Substitute Senate Bill 5801 (Chapter 6, Laws of 2011) amended RCW 51.36.010 to direct L&I to establish a statewide medical provider network for treating injured and ill workers. L&I adopted rules in 2012 so that, starting January 1, 2013, only network providers may treat injured workers beyond an initial visit. WAC 296-20-01020 allows providers to be provisionally enrolled while L&I decides on their application, but only for 60 days. The emergency rule allows providers who applied prior to January 1, 2013, to continue to treat injured workers until their application is approved, denied, or withdrawn; and it removes the 60-day limit on provisional enrollment until expiration of the emergency rule or until L&I takes further action to change the rule, whichever is first. The changes were adopted 3/1/2013 and became effective on 3/1/2013.677.

The purpose of this rulemaking is to ensure safe, appropriate and effective drug therapy designed to improve clinical outcomes and support successful return to work. The proposed rule language updates the coverage of and payment for prescription drugs and describes specific authorization requirements for the payment of opioids. Authorization requirements are based on best practices for prescribing opioids and will lead to safe and effective treatment for injured and ill workers. UPDATE: The comment period has been extended to 12 p.m. April 26.675.

This rule adoption updates L&I’s payment rates for health care services, which are published annually in the Medical Aid Rules and Fee Schedules. L&I is updating the anesthesia conversion factor that is used to determine the rates for most anesthesia services from $3.22 to $3.25, and updating the physical therapy (PT) and occupational therapy (OT) maximum daily payment level (PT/OT cap) from $119.01 to $119.96. The changes were adopted 5/7/2013 and will be effective on 7/1/2013.672.

Substitute Senate Bill (SSB) 5801 (Chapter 6, Laws of 2011) directs the Department of Labor & Industries (L&I) to establish a medical provider network to treat injured workers of employers insured with L&I and of self-insured employers. SSB 5801 also expands Centers for Occupational Health and Education (COHEs). Rules are necessary to implement the changes. L&I is creating and/or amending necessary rules in phases to ensure timely completion of all required provisions. This third rulemaking phase will amend, clarify, or delete further department rules that conflict with SSB 5801, or with the department’s implementation of SSB 5801. The changes were adopted 11/13/2012 and became effective on 12/14/2012.660.

RCW 51.36.010, as amended by Substitute Senate Bill (SSB) 5801 (Chapter 6, Laws of 2011), directs L&I to establish a statewide medical provider network to treat injured and ill workers. SSB 5801 states that “Once the provider network is established in the worker’s geographic area, an injured worker may receive care from a nonnetwork provider only for an initial office or emergency room visit.” This amended rule language clarifies “initial visit.” It also informs health care providers and workers as to what services may be provided by a nonnetwork provider and when care must be transferred to a network provider. The changes were adopted 3/6/2012 and became effective on 4/6/2012.641.

This rulemaking amends WAC sections to align with the Washington State Health Technology Clinical Committee decisions on spinal injections, nerve stimulators, discography, and structured intensive multidisciplinary programs. The changes were adopted 6/5/2012 and became effective on 7/6/2012.636.

Substitute Senate Bill 5801 (Chapter 6, Laws of 2011) amends RCW 51.36.010 and directs the Department of Labor and Industries to establish a statewide medical provider network and expand Centers of Occupational Health Education (COHEs). Rules are necessary to implement the changes. This initial set of rules includes establishing minimum standards for the credentialing of medical providers and other requirements for network participation, and defines “risk of harm” to injured workers. The changes were adopted 1/3/2012 and became effective on 2/3/2012.622.