MR. PRESIDENT:
The Senate Committee on Pensions and Labor, to which was referred House Bill No. 1553,
has had the same under consideration and begs leave to report the same back to the Senate
with the recommendation that said bill be AMENDED as follows:
SOURCE: Page 2, line 15; (01)CR155302.2. -->
Page 2, line 15, delete "that" and insert " independent contractor".
Page 2, line 16, delete "documentation must include at least" and
insert " independent contractor must obtain clearance from the
department of state revenue before issuance of the certificate.".
Page 2, delete lines 17 through 28.
Page 6, between lines 37 and 38, begin a new paragraph and insert:
SOURCE: IC 22-3-3-5.2; (01)CR155302.4. -->
"SECTION 4.
IC 22-3-3-5.2
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 5.2. (a) A billing
review service shall adhere to the following requirements to determine
the pecuniary liability of an employer or an employer's insurance
carrier for a specific service or product covered under worker's
compensation:
(1) The formation of a billing review standard, and any
subsequent analysis or revision of the standard, must use data that
is based on the medical service provider billing charges as
submitted to the employer and the employer's insurance carrier
from the same community. This subdivision does not apply when
a unique or specialized service or product does not have sufficient
comparative data to allow for a reasonable comparison.
in an amount not less than one hundred dollars ($100) and not
more than one thousand dollars ($1,000).
SOURCE: IC 22-3-3-13; (01)CR155302.5. -->
SECTION 5.
IC 22-3-3-13
, AS AMENDED BY P.L.235-1999,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 13. (a) As used in this section, "board" refers to
the worker's compensation board created under
IC 22-3-1-1.
(b) If an employee who from any cause, had lost, or lost the use of,
one (1) hand, one (1) arm, one (1) foot, one (1) leg, or one (1) eye, and
in a subsequent industrial accident becomes permanently and totally
impaired disabled by reason of the loss, or loss of use of, another such
member or eye, the employer shall be liable only for the compensation
payable for such second injury. However, in addition to such
compensation and after the completion of the payment therefor, the
employee shall be paid the remainder of the compensation that would
be due for such total permanent impairment disability out of a special
fund known as the second injury fund, and created in the manner
described in subsection (c).
(c) Whenever the board determines under the procedures set forth
in subsection (d) that an assessment is necessary to ensure that fund
beneficiaries, including applicants under section 4(e) of this chapter,
continue to receive compensation in a timely manner for a reasonable
prospective period, the board shall send notice not later than October
1 in any year to:
(1) all insurance carriers and other entities insuring or providing
coverage to employers who are or may be liable under this article
to pay compensation for personal injuries to or the death of their
employees under this article; and
(2) each employer carrying the employer's own risk;
stating that an assessment is necessary. After June 30, 1999, the board
may conduct an assessment under this subsection not more than one (1)
time annually. Every insurance carrier and other entity insuring or
providing coverage to employers who are or may be liable under this
article to pay compensation for personal injuries to or death of their
employees under this article and every employer carrying the
employer's own risk, shall, within thirty (30) days of the board sending
notice under this subsection, pay to the worker's compensation board
for the benefit of the fund an assessed amount that may not exceed one
and one-half percent (1.5%) two percent (2%) of the total amount of
all worker's compensation paid to injured employees or their
beneficiaries under
IC 22-3-2
through
IC 22-3-6
for the calendar year
next preceding the due date of such payment. For the purposes of
calculating the assessment under this subsection, the board may
consider payments for temporary total disability, temporary partial
disability, permanent total impairment, permanent partial impairment,
or death of an employee. The board may not consider payments for
medical benefits in calculating an assessment under this subsection. If
the amount to the credit of the second injury fund on or before October
1 of any year exceeds one million dollars ($1,000,000), the assessment
allowed under this subsection shall not be assessed or collected during
the ensuing year. But when on or before October 1 of any year the
amount to the credit of the fund is less than one million dollars
($1,000,000), the payments of not more than one and one-half percent
(1.5%) two percent (2%) of the total amount of all worker's
compensation paid to injured employees or their beneficiaries under
IC 22-3-2
through
IC 22-3-6
for the calendar year next preceding that
date shall be resumed and paid into the fund. In no case shall the
board use an assessment rate greater than twenty-five hundredths
of one percent (0.25%) above the amount recommended by the
study performed before the assessment.
