Around the PIA Western Alliance States, Week of July 22, 2024

California — Insurance Commissioner calls for comprehensive study on workers’ comp claims for silicosis:  In response to rising concerns over the prevalence of silicosis among California workers, Insurance Commissioner Ricardo Lara has issued a letter to the Workers’ Compensation Insurance Rating Bureau (WCIRB) requesting a detailed study and data collection on silicosis claims. This move aims to better understand the impact of this serious occupational disease and ensure that affected workers receive the benefits they are entitled to.

Silicosis is a progressive and incurable lung disease caused by inhaling crystalline silica dust, often during the cutting and finishing of engineered stone countertops, a consumer preference more prevalent in recent years. Reports indicate that this occupational hazard has been increasingly affecting workers, particularly young Latino men, since 2015.

Commissioner Lara's letter highlights the urgency of addressing this issue and outlines specific data points that the WCIRB is requested to provide. The requested data includes:

The number of silicosis cases filed in the past 10 years

The average age of the claimants

The percentage of claim acceptances and denials

The average medical, temporary disability, and permanent disability costs associated with these claims

The average allocated loss adjustment expenses on these claims

The average number of insurers associated with each claim

"We need to gather comprehensive data on silicosis claims to make informed decisions and protect California workers effectively,” said Commissioner Lara in his letter. “This disease has a devastating impact on individuals and their families, and it is our duty to ensure they are supported."

The California Department of Insurance remains committed to safeguarding consumers and will continue to work with the WCIRB and other stakeholders to address this critical issue.

Source link: California Department of Insurance — https://bit.ly/4dwJUY3

Oregon — Amend Rule: OAR 836-053-0435: Rule Summary: The amended rule updates the services that health plans are required to cover during a comprehensive well-woman visit to include the thirteen well-woman preventive services identified by the United States Health Resources and Services Administration (HRSA) as of December 2022. It aligns with the guidelines set forth by the Women's Preventive Services Initiative (WPSI) and requires carriers to adhere to current practice and form filing requirements.

Filed: June 27, 2024

Hearing Date/Time: July 23, 2024, 11:00 AM - 11:30 AM

This is a hybrid meeting conducted in-person and virtually via Microsoft Teams. See Notice of Proposed Rulemaking for Teams meeting instructions.

Last day/time to offer comment: August 6, 2024, 5:00 PM 

For more information on this recently adopted rule, please visit the division's website:

https://dfr.oregon.gov/laws-rules/Documents/Proposed/20240723-well-women.pdf

Washington — Implementation of SSB 5986 and updates to the Balance Billing Protection Act (BBPA) prepublication draft posted: We are releasing a prepublication draft for the Implementation of SSB 5986 and updates to the Balance Billing Protection Act (BBPA) rule (R 2024-01). SSB 5986 added ground ambulances to the BBPA. Rulemaking is necessary to revise Chapter 284-43B WAC to include ground ambulance services. This rulemaking will also update the rules for the BBPA, including but not limited to consideration of arbitrator fees and revisions to the arbitration process.

The comment period for the prepublication draft begins on July 17, 2024, and is open until July 31, 2024. Comments can be submitted to rulescoordinator@oic.wa.gov.

For more information, including the text of the prepublication draft, please visit the implementation of SSB 5986 and updates to the Balance Billing Protection Act (BBPA) R 2024-01 rule's webpage.

Washington — Balanced Billing: During the 2024 Legislative Session, the legislature passed Senate Bill 5986 (SSB 5986).  The new law adds balance billing protections for covered ground ambulance services to the Balance Billing Protection Act (BBPA).

OIC has updated the BBPA consumer notice template to include ground ambulance services.  The updated template should be used beginning January 1, 2025.  The consumer notice template informs consumers of their rights and protections against balance billing.

If you’ve received this message, you are signed up to get all updates on our balance billing work.

Washington — OIC Answers podcast: Is pet insurance worth the money? More than 5 million pets in the United States were covered by insurance plans in 2023, but the coverages and costs vary quite a bit between pets and plans. Accidents, surgeries, prescriptions, illnesses and emergencies are usually covered, while dental care and behavioral problems usually aren’t — and pre-existing conditions remain a point of confusion. Washington has about 4% of the country’s covered pets, and in this episode of the OIC Answers podcast, our hosts ask a consumer protection expert if the policies are worth the money.

Listen on Apple Podcasts — https://bit.ly/3Slk4xR

Listen on Spotify — https://bit.ly/3SlGNtw