1.1.................... moves to amend H.F. No. 3873, the second engrossment, as follows:
1.2Delete everything after the enacting clause and insert:


1.5    Section 1. Minnesota Statutes 2017 Supplement, section 15A.083, subdivision 7, is
1.6amended to read:
1.7    Subd. 7. Workers' Compensation Court of Appeals and compensation judges.
1.8Salaries of judges of the Workers' Compensation Court of Appeals are 98.52 105 percent
1.9of the salary for district court workers' compensation judges of the Office of Administrative
1.10Hearings. The salary of the chief judge of the Workers' Compensation Court of Appeals is
1.1198.52 107 percent of the salary for a chief district court judge workers' compensation judges
1.12of the Office of Administrative Hearings. Salaries of compensation judges are 98.52 percent
1.13of the salary of district court judges.
1.14EFFECTIVE DATE.This section is effective June 1, 2018.

1.15    Sec. 2. Minnesota Statutes 2016, section 175A.05, is amended to read:
1.16175A.05 QUORUM.
1.17    Subdivision 1. Judges' quorum. A majority of the judges of the Workers' Compensation
1.18Court of Appeals shall constitute a quorum for the exercise of the powers conferred and the
1.19duties imposed on the Workers' Compensation Court of Appeals except that all appeals
1.20shall be heard by no more than a panel of three of the five judges unless the case appealed
1.21is determined to be of exceptional importance by the chief judge prior to assignment of the
1.22case to a panel, or by a three-fifths vote of the judges prior to assignment of the case to a
2.1panel or after the case has been considered by the panel but prior to the service and filing
2.2of the decision.
2.3    Subd. 2. Vacancy. A vacancy shall not impair the ability of the remaining judges of the
2.4Workers' Compensation Court of Appeals to exercise all the powers and perform all of the
2.5duties of the Workers' Compensation Court of Appeals.
2.6    Subd. 3. Retired judges. Where the number of Workers' Compensation Court of Appeals
2.7judges available to hear a case is insufficient to constitute a quorum, the chief judge of the
2.8Workers' Compensation Court of Appeals may, with the retired judge's consent, assign a
2.9judge who is retired from the Workers' Compensation Court of Appeals or the Office of
2.10Administrative Hearings to hear any case properly assigned to a judge of the Workers'
2.11Compensation Court of Appeals. The retired judge assigned to the case may act on it with
2.12the full powers of the judge of the Workers' Compensation Court of Appeals. A retired
2.13judge performing this service shall receive pay and expenses in the amount and manner
2.14provided by law for judges serving on the court, less the amount of retirement pay the judge
2.15is receiving under chapter 352 or 490.
2.16EFFECTIVE DATE.This section is effective June 1, 2018.

2.17    Sec. 3. Minnesota Statutes 2016, section 176.231, subdivision 9, is amended to read:
2.18    Subd. 9. Uses which that may be made of reports. (a) Reports filed with the
2.19commissioner under this section may be used in hearings held under this chapter, and for
2.20the purpose of state investigations and for statistics. These reports are available to the
2.21Department of Revenue for use in enforcing Minnesota income tax and property tax refund
2.22laws, and the information shall be protected as provided in chapter 270B.
2.23(b) The division or Office of Administrative Hearings or Workers' Compensation Court
2.24of Appeals may permit the examination of its file by the employer, insurer, employee, or
2.25dependent of a deceased employee or any person who furnishes written signed authorization
2.26to do so from the employer, insurer, employee, or dependent of a deceased employee.
2.27Reports filed under this section and other information the commissioner has regarding
2.28injuries or deaths shall be made available to the Workers' Compensation Reinsurance
2.29Association for use by the association in carrying out its responsibilities under chapter 79.
2.30(c) The division may provide the worker identification number assigned under section
2.31176.275, subdivision 1, without a signed authorization required under paragraph (b) to an:
2.32(1) attorney who represents one of the persons described in paragraph (b);
2.33(2) attorney who represents an intervenor or potential intervenor under section 176.361;
3.1(3) intervenor; or
3.2(4) employee's assigned qualified rehabilitation consultant under section 176.102.
3.3EFFECTIVE DATE.This section is effective June 1, 2018.