(d) The board shall enter into a contract with an actuary or another
qualified firm that has experience in calculating worker's compensation
liabilities. Not later than September 1 of each year, the actuary or other
qualified firm shall calculate the recommended funding level of the
fund based on the previous year's claims and inform the board of the
results of the calculation. If the amount to the credit of the fund is less
than the amount required under subsection (c), the board may conduct
an assessment under subsection (c). The board shall pay the costs of the
contract under this subsection with money in the fund.
(e) An assessment collected under subsection (c) on an employer
who is not self-insured must be assessed through a surcharge based on
the employer's premium. An assessment collected under subsection (c)
does not constitute an element of loss, but for the purpose of collection
shall be treated as a separate cost imposed upon insured employers. A
premium surcharge under this subsection must be collected at the same
time and in the same manner in which the premium for coverage is
collected, and must be shown as a separate amount on a premium
statement. A premium surcharge under this subsection must be
excluded from the definition of premium for all purposes, including the
computation of agent commissions or premium taxes. However, an
insurer may cancel a worker's compensation policy for nonpayment of
the premium surcharge. A cancellation under this subsection must be
carried out under the statutes applicable to the nonpayment of
premiums.
(f) The sums shall be paid by the board to the treasurer of state, to
be deposited in a special account known as the second injury fund. The
funds are not a part of the general fund of the state. Any balance
remaining in the account at the end of any fiscal year shall not revert
to the general fund. The funds shall be used only for the payment of
awards of compensation and expense of medical examinations or
treatment made and ordered by the board and chargeable against the
fund pursuant to this section, and shall be paid for that purpose by the
treasurer of state upon award or order of the board.
(g) If an employee who is entitled to compensation under
IC 22-3-2
through
IC 22-3-6
either:
(1) exhausts the maximum benefits under section 22 of this
chapter without having received the full amount of award granted
to the employee under section 10 of this chapter; or
(2) exhausts the employee's benefits under section 10 of this
chapter;
then such employee may apply to the board, who may award the
employee compensation from the second injury fund established by this
section, as follows under subsection (h).
(h) An employee who has exhausted the employee's maximum
benefits under section 10 of this chapter may be awarded additional
compensation equal to sixty-six and two-thirds percent (66 2/3%) of the
employee's average weekly wage at the time of the employee's injury,
not to exceed the maximum then applicable under section 22 of this
chapter, for a period of not to exceed one hundred fifty (150) weeks
upon competent evidence sufficient to establish:
(1) that the employee is totally and permanently disabled from
causes and conditions of which there are or have been objective
conditions and symptoms proven that are not within the physical
or mental control of the employee; and
(2) that the employee is unable to support the employee in any
gainful employment, not associated with rehabilitative or
vocational therapy.
(i) The additional award may be renewed during the employee's total
and permanent disability after appropriate hearings by the board for
successive periods not to exceed one hundred fifty (150) weeks each.
The provisions of this section apply only to injuries occurring
subsequent to April 1, 1950, for which awards have been or are in the
future made by the board under section 10 of this chapter. Section 16
of this chapter does not apply to compensation awarded from the
second injury fund under this section.
(j) The board shall assign an employee who is responsible for
determining that claimants receiving benefits from the second
injury fund remain eligible and are not employed. The employee
shall examine records of the department of state revenue and the
department of workforce development in making the
determinations.
SOURCE: IC 22-3-6-1; (01)CR155302.6. -->
SECTION 6.
IC 22-3-6-1
, AS AMENDED BY P.L.31-2000,
SECTION 6, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 1. In
IC 22-3-2
through
IC 22-3-6
, unless the
context otherwise requires:
(a) "Employer" includes the state and any political subdivision, any
municipal corporation within the state, any individual or the legal
representative of a deceased individual, firm, association, limited
liability company, or corporation or the receiver or trustee of the same,
using the services of another for pay. A parent or a subsidiary of a
corporation or a lessor of employees shall each be considered to be the
employer of the corporation's, the lessee's, or the lessor's employees for
purposes of
IC 22-3-2-6.
If the employer is insured, the term includes
the employer's insurer so far as applicable. However, the inclusion of
an employer's insurer within this definition does not allow an
employer's insurer to avoid payment for services rendered to an
employee with the approval of the employer. The term also includes an
employer that provides on-the-job training under the federal School to
Work Opportunities Act (20 U.S.C. 6101 et seq.) to the extent set forth
in
IC 22-3-2-2.5.
(b) "Employee" means every person, including a minor, in the
service of another, under any contract of hire or apprenticeship, written
or implied, except one whose employment is both casual and not in the
usual course of the trade, business, occupation, or profession of the
employer.
