STATEMENT OF BASIS AND PURPOSE FOR
AMENDMENTS TO THE WORKERS’ COMPENSATION RULES OF PROCEDURE
7 CCR 1101-3

BASIS:  §8-47-107, C.R.S. provides the Director of the Division of Workers’ Compensation with authority to adopt and amend proper rules and regulations to govern the proceedings and hearings of the Division.  The Director also is given authority and directed to adopt rules concerning specific matters that fall within the Workers’ Compensation Act.  For instance, §8-42-101(3)(a)(I) requires the Director to annually review the medical fee schedule established by the Division.  

PURPOSE:  These rules will update, revise or clarify previous Workers’ Compensation Rules of Procedure. The rules identify and establish procedures for filing documents, submitting relevant documents, closing claims or payment of fees.  The rules are organized in a more logical manner and use clearer language where appropriate.  Further, the rules will update policy and reflect statutory changes.

The rules address the following subjects:

•	Claims Adjusting - Electronic Filing required for First Reports of Injury, Positions on Liability and Final Payment Notices filed with the Division.  
•	Modification of Temporary Disability Benefits - Treating Physician Inquiry Letter allows the insured as well as the insurer, to provide claimant a copy of the letter at the time the inquiry is made.
•	Closure of Claims - Final Admission of Liability may be filed if claimant abandons claim and fails to respond to 30-day letter.
•	Medical Utilization Review - Provider Under Review requires provider to provide a copy of their written response to all parties.
•	Independent Medical Examination’s reflects General Assembly’s discontinuation of rule regarding late fees for IME payments. Director adopted rule that sets specific amount for increased fee if payment is not timely made.
•	Utilization Standards updates to standard terminology, revision of administrative procedures and dispute resolution procedures.  This rule is used in conjunction with, and to implement the Medical Treatment Guidelines and Medical Fee Schedule.
•	Medical Fee Schedule required by statute and sets out maximum allowable fees for health care and related services falling within the purview of the Workers’ Compensation Act. Amendments clarify the language, update and revise medical billing codes, update conversion factors, and revisions to medical requirements and payments related to the fee schedule. 

Pursuant to §24-4-103(4)(b), C.R.S., the Director finds that: 1) there is a demonstrated need for the rule amendments; 2) the proper statutory authority exists for this regulation; 3) to the extent practicable, the rules are clearly stated so that their meaning will be understood by any party required to comply with the regulation; 4) the rules do not conflict with other provisions of law; and 5) the duplicating or overlapping of the regulation is explained by the agency proposing the rules.

Rules 5,6,7,10 and 11 will be effective October 1, 2006.  Rules 16 and 18 will be effective January 1, 2007.

_MaryAnn Whiteside  				__7/27/2006
MaryAnn Whiteside					Date
Director
Division of Workers’ Compensation