3.4    Sec. 4. [176.2611] COORDINATION OF THE OFFICE OF ADMINISTRATIVE
3.5HEARINGS' CASE MANAGEMENT SYSTEM AND THE WORKERS'
3.6COMPENSATION IMAGING SYSTEM.
3.7    Subdivision 1. Definitions. (a) For purposes of this section, the definitions in this
3.8subdivision apply unless otherwise specified.
3.9(b) "Commissioner" means the commissioner of labor and industry.
3.10(c) "Department" means the Department of Labor and Industry.
3.11(d) "Document" includes all data, whether in electronic or paper format, that is filed
3.12with or issued by the office or department related to a claim-specific dispute resolution
3.13proceeding under this section.
3.14(e) "Office" means the Office of Administrative Hearings.
3.15    Subd. 2. Applicability. This section governs filing requirements pending completion
3.16of the workers' compensation modernization program and access to documents and data in
3.17the office's case management system, the workers' compensation Informix imaging system,
3.18and the system that will be developed as a result of the workers' compensation modernization
3.19program. This section prevails over any conflicting provision in this chapter, Laws 1998,
3.20chapter 366, or corresponding rules.
3.21    Subd. 3. Documents that must be filed with the office. Except as provided in
3.22subdivision 4 and section 176.421, all documents that require action by the office under
3.23this chapter must be filed, electronically or in paper format, with the office as required by
3.24the chief administrative law judge. Filing a document that initiates or is filed in preparation
3.25for a proceeding at the office satisfies any requirement under this chapter that the document
3.26must be filed with the commissioner.
3.27    Subd. 4. Documents that must be filed with the commissioner. (a) The following
3.28documents must be filed directly with the commissioner in the format and manner prescribed
3.29by the commissioner:
3.30(1) all requests for an administrative conference under section 176.106, regardless of
3.31the amount in dispute;
4.1(2) a motion to intervene in an administrative conference that is pending at the department;
4.2(3) any other document related to an administrative conference that is pending at the
4.3department;
4.4(4) an objection to a penalty assessed by the commissioner or the department;
4.5(5) requests for medical and rehabilitation dispute certification under section 176.081,
4.6subdivision 1, paragraph (c), including related documents; and
4.7(6) except as provided in this subdivision or subdivision 3, any other document required
4.8to be filed with the commissioner.
4.9(b) The filing requirement in paragraph (a), clause (1), makes no changes to the
4.10jurisdictional provisions in section 176.106. A claim petition that contains only medical or
4.11rehabilitation issues, unless primary liability is disputed, is considered to be a request for
4.12an administrative conference and must be filed with the commissioner.
4.13(c) The commissioner must refer a timely, unresolved objection to a penalty under
4.14paragraph (a), clause (4), to the office within 60 calendar days.
4.15    Subd. 5. Form revision and access to documents and data. (a) The commissioner
4.16must revise dispute resolution forms, in consultation with the chief administrative law judge,
4.17to reflect the filing requirements in this section.
4.18(b) For purposes of this subdivision, "complete, read-only electronic access" means the
4.19ability to view all data and document contents, including scheduling information, related
4.20to workers' compensation disputes, except for the following:
4.21(1) a confidential mediation statement, including any documents submitted with the
4.22statement for the mediator's review;
4.23(2) work product of a compensation judge, mediator, or commissioner that is not issued.
4.24Examples of work product include personal notes of hearings or conferences and draft
4.25decisions;
4.26(3) the department's Vocational Rehabilitation Unit's case management system data;
4.27(4) the special compensation fund's case management system data; and
4.28(5) audit trail information.
4.29(c) The office must be provided with continued, complete, read-only electronic access
4.30to the workers' compensation Informix imaging system.
5.1(d) The department must be provided with read-only electronic access to the office's
5.2case management system, including the ability to view all data, including scheduling
5.3information, but excluding access into filed documents.
5.4(e) The office must send the department all documents that are accepted for filing or
5.5issued by the office. The office must send the documents to the department, electronically
5.6or by courier, within two business days of when the documents are accepted for filing or
5.7issued by the office.
5.8(f) The department must place documents that the office sends to the department in the
5.9appropriate imaged file for the employee.
5.10(g) The department must send the office copies of the following documents, electronically
5.11or by courier, within two business days of when the documents are filed with or issued by
5.12the department:
5.13(1) notices of discontinuance;
5.14(2) decisions issued by the department; and
5.15(3) mediated agreements.
5.16(h) Upon integration of the office's case management system and the department's system
5.17resulting from the workers' compensation modernization program, each agency will be
5.18provided with complete, read-only electronic access to the other agency's system.
5.19(i) Each agency's responsible authority pursuant to section 13.02, subdivision 16, is
5.20responsible for its own employees' use and dissemination of the data and documents in the
5.21workers' compensation Informix imaging system, the office's case management system, and
5.22the system developed as a result of the workers' compensation modernization program.
5.23    Subd. 6. Data privacy. (a) All documents filed with or issued by the department or the
5.24office under this chapter are private data on individuals and nonpublic data pursuant to
5.25chapter 13, except that the documents are available to the following:
5.26(1) the office;
5.27(2) the department;
5.28(3) the employer;
5.29(4) the insurer;
5.30(5) the employee;
5.31(6) the dependent of a deceased employee;
6.1(7) an intervenor in the dispute;
6.2(8) the attorney to a party in the dispute;
6.3(9) a person who furnishes written authorization from the employer, insurer, employee,
6.4or dependent of a deceased employee; and
6.5(10) a person, agency, or other entity allowed access to the documents under this chapter
6.6or other law.
6.7(b) The office and department may post notice of scheduled proceedings on the agencies'
6.8Web sites and at their principal places of business in any manner that protects the employee's
6.9identifying information.
6.10    Subd. 7. Workers' Compensation Court of Appeals. The Workers' Compensation
6.11Court of Appeals has authority to amend its rules of procedure to reflect electronic filing
6.12with the office under this section for purposes of section 176.421, subdivision 5, and to
6.13allow electronic filing with the court under section 176.285. The court may amend its rules
6.14using the procedure in section 14.389.
6.15EFFECTIVE DATE.This section is effective June 1, 2018.

6.16    Sec. 5. Laws 2017, chapter 94, article 1, section 6, is amended to read:

6.17 6.18

Sec. 6. WORKERS' COMPENSATION COURT OF APPEALS

$

1,913,000

$

1,913,000 1,946,000

6.19This appropriation is from the workers'
6.20compensation fund.


