob Mayer, Health Services Analysis, P.O. Box 44322, Olympia, WA 98504-4322, e-mail mayr235@Lni.wa.gov, fax (360) 902-5021, by March 24, 2010.

Assistance for Persons with Disabilities: Contact office of information and assistance by March 17, 2010, TTY (360) 902-5797 or (360) 902-4941.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of this rule change is to update department policy regarding injured workers traveling out of his/her immediate residential area to the nearest point of adequate treatment or other services. The anticipated effects would be to ensure a payment methodology that is reasonable, fair and cost efficient. Also the language allowing reimbursement for worker travel to treatment at department rehabilitation center will be deleted. This will have no effect because the department rehabilitation center no longer exists. Finally, the term attending doctor was updated to attending provider to be consistent with the definition of an attending provider as stated in WAC 296-20-01002.

Reasons Supporting Proposal: The proposed rule is intended to provide reasonable and fair reimbursement for injured workers traveling out of his/her immediate residential area to the nearest point of adequate treatment or other services. Reimbursement changes are also needed to achieve budget goals for the state fund worker's compensation program.

Statutory Authority for Adoption: RCW 51.04.020, 51.04.030.

Rule is not necessitated by federal law, federal or state court decision.

Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: The rule changes supports department goals of ensuring payment methodologies that are reasonable, fair and cost efficient.

Name of Proponent: Department of labor and industries, governmental.

Name of Agency Personnel Responsible for Drafting: Bob Mayer, 7273 Linderson Way S.W., Tumwater, WA, (360) 902-5021; Implementation: Janet Peterson, Health Services Analysis Program Manager, (360) 902-6699; and Enforcement: Bob Malooly, Assistant Director of Insurance Services, (360) 902-4209.

No small business economic impact statement has been prepared under chapter 19.85 RCW. There is no disproportionate cost to small business.

A cost-benefit analysis is not required under RCW 34.05.328. There is no more than minimal cost to business.

February 16, 2010

Judy Schurke

Director

OTS-3010.1


AMENDATORY SECTION(Amending WSR 93-16-072, filed 8/1/93, effective 9/1/93)

WAC 296-20-1103   Travel expense.   The department or self-insurer will reimburse travel expense incurred by workers for the following reasons:

(1) Examinations at department's or self-insurer's request;

(2) Vocational services at department's or self-insurer's request;

(3) ((treatment at department rehabilitation center;

(4))) Fitting of prosthetic device; and

(((5))) (4) Upon prior authorization for treatment when worker must travel more than ((ten)) fifteen miles one-way from the worker's home to the nearest point of adequate treatment. Travel expense is not payable when adequate treatment is available within ((ten)) fifteen miles of injured worker's home, yet the injured worker prefers to report to an attending ((doctor)) provider outside the worker's home area.

Under subsections (2), (3), and (4) of this section, when travel expense is authorized the first fifteen miles one-way are not payable. The first and last fifteen miles are not payable on an authorized round trip.

Travel expenses will be reimbursed at the current department rate.

Receipts are required for all expenses except parking expenses under ten dollars.

Claims for reimbursement of travel expenses must be received by the department or self-insurer within one year after the date expenses are incurred. Refer to WAC 296-20-125 and to department policy for additional rules.

[Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. 93-16-072, 296-20-1103, filed 8/1/93, effective 9/1/93. Statutory Authority: RCW 51.04.020. 91-12-010, 296-20-1103, filed 5/30/91, effective 7/1/91. Statutory Authority: RCW 51.04.020(4) and 51.04.030. 83-16-066 (Order 83-23), 296-20-1103, filed 8/2/83. Statutory Authority: RCW 51.04.020(4), 51.04.030, and 51.16.120(3). 81-24-041 (Order 81-28), 296-20-1103, filed 11/30/81, effective 1/1/82; 81-01-100 (Order 80-29), 296-20-1103, filed 12/23/80, effective 3/1/81.]

Washington State Code Reviser's Office