(1) An executive officer elected or appointed and empowered in
accordance with the charter and bylaws of a corporation, other
than a municipal corporation or governmental subdivision or a
charitable, religious, educational, or other nonprofit corporation,
is an employee of the corporation under
IC 22-3-2
through
IC 22-3-6.
(2) An executive officer of a municipal corporation or other
governmental subdivision or of a charitable, religious,
educational, or other nonprofit corporation may, notwithstanding
any other provision of
IC 22-3-2
through
IC 22-3-6
, be brought
within the coverage of its insurance contract by the corporation by
specifically including the executive officer in the contract of
insurance. The election to bring the executive officer within the
coverage shall continue for the period the contract of insurance is
in effect, and during this period, the executive officers thus
brought within the coverage of the insurance contract are
employees of the corporation under
IC 22-3-2
through
IC 22-3-6.
(3) Any reference to an employee who has been injured, when the
employee is dead, also includes the employee's legal
representatives, dependents, and other persons to whom
compensation may be payable.
(4) An owner of a sole proprietorship may elect to include the
owner as an employee under
IC 22-3-2
through
IC 22-3-6
if the
owner is actually engaged in the proprietorship business. If the
owner makes this election, the owner must serve upon the owner's
insurance carrier and upon the board written notice of the
election. No owner of a sole proprietorship may be considered an
employee under
IC 22-3-2
through
IC 22-3-6
until the notice has
been received. If the owner of a sole proprietorship is an
independent contractor in the construction trades and does not
make the election provided under this subdivision, the owner
must obtain an affidavit of exemption under
IC 22-3-2-14.5.
(5) A partner in a partnership may elect to include the partner as
an employee under
IC 22-3-2
through
IC 22-3-6
if the partner is
actually engaged in the partnership business. If a partner makes
this election, the partner must serve upon the partner's insurance
carrier and upon the board written notice of the election. No
partner may be considered an employee under
IC 22-3-2
through
IC 22-3-6
until the notice has been received. If a partner in a
partnership is an independent contractor in the construction trades
and does not make the election provided under this subdivision,
the partner must obtain an affidavit of exemption under
IC 22-3-2-14.5.
(6) Real estate professionals are not employees under
IC 22-3-2
through
IC 22-3-6
if:
(A) they are licensed real estate agents;
(B) substantially all their remuneration is directly related to
sales volume and not the number of hours worked; and
(C) they have written agreements with real estate brokers
stating that they are not to be treated as employees for tax
purposes.
(7) A person is an independent contractor in the construction
trades and not an employee under
IC 22-3-2
through
IC 22-3-6
if
the person is an independent contractor under the guidelines of
the United States Internal Revenue Service.
(8) An owner-operator that provides a motor vehicle and the
services of a driver under a written contract that is subject to
IC 8-2.1-24-23
, 45 IAC 16-1-13, or 49 CFR 1057, to a motor
carrier is not an employee of the motor carrier for purposes of
IC 22-3-2
through
IC 22-3-6.
The owner-operator may elect to be
covered and have the owner-operator's drivers covered under a
worker's compensation insurance policy or authorized
self-insurance that insures the motor carrier if the owner-operator
pays the premiums as requested by the motor carrier. An election
by an owner-operator under this subdivision does not terminate
the independent contractor status of the owner-operator for any
purpose other than the purpose of this subdivision.
(9) A member or manager in a limited liability company may elect
to include the member or manager as an employee under
IC 22-3-2
through
IC 22-3-6
if the member or manager is actually
engaged in the limited liability company business. If a member or
manager makes this election, the member or manager must serve
upon the member's or manager's insurance carrier and upon the
board written notice of the election. A member or manager may
not be considered an employee under
IC 22-3-2
through
IC 22-3-6
until the notice has been received.
(10) An unpaid participant under the federal School to Work
Opportunities Act (20 U.S.C. 6101 et seq.) is an employee to the
extent set forth in
IC 22-3-2-2.5.
(c) "Minor" means an individual who has not reached seventeen
(17) years of age.
(1) Unless otherwise provided in this subsection, a minor
employee shall be considered as being of full age for all purposes
of
IC 22-3-2
through
IC 22-3-6.