6.23    Section 1. [176.1364] WORKERS' COMPENSATION HOSPITAL OUTPATIENT
6.24FEE SCHEDULE.
6.25    Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in this
6.26subdivision have the meanings given them.
6.27(b) "Addendum A" means the addendum entitled "OPPS APCs for CY 2018," or its
6.28successor, developed by the Centers for Medicare and Medicaid Services (Medicare) for
6.29use in the Medicare Hospital Outpatient Prospective Payment System (OPPS) system under
6.30Code of Federal Regulations, title 42, part 419, as may be amended from time to time.
7.1(c) "Addendum B" means the addendum entitled "OPPS Payment by HCPCS Codes for
7.2CY 2018," or its successor, developed by the Centers for Medicare and Medicaid Services
7.3(Medicare) for use in the Medicare Hospital Outpatient Prospective Payment System (OPPS)
7.4system under Code of Federal Regulations, title 42, part 419, as may be amended from time
7.5to time.
7.6(d) "HCPCS code" means a numeric or alphanumeric code included in the Centers for
7.7Medicare and Medicaid Services' Healthcare Common Procedure Coding System. A HCPCS
7.8code is used to identify a specific medical service.
7.9(e) "Hospital" means a facility that is licensed by the Department of Health under section
7.10144.50.
7.11(f) "HOFS" means the workers' compensation hospital outpatient fee schedule established
7.12under subdivision 3.
7.13(g) "Insurer" includes workers' compensation insurers and self-insured employers.
7.14(h) "Services" includes articles, supplies, procedures, and implantable devices provided
7.15by the hospital with the service. Services are identified by a code described in subdivision
7.163.
7.17    Subd. 2. Applicability. (a) This section only applies to payment of charges for hospital
7.18outpatient services if the charges include a service listed in the workers' compensation
7.19hospital outpatient fee schedule established by the commissioner under subdivision 3. If
7.20the charges do not include a service listed in the HOFS, payment shall be:
7.21(1) the liability for each service that is included in the workers' compensation relative
7.22value fee schedule as provided in section 176.136, subdivision 1a, and corresponding rules
7.23adopted by the commissioner to implement the relative value fee schedule; or
7.24(2) the liability as provided in section 176.136, subdivision 1b, paragraphs (b) and (c),
7.25for each service that is not included in the workers' compensation relative value fee schedule.
7.26(b) This section does not apply to outpatient services provided at a hospital that is certified
7.27by Medicare as a critical access hospital. Outpatient services provided by these hospitals
7.28shall be paid as provided in section 176.136, subdivision 1b, paragraph (a).
7.29    Subd. 3. Hospital outpatient fee schedule (HOFS). (a) Effective for hospital outpatient
7.30services on or after October 1, 2018, the commissioner shall establish a workers'
7.31compensation hospital outpatient fee schedule (HOFS) to establish the payment for hospital
7.32bills with charges for services with a J1 or J2 status indicator as listed in the status indicator
7.33(SI) column of Addendum B and the comprehensive observation services Ambulatory
8.1Payment Classification (APC) 8011 with a J2 status indicator in Addendum A. The
8.2commissioner shall publish a link to the HOFS in the State Register before October 1, 2018,
8.3and shall maintain the current HOFS on the department's Web site.
8.4(b) The amount listed for each of the procedures in the HOFS as described in paragraph
8.5(a) shall be the relative weight for the procedure multiplied by a HOFS conversion factor
8.6that results in the same overall payment for hospital outpatient services under this section
8.7as the actual payments made in the most recent 12-month period available before the effective
8.8date of this section. The commissioner must establish separate conversion factors to achieve
8.9the same overall payment for noncritical access hospitals of 100 or fewer licensed beds and
8.10hospitals with more than 100 licensed beds. The commissioner shall establish the two
8.11conversion factors according to the requirements in clauses (1) to (4) in consultation with
8.12insurer and hospital representatives.
8.13(1) The commissioner shall obtain a suitable sample of de-identified data for Minnesota
8.14workers' compensation outpatient cases at Minnesota hospitals for the most recently available
8.1512-month period. The commissioner may obtain de-identified data from any reliable source,
8.16including Minnesota hospitals and insurers, or their representatives. Any data provided to
8.17the commissioner by a hospital, insurer, or their representative under this subdivision is
8.18nonpublic data under section 13.02, subdivision 9.
8.19(2) The sample must be divided into a data set for hospitals over 100 licensed beds, and
8.20100 or fewer licensed beds, excluding critical access hospitals.
8.21(3) For each data set the commissioner shall:
8.22(i) calculate the total amount of the actual payments made in the most recent 12-month
8.23period available before the effective date of this section, adjusted for inflation to July 2018;
8.24and
8.25(ii) apply all of the payment provisions in this section to each claim including, as
8.26applicable, payment under the relative value fee schedule or 85 percent of the hospital's
8.27usual and customary charge under section 176.136, subdivisions 1a and 1b, to determine
8.28the total payment amount using the Medicare conversion factor in effect for the OPPS in
8.29effect on July 1, 2018.
8.30(4) The commissioner shall calculate the Minnesota conversion factor to equal the
8.31Medicare conversion factor multiplied by the ratio of total payments under clause (3), item
8.32(i), divided by the total payments under clause (3), item (ii).
8.33(c) For purposes of this section:
9.1(1) the relative weight is the amount in the "relative weight" column in Addendum B
9.2and Addendum A for comprehensive observation services.
9.3(2) references to J1, J2, and H status indicators; Addenda A and B; APC 8011; and
9.4HCPCS code G0378 includes any successor status indicators, addenda, APC, or HCPCS
9.5code established by the Centers for Medicare and Medicaid Services.
9.6(d) On October 1 of each year, the commissioner shall adjust the HOFS conversion
9.7factors based on the market basket index for inpatient hospital services calculated by
9.8Medicare and published on its Web site. The adjustment on each October 1 shall be a
9.9percentage equal to the value of that index averaged over the four quarters of the most recent
9.10calendar year divided by the value of that index over the four quarters of the prior calendar
9.11year.
9.12(e) No later than October 1, 2021, and at least once every three years thereafter, the
9.13commissioner shall update the HOFS established under this subdivision by incorporating
9.14services with a J1 or J2 status indicator, and the corresponding relative weights, listed in
9.15the Addenda A and B most recently available on Medicare's Web site as of the preceding
9.16July 1. If Addenda A and B are not available on Medicare's Web site on the preceding July
9.171, the HOFS most recently published on the department's Web site remains in effect.
9.18(1) Each time the HOFS is updated under this paragraph, the commissioner shall adjust
9.19the conversion factors so that there is no difference between the overall payment under the
9.20new HOFS and the overall payment under the HOFS most recently in effect, for services
9.21in both HOFSs.
9.22(2) The conversion factor adjustments under this paragraph shall be made separately for
9.23each hospital category in paragraph (b).
9.24(3) The conversion factor adjustments under this paragraph must be made before making
9.25any additional adjustment under paragraph (d).
9.26(f) The commissioner shall give notice in the State Register of the adjusted conversion
9.27factor in paragraph (d) no later than October 1 annually. The commissioner shall give notice
9.28in the State Register of an updated HOFS under paragraph (e) no later than October 1 of
9.29the year in which the HOFS becomes effective. The notice must include a link to the HOFS
9.30published on the department's Web site. The notices, the updated fee schedules, and the
9.31adjusted conversion factors are not rules subject to chapter 14, but have the force and effect
9.32of law as of the effective date published in the State Register.
10.1    Subd. 4. Payment under the hospital outpatient fee schedule. (a) Services in the
10.2HOFS, and other hospital outpatient services provided with or as part of service in the
10.3HOFS, are paid according to paragraphs (b) and (c).
10.4(b) If a hospital bill includes a charge for one or more services with a J1 status indicator,
10.5payment shall be as provided in this paragraph.
10.6(1) If the bill includes a charge for only one service with only a J1 status indicator,
10.7payment shall be the amount listed in the HOFS for that service, regardless of the amount
10.8charged by the hospital.
10.9(2) If the bill includes charges for more than one service with a J1 status indicator, the
10.10service with the highest listed fee in the HOFS shall be paid at 100 percent of the listed fee.
10.11Each additional service listed in the hospital outpatient fee shall be paid at 50 percent of
10.12the listed fee. Payment under this clause shall be based on the applicable percentage of the
10.13listed fee, regardless of the amount charged by the hospital.
10.14(3) If the bill includes an additional charge for a service that does not have a J1 status
10.15indicator listed in the HOFS, no separate payment is made for the additional service. Payment
10.16for the additional service, including any service with a J2 status indicator, is packaged into
10.17and is not paid separately from the payment amount listed in the HOFS for the service with
10.18the J1 status indicator. Implantable devices are paid separately only as provided in subdivision
10.195.
10.20(4) The insurer must not deny payment for any additional service packaged into payment
10.21for a service listed in the HOFS on the basis that the additional service was not reasonably
10.22required or causally related to an admitted work injury.
10.23(c) If a hospital bill includes one or more charges for services with a J2 status indicator,
10.24and does not include any charges for services with a J1 status indicator, payment shall be
10.25as provided in this paragraph.
10.26(1) Except for services packaged into an observation service as provided in clause (4),
10.27payment for each service with a J2 status indicator shall be the amount listed in the HOFS,
10.28regardless of the amount charged by the hospital.
10.29(2) If a service without a HCPCS code is billed with a service with a J2 status indicator,
10.30payment is packaged into the payment for the J2 service.
10.31(3) Payment for drugs with a HCPCS code is separate from payment for the service with
10.32the J2 code as provided in this clause.
11.1(i) If the drug is delivered by injection or infusion, payment for the drug is packaged
11.2into payment for the injection or infusion service.
11.3(ii) If the drug is not delivered by injection or infusion, payment for the drug is paid at
11.4the Medicare Average Sales Price (ASP) of the drug on the day the drug is dispensed. No
11.5later than October 1, 2018, and October 1 of each subsequent year, the commissioner must
11.6publish on the department's Web site a link to the ASP most recently available as of the
11.7preceding July 1. If no ASP is available, the most recently posted ASP linked on the
11.8department's Web site remains in effect.
11.9(4) If a bill includes eight or more units of service with the HCPCS code G0378
11.10(observation services, per hour), and there is a physician's or dentist's order for observation,
11.11payment shall be the amount listed in the HOFS for the comprehensive observation services
11.12Ambulatory Payment Classification 8011, regardless of the amount charged by the hospital.
11.13All other services billed by the hospital, including other services with a J2 status indicator,
11.14are packaged into the payment amount and are not paid separately from the payment amount
11.15listed in the fee schedule for HCPCS code G0378.
11.16(5) For any other service on the same bill as the service with a J2 status indicator, payment
11.17shall be as provided in subdivision 2, paragraph (a).
11.18    Subd. 5. Implantable devices. The maximum fee for any service in the HOFS includes
11.19payment for all implantable devices, even if the Medicare OPPS would otherwise allow
11.20separate payment for the implantable device. However, separate payment in the amount of
11.2185 percent of the hospital's usual and customary charge for an implantable device is allowed
11.22if the implantable device:
11.23(1) has an H status indicator in Addendum B;
11.24(2) is properly charged on a bill with a service with a J1 status indicator in the HOFS;
11.25and
11.26(3) is properly billed with another HCPCS code, if required by Medicare's OPPS system.
11.27The commissioner shall update the HOFS each October 1 to include any HCPCS codes that
11.28are payable under this section according to the Addendum B most recently available on the
11.29preceding July 1.
11.30    Subd. 6. Study. (a) The commissioner shall conduct a study analyzing the percentage
11.31of claims with a service in the HOFS that were paid timely and the percentage of claims
11.32paid accurately. The commissioner must report the results of the study and recommendations
11.33to the Workers' Compensation Advisory Council and chairs and ranking minority members
12.1of the house of representatives and senate committees with jurisdiction over workers'
12.2compensation by January 15, 2021.
12.3(b) Based on the results of the study, the WCAC shall consider whether there is a
12.4minimum 80 percent compliance in timeliness and accuracy of payments, and additional
12.5statutory amendments, including but not limited to:
12.6(1) a maximum ten percent reduction in payments under the HOFS; and
12.7(2) an increase in indemnity benefits to injured workers.
12.8    Subd. 7. Rulemaking. The commissioner may adopt or amend rules, using the authority
12.9in section 14.386, paragraph (a), to implement this section. The rules are not subject to
12.10expiration under section 14.386, paragraph (b).
12.11EFFECTIVE DATE.This section is effective for hospital outpatient services provided
12.12on or after October 1, 2018.


