The Commission Claims Administration Electronic Filing Updating internal processes Adjudication Regulatory Authority Code Section Enforcement Untimely Filings Penalties Medical Fee Schedule

Why Does Compliance Matter? The mission of the Commission is to administer and enforce the Workers' Compensation Act set forth in Mississippi Code in an efficient and equitable manner through the performance of administrative and quasi-judicial functions. Cost of litigation Overall expense of the claim Penalties paid

How Is WC Going In Mississippi? Claims Filed in 2017 – 10,669 (2,580 controverted) Insurance Carriers – 7,812 Self-Insureds – 2,811 Untimely Filed First Reports in 2017 – 1,253 (roughly 10%) The Commission receives 0% of penalties collected. We are a general fund agency and all monies collected go to the state’s general fund. Carriers & Self-Insureds were becoming lax in claim reporting requirements. There were settlements with 4 year old injuries, with first documents filed on the day of the settlements (even when claimant had 1 year of TTD paid) The Commission hopes to see these penalties dwindle to zero.

How Can YOU Eliminate FROI Penalties? Communicate to your HR departments the importance of timely reporting when employees are out with injuries Communicate to your TPAs that timely reporting to the Commission is non-negotiable File the FROI within 10 days after the expiration of the waiting period, even if you are waiting on medical addressing causation (a first report of injury is not an admission of liability, nor does it waive any defenses that you may raise later; a B-52 may be filed concurrently to state that the claim is under investigation) Please remember that any penalty fine received may be appealed and will be reviewed by the Commission

Self-Insureds vs. Carriers in 2017 2,580 controverted claims Self-Insureds – 581 2,364 9i settlements Self-Insureds – 568 429 Administrative Judge orders Self-Insureds – 105 59 Commission appeals Self-Insureds – 20 21 Supreme Court / Court of Appeals appeals Self-Insureds – 8

Supreme Court Decisions Decisions By Supreme Court September 2015 – September 2018 Total Number of Rulings WC Cases 50 Cases that Affirmed the Commission 37 Cases Reversing and Remanding 10 Cases Affirmed in Part, Reversed in Part 3

Medical Fee Schedule According to NCCI’s financial data gathered in 2016 (their annual reports release in October so we are still waiting on the 2017 figures), the Mississippi Average Medical Claim Severity is $31,300.00. Medical benefits of the claim constitute 60.7% of the overall cost of the claim Regional average (including states AL, AR, LA, TN) with medical benefits attributing to 64.7% of total cost of claims 72% of claims are medical only Arguably, the Medical Fee Schedule is one of the most important regulatory duties that the Commission oversees.

Medical Fee Schedule Last thoroughly revised in 2016 Next update slated to be effective in 2019 Guidelines for Opiate Prescriptions effective June 14, 2017 Adopted in response to the opiate crisis that is prevalent in the workers’ compensation world as well as in the general population Address use of opiates in treatment of non-cancer related chronic pain, perimeters of when opiates are effective, prescription time limits, drug seeking and addiction behaviors, necessity of Prescription Monitoring Programs