(2) If the employee is a minor who, at the time of the accident, is
employed, required, suffered, or permitted to work in violation of
IC 20-8.1-4-25
, the amount of compensation and death benefits,
as provided in
IC 22-3-2
through
IC 22-3-6
, shall be double the
amount which would otherwise be recoverable. The insurance
carrier shall be liable on its policy for one-half (1/2) of the
compensation or benefits that may be payable on account of the
injury or death of the minor, and the employer shall be liable for
the other one-half (1/2) of the compensation or benefits. If the
employee is a minor who is not less than sixteen (16) years of age
and who has not reached seventeen (17) years of age and who at
the time of the accident is employed, suffered, or permitted to
work at any occupation which is not prohibited by law, this
subdivision does not apply.
(3) A minor employee who, at the time of the accident, is a
student performing services for an employer as part of an
approved program under
IC 20-10.1-6-7
shall be considered a
full-time employee for the purpose of computing compensation
for permanent impairment under
IC 22-3-3-10.
The average
weekly wages for such a student shall be calculated as provided
in subsection (d)(4).
(4) The rights and remedies granted in this subsection to a minor
under
IC 22-3-2
through
IC 22-3-6
on account of personal injury
or death by accident shall exclude all rights and remedies of the
minor, the minor's parents, or the minor's personal
representatives, dependents, or next of kin at common law,
statutory or otherwise, on account of the injury or death. This
subsection does not apply to minors who have reached seventeen
(17) years of age.
(d) "Average weekly wages" means the earnings of the injured
employee in the employment in which the employee was working at the
time of the injury during the period of fifty-two (52) weeks
immediately preceding the date of injury, divided by fifty-two (52),
except as follows:
(1) If the injured employee lost seven (7) or more calendar days
during this period, although not in the same week, then the
earnings for the remainder of the fifty-two (52) weeks shall be
divided by the number of weeks and parts thereof remaining after
the time lost has been deducted.
(2) Where the employment prior to the injury extended over a
period of less than fifty-two (52) weeks, the method of dividing
the earnings during that period by the number of weeks and parts
thereof during which the employee earned wages shall be
followed, if results just and fair to both parties will be obtained.
Where by reason of the shortness of the time during which the
employee has been in the employment of the employee's employer
or of the casual nature or terms of the employment it is
impracticable to compute the average weekly wages, as defined
in this subsection, regard shall be had to the average weekly
amount which during the fifty-two (52) weeks previous to the
injury was being earned by a person in the same grade employed
at the same work by the same employer or, if there is no person so
employed, by a person in the same grade employed in the same
class of employment in the same district.
(3) Wherever allowances of any character made to an employee
in lieu of wages are a specified part of the wage contract, they
shall be deemed a part of his earnings.
(4) In computing the average weekly wages to be used in
calculating an award for permanent impairment under
IC 22-3-3-10
for a student employee in an approved training
program under
IC 20-10.1-6-7
, the following formula shall be
used. Calculate the product of:
(A) the student employee's hourly wage rate; multiplied by
(B) forty (40) hours.
The result obtained is the amount of the average weekly wages for
the student employee.
employee under this chapter if he is actually engaged in the
partnership business. If a partner makes this election, he must
serve upon his insurance carrier and upon the board written notice
of the election. No partner may be considered an employee under
this chapter until the notice has been received. If a partner in a
partnership is an independent contractor in the construction trades
and does not make the election provided under this subdivision,
the partner must obtain an affidavit of exemption under
IC 22-3-7-34.5.
(4) Real estate professionals are not employees under this chapter
if:
(A) they are licensed real estate agents;
(B) substantially all their remuneration is directly related to
sales volume and not the number of hours worked; and
(C) they have written agreements with real estate brokers
stating that they are not to be treated as employees for tax
purposes.
(5) A person is an independent contractor in the construction
trades and not an employee under this chapter if the person is an
independent contractor under the guidelines of the United States
Internal Revenue Service.
(6) An owner-operator that provides a motor vehicle and the
services of a driver under a written contract that is subject to
IC 8-2.1-24-23
, 45 IAC 16-1-13, or 49 CFR 1057, to a motor
carrier is not an employee of the motor carrier for purposes of this
chapter. The owner-operator may elect to be covered and have the
owner-operator's drivers covered under a worker's compensation
insurance policy or authorized self-insurance that insures the
motor carrier if the owner-operator pays the premiums as
requested by the motor carrier. An election by an owner-operator
under this subdivision does not terminate the independent
contractor status of the owner-operator for any purpose other than
the purpose of this subdivision.
(7) An unpaid participant under the federal School to Work
Opportunities Act (20 U.S.C. 6101 et seq.) is an employee to the
extent set forth under section 2.5 of this chapter.
(c) As used in this chapter, "minor" means an individual who has
not reached seventeen (17) years of age. A minor employee shall be
considered as being of full age for all purposes of this chapter.
