SB456: Bill Text

SB456,36,8 102.42 (2) (a) 2. When the employer has notice of an injury to an employee who is not covered under a health benefit plan provided by the employer and of the relationship of the injury to the employment, the employer shall offer to the injured employee the employer's choice of any practitioner specified in subd. 1. for treatment of the injury in accordance with the employee's treatment plan. This subdivision permits an employer to choose a particular practitioner for treatment of an injury, but does not permit an employer to choose the type of treatment to be provided or the type of practitioner to provide that treatment.

SB456,49 Section 49. 102.42 (3) of the statutes is amended to read:

SB456,36,15 102.42 (3) Practitioner choice unrestricted. If the employer fails to tender treatment as provided in sub. (1) or choice of an attending practitioner as provided in sub. (2), the employee's right to choose the attending practitioner is not restricted subs. (1) and (2), the employee may choose an attending practitioner without restriction and the employer is liable for the reasonable and necessary expense thereof of any treatment provided by that attending practitioner.

SB456,50 Section 50. 102.425 (3) (am) of the statutes is created to read:

SB456,37,4 102.425 (3) (am) 1. Subject to subds. 2. and 3., if a prescription drug dispensed under sub. (2) (a) for outpatient use by an injured employee is a repackaged prescription drug, the liability of an employer or insurer for the cost of the repackaged prescription drug is limited to the average wholesale price, as determined under par. (a) 1., of the prescription drug set by the original manufacturer of the prescription drug, plus any dispensing fee that may be payable under par. (a) 2. and any taxes that may be applicable under par. (a) 3., except that if the national drug code number of the prescription drug as packaged by the original manufacturer of the prescription drug cannot be determined from the billing statement under par. (c), that liability is limited to the average wholesale price, as determined under par. (a) 1., of the lowest-priced drug product equivalent, plus any dispensing fee under par. (a) 2. and any taxes under par. (a) 3. that would be payable for the drug product equivalent.

SB456,37,6 2. An employer or insurer is not liable for the cost of a repackaged prescription drug dispensed from a retail, mail-order, or institutional pharmacy.

SB456,37,8 3. Subdivisions 1. and 2. do not apply to a repackaged prescription drug dispensed from a retail, mail-order, or institutional pharmacy.

SB456,51 Section 51. 102.425 (3) (b) of the statutes is amended to read:

SB456,37,13 102.425 (3) (b) In addition to the liability under par. (a) or (am), whichever is applicable, an employer or insurer is also liable for reimbursement to an injured employee for all out-of-pocket expenses incurred by the injured employee in obtaining the prescription drug dispensed.

SB456,52 Section 52. 102.425 (4) (a) of the statutes is amended to read:

SB456,37,19 102.425 (4) (a) Except as provided in par. (b), a pharmacist or practitioner who dispenses a prescription drug under sub. (2) to an injured employee may not collect, or bring an action to collect, from the injured employee any charge that is in excess of the liability of the injured employee under sub. (2) (c) 2. or the liability of the employer or insurer under sub. (3) (a) or (am), whichever is applicable.

SB456,53 Section 53. 102.425 (4) (b) of the statutes is amended to read:

SB456,38,7 102.425 (4) (b) If an employer or insurer denies or disputes liability for the cost of a drug prescribed to an injured employee under sub. (2), the pharmacist or practitioner who dispensed the drug may collect, or bring an action to collect, from the injured employee the cost of the prescription drug dispensed, subject to the limitations specified in sub. (3) (a) or (am), whichever is applicable. If an employer or insurer concedes liability for the cost of a drug prescribed to an injured employee under sub. (2), but disputes the reasonableness of the amount charged for the prescription drug, the employer or insurer shall provide notice under sub. (4m) (b) to the pharmacist or practitioner that the reasonableness of the amount charged is in dispute and the pharmacist or practitioner who dispensed the drug may not collect, or bring an action to collect, from the injured employee the cost of the prescription drug dispensed after receiving that notice.