12.15    Section 1. Minnesota Statutes 2016, section 176.136, subdivision 1b, is amended to read:
12.16    Subd. 1b. Limitation of liability. (a) The liability of the employer for treatment, articles,
12.17and supplies provided to an employee while an inpatient or outpatient at a Critical Access
12.18Hospital certified by the Centers for Medicare and Medicaid Services, or while an outpatient
12.19at a hospital with 100 or fewer licensed beds, shall be the hospital's usual and customary
12.20charge, unless the charge is determined by the commissioner or a compensation judge to
12.21be unreasonably excessive.
12.22    (b) The liability of the employer for the treatment, articles, and supplies that are not
12.23limited by paragraph (a), subdivision 1a, or 1c, or section 176.1362, 176.1363, or 176.1364,
12.24shall be limited to 85 percent of the provider's usual and customary charge, or 85 percent
12.25of the prevailing charges for similar treatment, articles, and supplies furnished to an injured
12.26person when paid for by the injured person, whichever is lower, except as provided in
12.27paragraph (e). On this basis, the commissioner or compensation judge may determine the
12.28reasonable value of all treatment, services, and supplies, and the liability of the employer
12.29is limited to that amount. The commissioner may by rule establish the reasonable value of
12.30a service, article, or supply in lieu of the 85 percent limitation in this paragraph. A prevailing
12.31charge established under Minnesota Rules, part 5221.0500, subpart 2, must be based on no
12.32more than two years of billing data immediately preceding the date of the service.
13.1    (c) The limitation of liability for charges provided by paragraph (b) does not apply to a
13.2nursing home that participates in the medical assistance program and whose rates are
13.3established by the commissioner of human services.
13.4    (d) An employer's liability for treatment, articles, and supplies provided under this chapter
13.5by a health care provider located outside of Minnesota is limited to the payment that the
13.6health care provider would receive if the treatment, article, or supply were paid under the
13.7workers' compensation law of the jurisdiction in which the treatment was provided.
13.8(e) The limitation of the employer's liability based on 85 percent of prevailing charge
13.9does not apply to charges by an ambulatory surgical center as defined in section 176.1363,
13.10subdivision 1, paragraph (b), or a hospital as defined in section 176.1364, subdivision 1,
13.11paragraph (e).
13.12(f) For purposes of this chapter, "inpatient" means a patient that has been admitted to a
13.13hospital by an order from a physician or dentist. If there is no inpatient admission order,
13.14the patient is deemed an outpatient. The hospital must provide documentation of an inpatient
13.15order upon the request of the employer.
13.16EFFECTIVE DATE.This section is effective for treatment, articles, and supplies
13.17provided on or after October 1, 2018.