However, if the employee is a minor who, at the time of the last
exposure, is employed, required, suffered, or permitted to work in
violation of the child labor laws of this state, the amount of
compensation and death benefits, as provided in this chapter, shall be
double the amount which would otherwise be recoverable. The
insurance carrier shall be liable on its policy for one-half (1/2) of the
compensation or benefits that may be payable on account of the
disability or death of the minor, and the employer shall be wholly liable
for the other one-half (1/2) of the compensation or benefits. If the
employee is a minor who is not less than sixteen (16) years of age and
who has not reached seventeen (17) years of age, and who at the time
of the last exposure is employed, suffered, or permitted to work at any
occupation which is not prohibited by law, the provisions of this
subsection prescribing double the amount otherwise recoverable do not
apply. The rights and remedies granted to a minor under this chapter on
account of disease shall exclude all rights and remedies of the minor,
his parents, his personal representatives, dependents, or next of kin at
common law, statutory or otherwise, on account of any disease.
(d) This chapter does not apply to casual laborers as defined in
subsection (b), nor to farm or agricultural employees, nor to household
employees, nor to railroad employees engaged in train service as
engineers, firemen, conductors, brakemen, flagmen, baggagemen, or
foremen in charge of yard engines and helpers assigned thereto, nor to
their employers with respect to these employees. Also, this chapter
does not apply to employees or their employers with respect to
employments in which the laws of the United States provide for
compensation or liability for injury to the health, disability, or death by
reason of diseases suffered by these employees.
(e) As used in this chapter, "disablement" means the event of
becoming disabled from earning full wages at the work in which the
employee was engaged when last exposed to the hazards of the
occupational disease by the employer from whom he claims
compensation or equal wages in other suitable employment, and
"disability" means the state of being so incapacitated.
(f) For the purposes of this chapter, no compensation shall be
payable for or on account of any occupational diseases unless
disablement, as defined in subsection (e), occurs within two (2) years
after the last day of the last exposure to the hazards of the disease
except for the following:
(1) In all cases of occupational diseases caused by the inhalation
of silica dust or coal dust, no compensation shall be payable
unless disablement, as defined in subsection (e), occurs within
three (3) years after the last day of the last exposure to the hazards
of the disease.
(2) In all cases of occupational disease caused by the exposure to
radiation, no compensation shall be payable unless disablement,
as defined in subsection (e), occurs within two (2) years from the
date on which the employee had knowledge of the nature of his
occupational disease or, by exercise of reasonable diligence,
should have known of the existence of such disease and its causal
relationship to his employment.
(3) In all cases of occupational diseases caused by the inhalation
of asbestos dust, no compensation shall be payable unless
disablement, as defined in subsection (e), occurs within three (3)
years after the last day of the last exposure to the hazards of the
disease if the last day of the last exposure was before July 1, 1985.
(4) In all cases of occupational disease caused by the inhalation
of asbestos dust in which the last date of the last exposure occurs
on or after July 1, 1985, and before July 1, 1988, no compensation
shall be payable unless disablement, as defined in subsection (e),
occurs within twenty (20) years after the last day of the last
exposure.
(5) In all cases of occupational disease caused by the inhalation
of asbestos dust in which the last date of the last exposure occurs
on or after July 1, 1988, no compensation shall be payable unless
disablement (as defined in subsection (e)) occurs within
thirty-five (35) years after the last day of the last exposure.
(g) For the purposes of this chapter, no compensation shall be
payable for or on account of death resulting from any occupational
disease unless death occurs within two (2) years after the date of
disablement. However, this subsection does not bar compensation for
death:
(1) where death occurs during the pendency of a claim filed by an
employee within two (2) years after the date of disablement and
which claim has not resulted in a decision or has resulted in a
decision which is in process of review or appeal; or
(2) where, by agreement filed or decision rendered, a
compensable period of disability has been fixed and death occurs
within two (2) years after the end of such fixed period, but in no
event later than three hundred (300) weeks after the date of
disablement.
(h) As used in this chapter, "billing review service" refers to a
person or an entity that reviews a medical service provider's bills or
statements for the purpose of determining pecuniary liability. The term
includes an employer's worker's compensation insurance carrier if the
insurance carrier performs such a review.
(i) As used in this chapter, "billing review standard" means the data
used by a billing review service to determine pecuniary liability.
