The ongoing impacts of COVID-19, cannabis legalization and medical cost containment are among the key regulatory and legislative issues that states across the country are grappling with, according to NCCI.
The ongoing impacts of COVID-19 in the workplace, cannabis legalization and medical cost containment are a few of the top issues that states across the country are grappling with, according to a report that follows compensation-related legislative activity.
This is the tenth year the Regulatory and Legislative Trends Report has been compiled by the National Council on Compensation Insurance (NCCI).
The 2022 report highlights workers’ compensation-related legislative activity and trending issues throughout the country.
By the Numbers
As of July 31, the report tracked 844 state and federal bills, including 447 bills in states where NCCI provides ratemaking services.
To date, 98 bills were enacted.
In addition, NCCI monitored 243 proposed workers’ compensation-related regulations. As of July 31, 95 of those proposed regulations were adopted.
“As in prior years, medical cost containment was the top theme of the regulations adopted, including medical fee schedules and treatment guidelines, while several of the adopted regulations addressed claims reporting requirements, surcharges, and assessment,” said Laura Kersey, executive director, regulatory & legislative analysis For NCCI.
1) COVID-19
NCCI followed more than 118 bills related to COVID-19 and insurance this year.
Laura Kersey, executive director, regulatory & legislative analysis, NCCI.
“This year we continued to see states focused on COVID-19 legislation, including COVID-19 workers’ compensation presumptions,” Kersey said.
The report found that during 2020 and 2021, 18 states established COVID-19 presumptions through legislation, directives, and/or emergency rules.
Generally, these are presumptions that an employee’s exposure to, or contraction of, COVID-19 is work-related or is a compensable injury or disease.
Most of these presumptions contained expiration dates or sunset provisions tied to the end of the state of emergency or another specified date.
The report noted that several states proposed legislation this year to extend the expiration dates for COVID-19 workers’ compensation presumptions, while some states considered legislation to establish new COVID-19 presumptions.
In addition, several states considered legislation to establish a broader infectious disease workers’ compensation presumption that could be applicable beyond the COVID-19 pandemic.
2) COVID-19 Vaccines
A new trend emerging in 2021 and the beginning of 2022 involved workers’ compensation and COVID-19 vaccinations.
Several states proposed legislation that would either establish a workers’ compensation presumption for an employee’s adverse effects from an employer-mandated COVID-19 vaccination or would specify that injuries from required COVID-19 vaccinations should be compensable under the workers’ compensation law.
In addition, a few states proposed legislation that would create a private right of action against an employer for certain injuries or death resulting from an employer-mandated COVID-19 vaccination.
While the issue of workers’ compensation and COVID-19 vaccinations merits watching, it did not gain momentum during the legislative season and to date none of the bills have been enacted, Kersey said.
3) Mental Health
Another hot topic cited in the report is mental health.
“Workers’ compensation for workplace related mental injuries continued to be a key topic this year, including legislation addressing post-traumatic stress disorder,” Kersey said.
Of the 61 bills NCCI monitored regarding workers’ compensation and mental health, 46 of the bills were related to post-traumatic stress disorder.
A new law in New Hampshire, for instance, reestablishes a commission to study incidence of PTSD in first responders and ensures that mental health training is available for first responders, law enforcement, fire service, emergency medical service and corrections personnel.
In Florida, a new law extends workers’ compensation benefits for PTSD to correctional officers under certain circumstances.
4) Cannabis
While marijuana is still illegal at the federal level, states continue to legalize it in various forms through legislation and ballot measures. States also continue to debate issues around reimbursement for medical marijuana in workers’ compensation.
So far this year, two states — Rhode Island and Maryland — have passed legislation to legalize the recreational use of marijuana.
However, the Maryland legislation requires voter approval of a state constitutional amendment before recreational marijuana will be legal in the state.
Mississippi enacted legislation legalizing the medical use of marijuana, which also provided that workers’ compensation insurers are not required to reimburse for medical marijuana as a workers compensation treatment.
Rhode Island and South Dakota also enacted legislation this year stating that reimbursement is not required.
New Jersey and New York are considering proposals that require workers’ compensation coverage for medical marijuana treatment under certain circumstances.
5) Single-Payer Health
The idea of a single-payer health insurance system has been discussed at both the state and federal levels for years.
To date, no state has fully implemented such an approach, but several jurisdictions, are studying the issue.
Kersey said bills that include a reference to workers’ compensation are of particular interest.
In most states that reference workers’ compensation, the legislation generally contains similar language directing a board of the new state single-payer healthcare program to develop a proposal for coverage of health care items and services currently covered under the workers’ compensation system, including whether and how to continue funding for those health care services currently covered by the workers’ compensation system and whether and how to incorporate an element of experience rating.
Four states, California, Kansas, New York and Rhode Island, considered or are considering single-payer health insurance proposals with a workers’ compensation component.
6) Independent Contractors/The Gig Economy
States continue to debate legislative proposals that provide criteria for determining whether a worker is classified as an employee of a company or as an independent contractor.
This year, two states considered legislation to establish a test for determining worker status, similar to California’s three-part test, also known as the ABC test.
In Rhode Island, proposed legislation would have created a three-part test to determine whether a worker is an employee or an independent contractor, similar to California’s ABC test. The bill was held in Senate committee.
Vermont also considered a multi-prong test for determining whether a worker is an employee or an independent contractor, but the bill did not advance this session.
Three states enacted legislation related to the gig economy.
In Alabama, for instance, a new law excludes certain marketplace contractors (gig workers) who work for marketplace platforms such as Uber, Grubhub, Shipt and others from the definition of employment and considers them independent contractors.
Information By Region
The report also highlights legislative activity and trending issues in four zones — the Midwest, the Northeast, Southeast and West.
Kersey said two interactive elements are helpful for users who want to tailor the information they seek.
One interactive feature enables a countrywide view of workers’ compensation legislation enacted in 2022 that can be sorted by state, zone and topic of interest.
Another interactive feature is the Loss Cost/Rate Filing Interactive Dashboard that allows users to navigate filed and approved loss cost/rate information based on the 2021-2022 filing season.
A “Show Me How” button at the top of each dashboard provides more information about interacting with the dashboards.
Kersey said the interactive features allow users to “customize their experience and interact with workers compensation information in new ways.” &