13.18    Sec. 2. [176.1365] OUTPATIENT BILLING, PAYMENT, AND DISPUTE
13.19RESOLUTION.
13.20    Subdivision 1. Scope. This section applies to billing, payment, and dispute resolution
13.21for services provided by an ambulatory surgical center (ASC) under section 176.1363 and
13.22hospital outpatient services under section 176.1364. For purposes of this section, "insurer"
13.23includes self-insured employer and "services" is as defined in section 176.1364.
13.24    Subd. 2. Outpatient billing, coding, and prior notification. (a) Ambulatory surgical
13.25centers and hospitals must bill workers' compensation insurers for services governed by
13.26sections 176.1363 and 176.1364 using the same codes, formats, and details that are required
13.27for billing the Medicare program, including coding consistent with the American Medical
13.28Association Current Procedural Terminology coding system and Medicare's Ambulatory
13.29Surgical Center Payment System, Outpatient Prospective Payment System, Outpatient Code
13.30Editor, Healthcare Current Procedural Terminology Coding System, and the National Correct
13.31Coding Initiative Policy Manual for Medicare Services and associated Web page and tables.
13.32(b) All charges for ASC or hospital outpatient fee schedule services governed by sections
13.33176.1363 and 176.1364 must be submitted to the insurer on the appropriate electronic
14.1transaction required by section 176.135, subdivisions 7 and 7a. ASCs must submit charges
14.2on the electronic 837P form. ASCs must not separately bill for the services and items
14.3included in the ASC facility fee under Code of Federal Regulations, title 42, section
14.4416.164(a). Minnesota Rules, part 5221.4033, subpart 1a, does not apply to ASCs under
14.5this section, but does apply to hospital outpatient facility fees to the extent they are not
14.6covered by the hospital outpatient fee schedule under section 176.1364.
14.7(c) Hospitals, ASCs, and insurers must comply with the prior notification and approval
14.8or authorization requirements specified in Minnesota Rules, part 5221.6050, subpart 9. Prior
14.9notification may be provided by either the hospital, ASC, or the surgeon. For purposes of
14.10prior notification under Minnesota Rules, part 5221.6050, subpart 9, "inpatient" has the
14.11meaning as provided under section 176.136, subdivision 1b, paragraph (d).
14.12(d) ASC or hospital bills must be submitted to insurers as required by section 176.135,
14.13subdivisions 7 and 7a, and within the time period required by section 62Q.75, subdivision
14.143. Insurers must respond to the initial bill as provided in section 176.135, subdivisions 6
14.15and 7a. Copies of any records or reports relating to the items for which payment is sought
14.16are separately payable as provided in section 176.135, subdivision 7, paragraph (a).
14.17    Subd. 3. ASC or hospital request for reconsideration; insurer response; time frames.
14.18(a) Following receipt of the insurer's explanation of review (EOR) or explanation of benefits
14.19(EOB), the ASC or hospital may request reconsideration of a payment denial or reduction.
14.20The ASC or hospital must submit its request for reconsideration in writing to the insurer
14.21within one year of the date of the EOR or EOB.
14.22(b) The insurer must issue a written response to the ASC or hospital's request for
14.23reconsideration within 30 days, as provided in section 176.135, subdivision 6. The written
14.24response must address the issues raised by the request for reconsideration and not simply
14.25reiterate the information on the EOR or EOB.
14.26    Subd. 4. Insurer request for reimbursement of overpayment; time frame. If the
14.27payer determines it has overpaid an ASC or hospital's charges based on workers'
14.28compensation statutes and rules, the payer must submit its request for reimbursement in
14.29writing to the ASC or hospital within one year of the date of the payment.
14.30    Subd. 5. Medical requests for administrative conference; time frame to file. (a) An
14.31ASC, hospital, or insurer must notify the provider or payer, as applicable, of its intent to
14.32file a medical request for an administrative conference under section 176.106 at least 20
14.33days before filing one with the department. The insurer, or the ASC or hospital if permitted
15.1by section 176.136, subdivision 2, must file the medical request for an administrative
15.2conference no later than the latest of:
15.3(1) one year after the date of the initial EOR or EOB if the ASC or hospital does not
15.4request a reconsideration of a payment denial or reduction under subdivision 3;
15.5(2) one year after the date of the insurer's response to the ASC or hospital's request for
15.6reconsideration under subdivision 3; or
15.7(3) one year after the insurer's request for reimbursement of an overpayment from an
15.8ASC or hospital under subdivision 4.
15.9(b) Paragraph (a) does not prohibit an employee from filing a medical request for
15.10assistance or claim petition for the payment denied or reduced by the insurer. However, the
15.11ASC or hospital may not bill the employee for the denied or reduced payment when
15.12prohibited by this chapter.
15.13    Subd. 6. Interest. (a) An insurer must pay the ASC or hospital interest at an annual rate
15.14of four percent if it is determined that the insurer is liable for additional ASC or hospital
15.15charges following a denial of payment. Interest is payable by the insurer on the additional
15.16amount owed from the date payment was due.
15.17(b) An ASC or hospital must pay the insurer interest at an annual rate of four percent if
15.18it is determined that the hospital owes the insurer reimbursement following the insurer's
15.19request for reimbursement of an overpayment. Interest is payable by the ASC or hospital
15.20on the amount of the overpayment from the date the overpayment was made.
15.21EFFECTIVE DATE.This section is effective for services provided on or after October
15.221, 2018.


15.25    Section 1. [176.1363] AMBULATORY SURGICAL CENTER PAYMENT.
15.26    Subdivision 1. Definitions. (a) For the purpose of this section, the terms defined in this
15.27subdivision have the meanings given them.
15.28(b) "Ambulatory surgical center" or "ASC" means a facility that is: (1) certified as an
15.29ASC by the Centers for Medicare and Medicaid Services; or (2) licensed by the Department
15.30of Health as a freestanding outpatient surgical center and not owned by a hospital.
16.1(c) "Conversion factor" means the Medicare ambulatory surgical center payment system
16.2(ASCPS) conversion factor used for ASCs that meet the Medicare quality reporting
16.3requirements, whether or not the ASC submitting the bill has met the quality reporting
16.4requirements.
16.5(d) "Covered surgical procedures and ancillary services" means the procedures listed in
16.6ASCPS, addendum AA, and the ancillary services integral to covered surgical procedures
16.7listed in ASCPS, addendum BB.
16.8(e) "Insurer" includes workers' compensation insurers and self-insured employers.
16.9(f) "Ambulatory surgical center payment system" or "ASCPS" means the system
16.10developed by the Centers for Medicare and Medicaid Services for payment of surgical
16.11services provided by federally certified ASCs as specified in:
16.12(1) Code of Federal Regulations, title 42, part 416, including without limitation the
16.13geographic adjustment for the ASC and the multiple surgical procedure reduction rule;
16.14(2) annual revisions to Code of Federal Regulations, title 42, part 416, as published in
16.15the Federal Register;
16.16(3) the corresponding addendum AA (final ASC covered surgical procedures), addendum
16.17BB (final covered ancillary services integral to covered surgical procedures), addendum
16.18DD1 (final ASC payment indicators), and any successor or replacement addenda; and
16.19(4) the Medicare claims processing manual.
16.20(g) "Medicare ASCPS payment" means the Medicare ASCPS payment used for ASCs
16.21that meet the Medicare quality reporting requirements, whether or not the ASC submitting
16.22the bill has met the Medicare quality reporting requirements.
16.23    Subd. 2. Payment for covered surgical procedures and ancillary services based on
16.24Medicare ASCPS. (a) Except as provided in subdivisions 3 and 4, the payment to the ASC
16.25for covered surgical procedures and ancillary services shall be the lesser of:
16.26(1) the ASC's usual and customary charge for all services, supplies, and implantable
16.27devices provided; or
16.28(2) the Medicare ASCPS payment, times a multiplier of 320 percent.
16.29(i) The amount payable under this clause includes payment for all implantable devices,
16.30even if the Medicare ASCPS would otherwise allow separate payment for the implantable
16.31device.
17.1(ii) The 320 percent described in this clause must be adjusted if, on July 1, 2019, or any
17.2subsequent July 1, the conversion factor is less than 98 percent of the conversion factor in
17.3effect on the previous July 1. When this occurs, the multiplier must be 320 percent times
17.498 percent divided by the percentage that the current Medicare conversion factor bears to
17.5the Medicare conversion factor in effect on the prior July 1. In subsequent years, the
17.6multiplier is 320 percent, unless the Medicare ASCPS conversion factor declines by more
17.7than two percent.
17.8(b) Payment under this section is effective for covered surgical procedures and ancillary
17.9services provided by an ASC on or after October 1, 2018, through September 30, 2019, and
17.10shall be based on the addenda AA, BB, and DD1 most recently available on the Centers for
17.11Medicare and Medicaid Services Web site as of July 1, 2018, and the corresponding rules
17.12and Medicare claims processing manual described in subdivision 1, paragraph (f).
17.13(1) Payment for covered surgical procedures and ancillary services provided by an ASC
17.14on or after each subsequent October 1 shall be based on the addenda AA, BB, and DD1
17.15most recently available on the Centers for Medicare and Medicaid Services Web site as of
17.16the preceding July 1 and the corresponding rules and Medicare claims processing manual.
17.17(2) If the Centers for Medicare and Medicaid Services has not updated addendum AA,
17.18BB, or DD1 on its Web site since the commissioner's previous notice under paragraph (c),
17.19the addenda identified in the notice published by the commissioner in paragraph (c) and the
17.20corresponding rules and Medicare claims processing manual shall remain in effect.
17.21(3) Addenda AA, BB, and DD1 under this subdivision includes successor or replacement
17.22addenda.
17.23(c) The commissioner shall annually give notice in the State Register of any adjustment
17.24to the multiplier under paragraph (a), clause (2), and of the applicable addenda in paragraph
17.25(b) no later than October 1. The notice must identify and include a link to the applicable
17.26addenda. The notices and any adjustment to the multiplier are not rules subject to chapter
17.2714, but have the force and effect of law as of the effective date published in the State Register.
17.28    Subd. 3. Payment for compensable surgical services not covered under ASCPS. (a)
17.29If a surgical procedure provided by an ASC is compensable under this chapter but is not
17.30listed in addendum AA or BB of the Medicare ASCPS, payment must be 75 percent of the
17.31ASC's usual and customary charge for the procedure with the highest charge. Payment for
17.32each subsequent surgical procedure not listed in addendum AA or BB must be paid at 50
17.33percent of the ASC's usual and customary charge.
18.1(b) Payment must be 75 percent of the ASC's usual and customary charge for a surgical
18.2procedure or ancillary service if the procedure or service is listed in Medicare ASCPS
18.3addendum AA or BB and: (1) the payment indicator provides it is paid at a reasonable cost;
18.4(2) the payment indicator provides it is contractor priced; or (3) a payment rate is not
18.5otherwise provided.
18.6    Subd. 4. Study. The commissioner shall conduct a study analyzing the impact of the
18.7reforms, including timeliness and accuracy of payment under this section, and recommend
18.8further changes if needed. The commissioner must report the results of the study to the
18.9Workers' Compensation Advisory Council and the chairs and ranking minority members
18.10of the legislative committees with jurisdiction over workers' compensation by January 15,
18.112021.
18.12    Subd. 5. Rulemaking. The commissioner may adopt or amend rules using the authority
18.13in section 14.386, paragraph (a), to implement this section and the Medicare ASCPS for
18.14workers' compensation. The rules are not subject to expiration under section 14.386,
18.15paragraph (b).
18.16EFFECTIVE DATE.This section is effective for procedures and services provided by
18.17an ASC on or after October 1, 2018, except subdivision 5 is effective the day following
18.18final enactment.