(j) As used in this chapter, "community" means a geographic service
area based on zip code districts defined by the United States Postal
Service according to the following groupings:
(1) The geographic service area served by zip codes with the first
three (3) digits 463 and 464.
(2) The geographic service area served by zip codes with the first
three (3) digits 465 and 466.
(3) The geographic service area served by zip codes with the first
three (3) digits 467 and 468.
(4) The geographic service area served by zip codes with the first
three (3) digits 469 and 479.
(5) The geographic service area served by zip codes with the first
three (3) digits 460, 461 (except 46107), and 473.
(6) The geographic service area served by the 46107 zip code and
zip codes with the first three (3) digits 462.
(7) The geographic service area served by zip codes with the first
three (3) digits 470, 471, 472, 474, and 478.
(8) The geographic service area served by zip codes with the first
three (3) digits 475, 476, and 477.
(k) As used in this chapter, "medical service provider" refers to a
person or an entity that provides medical services, treatment, or
supplies to an employee under this chapter.
(l) As used in this chapter, "pecuniary liability" means the
responsibility of an employer or the employer's insurance carrier for the
payment of the charges for each specific service or product for human
medical treatment provided under this chapter in a defined community,
equal to or less than the charges made by medical service providers at
the eightieth percentile in the same community for like services or
products.
SOURCE: IC 22-3-7-17.2; (01)CR155302.8. -->
SECTION 8.
IC 22-3-7-17.2
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 17.2. (a) A billing
review service shall adhere to the following requirements to determine
the pecuniary liability of an employer or an employer's insurance
carrier for a specific service or product covered under this chapter:
(1) The formation of a billing review standard, and any
subsequent analysis or revision of the standard, must use data that
is based on the medical service provider billing charges as
submitted to the employer and the employer's insurance carrier
from the same community. This subdivision does not apply when
a unique or specialized service or product does not have sufficient
comparative data to allow for a reasonable comparison.
(2) Data used to determine pecuniary liability must be compiled
on or before June 30 and December 31 of each year.
(3) Billing review standards must be revised for prospective
future payments of medical service provider bills to provide for
payment of the charges at a rate not more than the charges made
by eighty percent (80%) of the medical service providers during
the prior six (6) months within the same community. The data
used to perform the analysis and revision of the billing review
standards may not be more than two (2) years old and must be
periodically updated by a representative inflationary or
deflationary factor. Reimbursement for these charges may not
exceed the actual charge invoiced by the medical service
provider.
(4) The billing review standard shall include the billing charges
of all hospitals in the applicable community for the service or
product.
(b) A medical service provider may request an explanation from a
billing review service if the medical service provider's bill has been
reduced as a result of application of the eightieth percentile or of a
Current Procedural Terminology (CPT) coding change. The request
must be made not later than sixty (60) days after receipt of the notice
of the reduction. If a request is made, the billing review service must
provide:
(1) the name of the billing review service used to make the
reduction;
(2) the dollar amount of the reduction;
(3) the dollar amount of the medical service at the eightieth
percentile; and
(4) in the case of a CPT coding change, the basis upon which the
change was made;
not later than thirty (30) days after the date of the request.
(c) If after a hearing the worker's compensation board finds
that a billing review service used a billing review standard that did
not comply with subsection (a)(1) through (a)(4) in determining the
pecuniary liability of an employer or an employer's insurance
carrier for a health care provider's charge for services or products
covered under occupational disease compensation, the worker's
compensation board may assess a civil penalty against the billing
review service in an amount not less than one hundred dollars
($100) and not more than one thousand dollars ($1,000).".
SOURCE: Page 13, line 41; (01)CR155302.13. -->
Page 13, between lines 41 and 42, begin a new paragraph and insert:
SOURCE: IC 27-7-2-34; (01)CR155302.11. -->
"SECTION 11.
IC 27-7-2-34
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 34. The management
of the bureau shall furnish to all members of the bureau complete
information concerning each rejected risk and any member of such
bureau may write any rejected risk as regular business in which event
the risk so written shall no longer be treated as provided for in section
29 of this chapter. The bureau shall, at least ninety (90) days prior to
expiration, investigate such rejected risk as to its classifications, rates,
accident record, attitude toward accident prevention, financial standing,
and other matters pertinent to such risk. Sixty (60) days prior to the
expiration date of such risk, the bureau shall bulletin all members of
the bureau giving results of the investigation and the rates to become
effective upon expiration of the current policy. If, at expiration, the risk
and when so amended that said bill do pass.
Committee Vote: Yeas 9, Nays 0.
Harrison
CR155302/DI 102 2001