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The latest legislative and regulatory activity that impacts you and the services we provide
Policy Matters Brief - July 9, 2025
July 9, 2025 · Public Policy & Regulatory Affairs Team
California passes several workers’ compensation related bills during legislative cross-over timeline
The California Legislature recently passed a number of bills.
- Assembly Bill 1048 – allows providers to use an independent bill review (IBR) process to dispute the application of a contractual discount or reduction to a payment. The bill would also require a bill review entity to provide the rationale for upholding the application of a discount and include a copy of the contract relied upon to apply the discount. If the payer can’t produce a valid contract justifying the discount, the bill would require IBR to award the provider reimbursement at full fee schedule. The bill passed the State Assembly and is currently in the Senate. It can be found here .
- Assembly Bill 1125 –applies a heart trouble presumption to all peace officers working for the Department of State Hospitals. The bill recently passed the State Assembly and is currently in the Senate. It can be found here.
- Assembly Bill 1293 – requires the Division of Workers’ Compensation (DWC) to make several changes to the medical-legal process and create templates for communicating with qualified medical evaluators and a med-legal report to comply with updated statutes and the Labor Code. The bill recently passed the State Assembly and is currently in the Senate. It can be found here.
- Senate Bill 632 – creates a presumption that musculoskeletal injures, PTSD, and cancer are compensable for hospital workers who provide direct patient care. The bill would also create presumptions for infectious diseases, including tuberculosis, meningitis and COVID-19, among others. The bill has passed the State Senate and is currently in the Assembly. It can be found here.
Minnesota Workers' Compensation passes rule amendments on registration of Rehabilitation Providers
The rule amendments, which took effect on June 30, 2025, update and reorganize the registration processes and requirements of workers’ compensation rehabilitation providers found in Minnesota Rules, chapter 5220. New sections of the rule are more user-friendly and clarify the requirements for qualified rehabilitation consultants (QRC), QRC interns, QRC firms, and rehabilitation vendors.
More information can be found here.
Nevada passes Workers’ Compensation reform bill which includes drug formulary
Nevada Governor Joe Lombardo recently signed into law Senate Bill 317, a workers’ compensation reform bill that amended various aspects of the workers’ compensation system. Of note is a provision requiring implementation of a workers’ compensation drug formulary – based on the official disability guidelines (ODG) – to take effect no later than January 1, 2027. The drug formulary segment of the bill also requires the Nevada Division of Industrial Relations to implement provisions of the drug formulary process.
Senate Bill 317 can be found here.
Oregon expands its disability benefits under Public Employees Retirements System.
Oregon Senate Bill 588 (SB 588), enacted on May 27, introduced important changes to how disability benefits are handled for police officers and firefighters under the Public Employees Retirement System (PERS). Post-traumatic stress disorder is now recognized as a work-related injury or disease for police officers and firefighters under certain conditions.
More information can be found here.
Rhode Island clarifies and updates its workers' compensation disability laws
Rhode Island House Bill 631 took effect on July 1. The new law introduced clarifications and updates to the state’s workers’ compensation laws, particularly focusing on definitions and court authority related to disability and employment status. The bill’s definition of functional impairment is based on the 6th edition of the AMA Guide to the Evaluation of Permanent Impairment or comparable standards.
More information can be found here.
Rhode Island passes the Uniform Controlled Substances Act
Rhode Island Senate Bill 795 took effect on June 23, 2025. Although this bill does not directly impact workers' compensation, it could indirectly benefit injured workers who rely on long-term, non-opioid medications for recovery or pain management. The bill also increased pharmacy dispensing limits.
More information can be found here.
Washington updates the role of attending providers and the inclusion of psychologists.
Washington House Bill 1197 (HB 1197), which took effect on July 1, introduces significant updates to the workers’ compensation system, particularly around the role of attending providers and the inclusion of psychologists. State-licensed psychologists are now authorized to serve as attending providers for workers’ compensation claims solely for mental health conditions. They can: direct and coordinate care; submit documentation; and help injured workers return to work. To continue treating injured workers beyond the initial visit, they must join the Department of Labor & Industries’ Medical Provider Network (MPN) . Psychologists not enrolled in the MPN by June 30, are limited to initial visits only and cannot treat cases involving physical injuries.
More information can be found here.
Washington updates its maximum allowable payments for most professional services
Washington Regulation 45287 raised maximum allowable payments for most professional services. This rule updates the anesthesia and occupational therapy conversion factors in following the methodologies of the Washington State Department of Labor & Industries. Anesthesia services paid with base and time units with a conversion factor of $3.89 have been increased to $3.91 per minute, which is equivalent to $58.65 per 15 minutes. Conversion factors are used to calculate payment levels for services reimbursed under the Washington resource based relative value scale (RBRVS) and for anesthesia services payable with base and time units. Occupational therapy visits are updated from $147.97 to $149.45. Effective July 1, 2025.
More information can be found here.
Wisconsin Prescription Drug Monitoring Program to include mail delivered prescriptions
On July 1, Wisconsin CSB 4.04 (2)(p) was amended in accordance with Phar 8.06.2 (unless exempted pursuant to s. Phar 8.06 (2), to allow practitioners to mail prescriptions.
More information can be found here.
Additional Optum resources: For more information on these policy developments and others we have been tracking this year, be sure to visit our Legislative and Regulatory Tracker. Bills or regulations can be filtered by insurance line, topic, status and jurisdiction. If you have questions on these or any other public policy developments, please contact our team at OptumWC.PolicyMatters@optum.com. |