18.21    Section 1. Minnesota Statutes 2016, section 176.011, subdivision 15, is amended to read:
18.22    Subd. 15. Occupational disease. (a) "Occupational disease" means a mental impairment
18.23as defined in paragraph (d) or physical disease arising out of and in the course of employment
18.24peculiar to the occupation in which the employee is engaged and due to causes in excess of
18.25the hazards ordinary of employment and shall include undulant fever. Physical stimulus
18.26resulting in mental injury and mental stimulus resulting in physical injury shall remain
18.27compensable. Mental impairment is not considered a disease if it results from a disciplinary
18.28action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement,
18.29or similar action taken in good faith by the employer. Ordinary diseases of life to which the
18.30general public is equally exposed outside of employment are not compensable, except where
18.31the diseases follow as an incident of an occupational disease, or where the exposure peculiar
18.32to the occupation makes the disease an occupational disease hazard. A disease arises out of
18.33the employment only if there be a direct causal connection between the conditions under
19.1which the work is performed and if the occupational disease follows as a natural incident
19.2of the work as a result of the exposure occasioned by the nature of the employment. An
19.3employer is not liable for compensation for any occupational disease which cannot be traced
19.4to the employment as a direct and proximate cause and is not recognized as a hazard
19.5characteristic of and peculiar to the trade, occupation, process, or employment or which
19.6results from a hazard to which the worker would have been equally exposed outside of the
19.7employment.
19.8(b) If immediately preceding the date of disablement or death, an employee was employed
19.9on active duty with an organized fire or police department of any municipality, as a member
19.10of the Minnesota State Patrol, conservation officer service, state crime bureau, as a forest
19.11officer by the Department of Natural Resources, state correctional officer, or sheriff or
19.12full-time deputy sheriff of any county, and the disease is that of myocarditis, coronary
19.13sclerosis, pneumonia or its sequel, and at the time of employment such employee was given
19.14a thorough physical examination by a licensed doctor of medicine, and a written report
19.15thereof has been made and filed with such organized fire or police department, with the
19.16Minnesota State Patrol, conservation officer service, state crime bureau, Department of
19.17Natural Resources, Department of Corrections, or sheriff's department of any county, which
19.18examination and report negatived any evidence of myocarditis, coronary sclerosis, pneumonia
19.19or its sequel, the disease is presumptively an occupational disease and shall be presumed
19.20to have been due to the nature of employment. If immediately preceding the date of
19.21disablement or death, any individual who by nature of their position provides emergency
19.22medical care, or an employee who was employed as a licensed police officer under section
19.23626.84, subdivision 1 ; firefighter; paramedic; state correctional officer; emergency medical
19.24technician; or licensed nurse providing emergency medical care; and who contracts an
19.25infectious or communicable disease to which the employee was exposed in the course of
19.26employment outside of a hospital, then the disease is presumptively an occupational disease
19.27and shall be presumed to have been due to the nature of employment and the presumption
19.28may be rebutted by substantial factors brought by the employer or insurer. Any substantial
19.29factors which shall be used to rebut this presumption and which are known to the employer
19.30or insurer at the time of the denial of liability shall be communicated to the employee on
19.31the denial of liability.
19.32(c) A firefighter on active duty with an organized fire department who is unable to
19.33perform duties in the department by reason of a disabling cancer of a type caused by exposure
19.34to heat, radiation, or a known or suspected carcinogen, as defined by the International
19.35Agency for Research on Cancer, and the carcinogen is reasonably linked to the disabling
20.1cancer, is presumed to have an occupational disease under paragraph (a). If a firefighter
20.2who enters the service after August 1, 1988, is examined by a physician prior to being hired
20.3and the examination discloses the existence of a cancer of a type described in this paragraph,
20.4the firefighter is not entitled to the presumption unless a subsequent medical determination
20.5is made that the firefighter no longer has the cancer.
20.6(d) For the purposes of this chapter, "mental impairment" means a diagnosis of
20.7post-traumatic stress disorder by a licensed psychiatrist or psychologist. For the purposes
20.8of this chapter, "post-traumatic stress disorder" means the condition as described in the most
20.9recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by
20.10the American Psychiatric Association. For purposes of section 79.34, subdivision 2, one or
20.11more compensable mental impairment claims arising out of a single event or occurrence
20.12shall constitute a single loss occurrence.
20.13(e) If, preceding the date of disablement or death, an employee who was employed on
20.14active duty as: a licensed police officer; a firefighter; a paramedic; an emergency medical
20.15technician; a licensed nurse employed to provide emergency medical services outside of a
20.16medical facility; a public safety dispatcher; an officer employed by the state or a political
20.17subdivision at a corrections, detention, or secure treatment facility; a sheriff or full-time
20.18deputy sheriff of any county; or a member of the Minnesota State Patrol is diagnosed with
20.19a mental impairment as defined in paragraph (d), and had not been diagnosed with the mental
20.20impairment previously, then the mental impairment is presumptively an occupational disease
20.21and shall be presumed to have been due to the nature of employment. This presumption
20.22may be rebutted by substantial factors brought by the employer or insurer. Any substantial
20.23factors that are used to rebut this presumption and that are known to the employer or insurer
20.24at the time of the denial of liability shall be communicated to the employee on the denial
20.25of liability. The mental impairment is not considered an occupational disease if it results
20.26from a disciplinary action, work evaluation, job transfer, layoff, demotion, promotion,
20.27termination, retirement, or similar action taken in good faith by the employer.
20.28EFFECTIVE DATE.This section is effective for employees with dates of injury on
20.29or after January 1, 2019.

