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Senate Study Bill 1021

Bill Text

PAG LIN
  1  1    Section 1.  Section 85.27, subsection 3, Code 2003, is
  1  2 amended to read as follows:
  1  3    3.  Notwithstanding section 85.26, subsection 4, charges
  1  4 believed to be excessive or unnecessary may be referred by the
  1  5 employer, insurance carrier, or health service provider to the
  1  6 workers' compensation commissioner for determination, and the
  1  7 commissioner may utilize the procedures provided in sections
  1  8 86.38 and 86.39, or set by rule, and conduct such inquiry as
  1  9 the commissioner deems necessary.  Any health service provider
  1 10 charges not in dispute shall be paid directly to the health
  1 11 service provider prior to utilization of procedures provided
  1 12 in sections 86.38 and 86.39 or set by rule.  A health service
  1 13 provider rendering treatment to an employee whose injury is
  1 14 compensable under this section agrees to be bound by such
  1 15 charges as allowed by the workers' compensation commissioner
  1 16 and shall not recover in law or equity any amount in excess of
  1 17 charges set by the commissioner.  When a dispute under chapter
  1 18 85, 85A, or 85B regarding reasonableness of a fee for medical
  1 19 services arises between a health service provider and an
  1 20 employer or insurance carrier, the health service provider,
  1 21 employer, or insurance carrier shall not seek payment from the
  1 22 injured employee, employer, or its workers' compensation
  1 23 insurance carrier prior to a determination of the
  1 24 reasonableness of the charges under this subsection.
  1 25    Sec. 2.  Section 85.27, subsection 7, Code 2003, is amended
  1 26 to read as follows:
  1 27    7.  If, after the third day of incapacity to work following
  1 28 the date of sustaining a compensable injury which does not
  1 29 result in permanent partial disability, or if, at any time
  1 30 after sustaining a compensable injury which results in
  1 31 permanent partial disability, an employee, who is not
  1 32 receiving weekly benefits under section 85.33 or section
  1 33 85.34, subsection 1, returns to work and is required to leave
  1 34 work for one full day or less to receive services pursuant to
  1 35 this section, the employee shall be paid an amount equivalent
  2  1 to the wages lost at the employee's regular rate of pay for
  2  2 the time the employee is required to leave work.  For the
  2  3 purposes of this subsection only, "day of incapacity to work"
  2  4 means eight hours of accumulated absence from work due to
  2  5 incapacity to work or due to the receipt of services pursuant
  2  6 to this section.  The employer shall make the payments under
  2  7 this subsection as wages to the employee after making such
  2  8 deductions from the amount as legally required or customarily
  2  9 made by the employer from wages.  Payments made under this
  2 10 subsection shall be required to be reimbursed pursuant to any
  2 11 insurance policy covering workers' compensation.  Payments
  2 12 under this subsection shall not be construed to be payment of
  2 13 weekly benefits.
  2 14    Sec. 3.  Section 85.38, subsection 2, unnumbered paragraph
  2 15 2, Code 2003, is amended to read as follows:
  2 16    If an employer denies liability under this chapter, chapter
  2 17 85A, or chapter 85B, for payment for any medical services
  2 18 received or weekly compensation requested by an employee with
  2 19 a disability, and the employee is a beneficiary under either
  2 20 an individual or group plan for nonoccupational illness,
  2 21 injury, or disability, the nonoccupational plan shall not deny
  2 22 payment for the medical services received of benefits under
  2 23 the plan on the basis that the employer's liability for the
  2 24 medical services under this chapter, chapter 85A, or chapter
  2 25 85B is unresolved.
  2 26    Sec. 4.  Section 86.42, Code 2003, is amended to read as
  2 27 follows:
  2 28    86.42  JUDGMENT BY DISTRICT COURT ON AWARD.
  2 29    Any party in interest may present a certified copy of an
  2 30 order or decision of the commissioner, from which a timely
  2 31 petition for judicial review has not been filed or if judicial
  2 32 review has been filed, which has not had execution or
  2 33 enforcement stayed as provided in section 17A.19, subsection
  2 34 5, or an order or decision of a deputy commissioner from which
  2 35 a timely appeal has not been taken within the agency and which
  3  1 has become final by the passage of time as provided by rule
  3  2 and section 17A.15, or an agreement for settlement approved by
  3  3 the commissioner, and all papers in connection therewith, to
  3  4 the district court where judicial review of the agency action
  3  5 may be commenced.  The court shall render a decree or judgment
  3  6 and cause the clerk to notify the parties.  The decree or
  3  7 judgment, in the absence of a petition for judicial review or
  3  8 if judicial review has been commenced, in the absence of a
  3  9 stay of execution or enforcement of the decision or order of
  3 10 the workers' compensation commissioner, or in the absence of
  3 11 an act of any party which prevents a decision of a deputy
  3 12 workers' compensation commissioner from becoming final, has
  3 13 the same effect and in all proceedings in relation thereto is
  3 14 the same as though rendered in a suit duly heard and
  3 15 determined by the court.
  3 16    Sec. 5.  Section 86.43, Code 2003, is amended to read as
  3 17 follows:
  3 18    86.43  JUDGMENT – MODIFICATION OF.
  3 19    Upon the presentation to the court of a certified copy of a
  3 20 decision of the workers' compensation commissioner, ending,
  3 21 diminishing, or increasing the compensation under the
  3 22 provisions of this chapter, the court shall revoke or modify
  3 23 the decree or judgment to conform to such decision.  
  3 24                           EXPLANATION
  3 25    This bill amends several provisions relating to workers'
  3 26 compensation law in Iowa.  Code section 85.27, subsection 3,
  3 27 is amended to provide that when there is a dispute as to the
  3 28 reasonableness of a fee for medical services between a health
  3 29 service provider and an employer or the employer's insurance
  3 30 carrier, the employer or its workers' compensation insurance
  3 31 carrier as well as the employee cannot be asked for payment of
  3 32 the fee for medical services until a determination of the
  3 33 reasonableness of the fee has been made by the workers'
  3 34 compensation commissioner.
  3 35    Code section 85.27, subsection 7, is amended to provide
  4  1 that for the purposes of this subsection only, a "day of
  4  2 incapacity to work" means eight hours of accumulated absence
  4  3 from work due to incapacity to work or due to the employee's
  4  4 receipt of medical services pursuant to Code section 85.27.
  4  5    Code section 85.38, subsection 2, is amended to provide
  4  6 that weekly wage replacement benefits for an injured worker
  4  7 will be treated the same as medical benefits so that if an
  4  8 employee has both group disability and workers' compensation
  4  9 coverage, the group disability carrier will pay benefits to
  4 10 the injured employee until the workers' compensation liability
  4 11 is resolved without prejudicing the rights of either the
  4 12 employer or the employee.
  4 13    Code sections 86.42 and 86.43 are amended to provide that a
  4 14 party may present a copy instead of a certified copy of an
  4 15 order or decision of the workers' compensation commissioner to
  4 16 the district court to obtain a judgment on an award of
  4 17 workers' compensation benefits.  
  4 18 LSB 1491SC 80
  4 19 av/pj/5
     

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