SB 190: Workers' Compensation Modifications - Utah

Amended Excerpts 2/5/2025 09:02:422 → Amended 2/5/2025 09:02:422 · 6 edits

MODERATE

This bill amends Utah's Workers' Compensation Act to clarify definitions, expand the Labor Commission's authority over healthcare provider fees and medical record disclosures, and update reporting requirements for workplace injuries. The changes aim to standardize how medical fees are handled, prevent balance billing, and ensure consistent reporting across employers, healthcare providers, and insurance carriers.

Scope change

The bill expands the scope of the Labor Commission's regulatory authority to include hospitals and all healthcare providers, not just physicians, and clarifies which entities must file injury reports.

DEFINITION

Added new definitions for 'balance billing', 'covered medical services', 'health care provider', 'hospital', and 'self-insured employer' to clarify terms used in workers' compensation claims.

REQUIREMENT

Expanded notification requirements to allow an employee's next of kin or attorney to report workplace injuries if the employee is unable to do so.

Updated medical record disclosure rules to apply to all work-related injury claims and give the Labor Commission broader authority to set disclosure requirements.

Added specific requirements for healthcare providers to report fees for hospital services based on Medicare reimbursement rates if the Labor Commission establishes such rules.

Updated injury reporting requirements to include more detailed circumstances (such as loss of consciousness or work restrictions) and clarified which entities must file reports.

ENFORCEMENT

Clarified that balance billing is prohibited for workers' compensation claims, preventing healthcare providers from charging patients amounts beyond what insurance carriers reimburse.

Enrolled → Amended Excerpts 2/5/2025 09:02:422 · 5 edits

MODERATE

This bill amends Utah's Workers' Compensation Act to clarify notification requirements for workplace injuries, update reporting rules for employers and health care providers, and strengthen protections against balance billing. The changes expand the Labor Commission's authority to regulate fees and disclosures while ensuring consistent application of rules across physicians, hospitals, and other health care providers.

Scope change

The bill expands applicability from only physicians to include all health care providers and hospitals in fee regulation and reporting requirements, and clarifies that notification of injury can come from employers, next of kin, or attorneys.

REQUIREMENT

Changed who must file injury reports from only physicians to include all health care providers treating injured employees, with specific rules for fee regulation and medical record disclosure.

Added specific requirements for hospitals to comply with commission-established fee schedules based on Medicare reimbursement rates for covered medical services.

DEFINITION

Updated definitions to clarify that 'health care provider' now includes hospitals in certain contexts, and expanded the scope of who constitutes proper notification of injury.

ENFORCEMENT

Modified civil assessment procedures for employers or insurance carriers who fail to file required reports, including good cause exceptions and proper deposit of fines into the Uninsured Employers' Fund.

TECHNICAL

Made technical corrections to numbering, formatting, and cross-references throughout the section to improve clarity and consistency.

Introduced → Enrolled · 4 edits · Mar 26, 2025

MODERATE

This bill amends Utah's Workers' Compensation Act to expand the Labor Commission's authority over health care providers, including their ability to disclose medical records and set fees. It also strengthens the prohibition against balance billing for workers' compensation claims and clarifies reporting requirements for workplace injuries.

Scope change

The bill expands the scope of the Labor Commission's regulatory authority to include health care providers, not just employers and employees. It also extends the prohibition on balance billing to cover health care providers.

REQUIREMENT

Health care providers must now comply with Labor Commission rules regarding medical record disclosures, fees for services, and reporting to the division.

ENFORCEMENT

Balance billing is now explicitly prohibited for health care providers, not just other parties in workers' compensation claims.

DEFINITION

Updated definitions to clarify that 'physician' and 'health care provider' are subject to specific regulatory requirements under the Workers' Compensation Act.

TECHNICAL

Technical formatting and wording changes were made throughout the bill text to improve clarity and consistency.

Workers' Compensation Modifications

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