20.30    Sec. 2. Minnesota Statutes 2016, section 176.101, subdivision 2, is amended to read:
20.31    Subd. 2. Temporary partial disability. (a) In all cases of temporary partial disability
20.32the compensation shall be 66-2/3 percent of the difference between the weekly wage of the
20.33employee at the time of injury and the wage the employee is able to earn in the employee's
20.34partially disabled condition. This compensation shall be paid during the period of disability
21.1except as provided in this section, payment to be made at the intervals when the wage was
21.2payable, as nearly as may be, and subject to the maximum rate for temporary total
21.3compensation.
21.4(b) Temporary partial compensation may be paid only while the employee is employed,
21.5earning less than the employee's weekly wage at the time of the injury, and the reduced
21.6wage the employee is able to earn in the employee's partially disabled condition is due to
21.7the injury. Except as provided in section 176.102, subdivision 11, paragraphs (b) and (c),
21.8temporary partial compensation may not be paid for more than 225 275 weeks, or after 450
21.9weeks after the date of injury, whichever occurs first.
21.10(c) Temporary partial compensation must be reduced to the extent that the wage the
21.11employee is able to earn in the employee's partially disabled condition plus the temporary
21.12partial disability payment otherwise payable under this subdivision exceeds 500 percent of
21.13the statewide average weekly wage.

21.14    Sec. 3. Minnesota Statutes 2016, section 176.101, subdivision 2a, is amended to read:
21.15    Subd. 2a. Permanent partial disability. (a) Compensation for permanent partial disability
21.16is as provided in this subdivision. Permanent partial disability must be rated as a percentage
21.17of the whole body in accordance with rules adopted by the commissioner under section
21.18176.105 . The percentage determined pursuant to the rules must be multiplied by the
21.19corresponding amount in the following table:

21.20	Impairment Rating			Amount
21.21	(percent)
21.22 21.23	less than 5.5		$	75,000 78,800
21.24 21.25	5.5 to less than 10.5			80,000 84,000
21.26 21.27	10.5 to less than 15.5			85,000 89,300
21.28 21.29	15.5 to less than 20.5			90,000 94,500
21.30 21.31	20.5 to less than 25.5			95,000 99,800
21.32 21.33	25.5 to less than 30.5			100,000 105,000
21.34 21.35	30.5 to less than 35.5			110,000 115,500
21.36 21.37	35.5 to less than 40.5			120,000 126,000
22.1 22.2	40.5 to less than 45.5			130,000 136,500
22.3 22.4	45.5 to less than 50.5			140,000 147,000
22.5 22.6	50.5 to less than 55.5			165,000 173,300
22.7 22.8	55.5 to less than 60.5			190,000 199,500
22.9 22.10	60.5 to less than 65.5			215,000 225,800
22.11 22.12	65.5 to less than 70.5			240,000 252,000
22.13 22.14	70.5 to less than 75.5			265,000 278,300
22.15 22.16	75.5 to less than 80.5			315,000 330,800
22.17 22.18	80.5 to less than 85.5			365,000 383,300
22.19 22.20	85.5 to less than 90.5			415,000 435,800
22.21 22.22	90.5 to less than 95.5			465,000 488,300
22.23 22.24	95.5 up to and including 100			515,000 540,800

22.25    An employee may not receive compensation for more than a 100 percent disability of
22.26the whole body, even if the employee sustains disability to two or more body parts.
22.27(b) Permanent partial disability is payable upon cessation of temporary total disability
22.28under subdivision 1. If the employee requests payment in a lump sum, then the compensation
22.29must be paid within 30 days. This lump-sum payment may be discounted to the present
22.30value calculated up to a maximum five percent basis. If the employee does not choose to
22.31receive the compensation in a lump sum, then the compensation is payable in installments
22.32at the same intervals and in the same amount as the employee's temporary total disability
22.33rate on the date of injury. Permanent partial disability is not payable while temporary total
22.34compensation is being paid.

22.35    Sec. 4. Minnesota Statutes 2016, section 176.101, subdivision 4, is amended to read:
22.36    Subd. 4. Permanent total disability. For permanent total disability, as defined in
22.37subdivision 5, the compensation shall be 66-2/3 percent of the daily wage at the time of the
22.38injury, subject to a maximum weekly compensation equal to the maximum weekly
22.39compensation for a temporary total disability and a minimum weekly compensation equal
23.1to 65 percent of the statewide average weekly wage. This compensation shall be paid during
23.2the permanent total disability of the injured employee but after a total of $25,000 of weekly
23.3compensation has been paid, the amount of the weekly compensation benefits being paid
23.4by the employer shall be reduced by the amount of any disability benefits being paid by
23.5any government disability benefit program if the disability benefits are occasioned by the
23.6same injury or injuries which give rise to payments under this subdivision. This reduction
23.7shall also apply to any old age and survivor insurance benefits. Payments shall be made at
23.8the intervals when the wage was payable, as nearly as may be. In case an employee who is
23.9permanently and totally disabled becomes an inmate of a public institution, no compensation
23.10shall be payable during the period of confinement in the institution, unless there is wholly
23.11dependent on the employee for support some person named in section 176.111, subdivision
23.121, 2 or 3 , in which case the compensation provided for in section 176.111, during the period
23.13of confinement, shall be paid for the benefit of the dependent person during dependency.
23.14The dependency of this person shall be determined as though the employee were deceased.
23.15Permanent total disability shall cease at age 67 because the employee is presumed retired
23.16from the labor market 72, except that if an employee is injured after age 67, permanent total
23.17disability benefits shall cease after five years of those benefits have been paid. This
23.18presumption is rebuttable by the employee. The subjective statement the employee is not
23.19retired is not sufficient in itself to rebut the presumptive evidence of retirement but may be
23.20considered along with other evidence.

23.21    Sec. 5. Minnesota Statutes 2016, section 176.102, subdivision 11, is amended to read:
23.22    Subd. 11. Retraining; compensation. (a) Retraining is limited to 156 weeks. An
23.23employee who has been approved for retraining may petition the commissioner or
23.24compensation judge for additional compensation not to exceed 25 percent of the
23.25compensation otherwise payable. If the commissioner or compensation judge determines
23.26that this additional compensation is warranted due to unusual or unique circumstances of
23.27the employee's retraining plan, the commissioner may award additional compensation in
23.28an amount not to exceed the employee's request. This additional compensation shall cease
23.29at any time the commissioner or compensation judge determines the special circumstances
23.30are no longer present.
23.31(b) If the employee is not employed during a retraining plan that has been specifically
23.32approved under this section, temporary total compensation is payable for up to 90 days after
23.33the end of the retraining plan; except that, payment during the 90-day period is subject to
23.34cessation in accordance with section 176.101. If the employee is employed during the
23.35retraining plan but earning less than at the time of injury, temporary partial compensation
24.1is payable at the rate of 66-2/3 percent of the difference between the employee's weekly
24.2wage at the time of injury and the weekly wage the employee is able to earn in the employee's
24.3partially disabled condition, subject to the maximum rate for temporary total compensation.
24.4Temporary partial compensation is not subject to the 225-week 275-week or 450-week
24.5limitations provided by section 176.101, subdivision 2, during the retraining plan, but is
24.6subject to those limitations before and after the plan.
24.7(c) Any request for retraining shall be filed with the commissioner before 208 weeks of
24.8any combination of temporary total or temporary partial compensation have been paid.
24.9Retraining shall not be available after 208 weeks of any combination of temporary total or
24.10temporary partial compensation benefits have been paid unless the request for the retraining
24.11has been filed with the commissioner prior to the time the 208 weeks of compensation have
24.12been paid.
24.13(d) The employer or insurer must notify the employee in writing of the 208-week
24.14limitation for filing a request for retraining with the commissioner. This notice must be
24.15given before 80 weeks of temporary total disability or temporary partial disability
24.16compensation have been paid, regardless of the number of weeks that have elapsed since
24.17the date of injury. If the notice is not given before the 80 weeks, the period of time within
24.18which to file a request for retraining is extended by the number of days the notice is late,
24.19but in no event may a request be filed later than 225 weeks after any combination of
24.20temporary total disability or temporary partial disability compensation have been paid. The
24.21commissioner may assess a penalty of $25 per day that the notice is late, up to a maximum
24.22penalty of $2,000, against an employer or insurer for failure to provide the notice. The
24.23penalty is payable to the commissioner for deposit in the assigned risk safety account.

24.24    Sec. 6. Minnesota Statutes 2016, section 176.83, subdivision 5, is amended to read:
24.25    Subd. 5. Treatment standards for medical services. (a) In consultation with the Medical
24.26Services Review Board or the rehabilitation review panel, the commissioner shall adopt
24.27rules establishing standards and procedures for health care provider treatment. The rules
24.28shall apply uniformly to all providers including those providing managed care under section
24.29176.1351 . The rules shall be used to determine whether a provider of health care services
24.30and rehabilitation services, including a provider of medical, chiropractic, podiatric, surgical,
24.31hospital, or other services, is performing procedures or providing services at a level or with
24.32a frequency that is excessive, unnecessary, or inappropriate under section 176.135,
24.33subdivision 1 , based upon accepted medical standards for quality health care and accepted
24.34rehabilitation standards.
25.1(b) The rules shall include, but are not limited to, the following:
25.2(1) criteria for diagnosis and treatment of the most common work-related injuries
25.3including, but not limited to, low back injuries and upper extremity repetitive trauma injuries;
25.4(2) criteria for surgical procedures including, but not limited to, diagnosis, prior
25.5conservative treatment, supporting diagnostic imaging and testing, and anticipated outcome
25.6criteria;
25.7(3) criteria for use of appliances, adaptive equipment, and use of health clubs or other
25.8exercise facilities;
25.9(4) criteria for diagnostic imaging procedures;
25.10(5) criteria for inpatient hospitalization;
25.11(6) criteria for treatment of chronic pain; and
25.12(7) criteria for the long-term use of opioids or other scheduled medications to alleviate
25.13intractable pain and improve function, including the use of written contracts between the
25.14injured worker and the health care provider who prescribes the medication.; and
25.15(8) criteria for treatment of post-traumatic stress disorder. In developing such treatment
25.16criteria, the commissioner and the Medical Services Review Board shall consider the
25.17guidance set forth in the American Psychological Association's most recently adopted
25.18Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in
25.19Adults. The commissioner shall adopt such rules using the expedited rulemaking process
25.20in section 14.389, including subdivision 5, to commence promptly upon final enactment of
25.21the legislation enacting this clause. Such rules shall apply to employees with all dates of
25.22injury who receive treatment after the commissioner adopts the rules. In consultation with
25.23the Medical Services Review Board, the commissioner shall review and update the rules
25.24governing criteria for treatment of post-traumatic stress disorder each time the American
25.25Psychological Association adopts a significant change to their Clinical Practice Guideline
25.26for the Treatment of PTSD in Adults, using the expedited rulemaking process in section
25.2714.389, including subdivision 5.
25.28(c) If it is determined by the payer that the level, frequency, or cost of a procedure or
25.29service of a provider is excessive, unnecessary, or inappropriate according to the standards
25.30established by the rules, the provider shall not be paid for the procedure, service, or cost by
25.31an insurer, self-insurer, or group self-insurer, and the provider shall not be reimbursed or
25.32attempt to collect reimbursement for the procedure, service, or cost from any other source,
25.33including the employee, another insurer, the special compensation fund, or any government
26.1program unless the commissioner or compensation judge determines at a hearing or
26.2administrative conference that the level, frequency, or cost was not excessive under the
26.3rules in which case the insurer, self-insurer, or group self-insurer shall make the payment
26.4deemed reasonable.
26.5(d) A rehabilitation provider who is determined by the rehabilitation review panel board,
26.6after hearing, to be consistently performing procedures or providing services at an excessive
26.7level or cost may be prohibited from receiving any further reimbursement for procedures
26.8or services provided under this chapter. A prohibition imposed on a provider under this
26.9subdivision may be grounds for revocation or suspension of the provider's license or
26.10certificate of registration to provide health care or rehabilitation service in Minnesota by
26.11the appropriate licensing or certifying body. The commissioner and Medical Services Review
26.12Board shall review excessive, inappropriate, or unnecessary health care provider treatment
26.13under section 176.103.
26.14EFFECTIVE DATE.This section is effective June 1, 2018.

26.15    Sec. 7. EFFECTIVE DATE.
26.16Unless otherwise specified, this article is effective for employees with dates of injury
26.17on or after October 1, 2018."
26.18Delete the title and insert:
26.20relating to workers' compensation; adopting recommendations of the Workers'
26.21Compensation Advisory Council; modifying workers' compensation provisions;
26.22modifying hospital outpatient fee schedules; modifying billing, payment, and
26.23dispute resolution; defining ambulatory surgical center payments; modifying
26.24covered benefits;amending Minnesota Statutes 2016, sections 175A.05; 176.011,
26.25subdivision 15; 176.101, subdivisions 2, 2a, 4; 176.102, subdivision 11; 176.136,
26.26subdivision 1b; 176.231, subdivision 9; 176.83, subdivision 5; Minnesota Statutes
26.272017 Supplement, section 15A.083, subdivision 7; Laws 2017, chapter 94, article
26.281, section 6; proposing coding for new law in Minnesota Statutes, chapter 176."