SB456,54 Section 54. 102.425 (4m) (b) of the statutes, as affected by 2015 Wisconsin Act 55, is amended to read:

SB456,38,19 102.425 (4m) (b) An employer or insurer that disputes the reasonableness of the amount charged for a prescription drug dispensed under sub. (2) for outpatient use by an injured employee or the department or division under sub. (4) (b) or s. 102.16 (1m) (c) or 102.18 (1) (bg) 3. shall provide, within 30 days after receiving a completed bill for the prescription drug, reasonable written notice to the pharmacist or practitioner that the charge is being disputed. After receiving reasonable written notice under this paragraph or under sub. (4) (b) or s. 102.16 (1m) (c) or 102.18 (1) (bg) 1. 3. that a prescription drug charge is being disputed, a pharmacist or practitioner may not collect the disputed charge from, or bring an action for collection of the disputed charge against, the employee who received the prescription drug.

SB456,55 Section 55. 102.43 (5) (c) of the statutes is amended to read:

SB456,39,7 102.43 (5) (c) Compensation for temporary disability on account of receiving instruction under s. 102.61 (1) or (1m) shall not be reduced under sub. (2) on account of any wages earned for the first 24 hours worked by an employee during a week in which the employee is receiving that instruction. If an employee performs more than 24 hours of work during a week in which the employee is receiving that instruction, all wages earned for hours worked in excess of 24 during that week shall be offset against the employee's average weekly wage in calculating compensation for temporary disability under sub. (2). An employee who is receiving compensation for temporary disability on account of receiving instruction under s. 102.61 (1) or (1m) shall report any wages earned during the period in which the employee is receiving that instruction to the insurance carrier or self-insured employer paying that compensation. This paragraph does not apply after April 30, 2014 2018.

SB456,56 Section 56. 102.43 (7) (c) 1. of the statutes is amended to read:

SB456,39,12 102.43 (7) (c) 1. If the employee was entitled to maximum weekly benefits at the time of injury, payment for the renewed period of temporary disability or the rehabilitative training shall be at the maximum rate in effect at the commencement of the new period time of injury.

SB456,57 Section 57. 102.43 (7) (c) 2. of the statutes is amended to read:

SB456,39,19 102.43 (7) (c) 2. If the employee was entitled to less than the maximum rate, the employee shall receive the same proportion of the maximum which is in effect at the time of the commencement of weekly benefit at the time of injury, payment for the renewed period of temporary disability or the rehabilitative training shall be at the same rate as the employee's actual rate at the time of injury bore to the maximum rate in effect at that time.

SB456,58 Section 58. 102.43 (9) (e) of the statutes is created to read:

SB456,39,24 102.43 (9) (e) The employee's employment with the employer has been suspended or terminated due to misconduct, as defined in s. 108.04 (5), or substantial fault, as defined in s. 108.04 (5g) (a), by the employee connected with the employee's work.

SB456,59 Section 59. 102.44 (1) (ag) of the statutes, as affected by 2015 Wisconsin Act 55, section 2943, is amended to read:

SB456,40,12 102.44 (1) (ag) Notwithstanding any other provision of this chapter, every employee who is receiving compensation under this chapter for permanent total disability or continuous temporary total disability more than 24 months after the date of injury resulting from an injury that occurred prior to January 1, 2001 2003, shall receive supplemental benefits that shall be payable by the employer or, subject to par. (c), by the employer's insurance carrier, or in the case of benefits payable to an employee under s. 102.66, shall be paid by the department out of the fund created under s. 102.65. Those supplemental benefits shall be paid only for weeks of disability occurring after January 1, 2003 2005, and shall continue during the period of such total disability subsequent to that date.

SB456,60 Section 60. 102.44 (1) (am) of the statutes is amended to read:

SB456,40,18 102.44 (1) (am) If the employee is receiving the maximum weekly benefits in effect at the time of the injury, the supplemental benefit for a week of disability occurring after May 1, 2010 the effective date of this paragraph .... [LRB inserts date], shall be an amount that, when added to the regular benefit established for the case, shall equal $582 $615.

SB456,61 Section 61. 102.44 (1) (b) of the statutes is amended to read:

SB456,40,25 102.44 (1) (b) If the employee is receiving a weekly benefit that is less than the maximum benefit that was in effect on the date of the injury, the supplemental benefit for a week of disability occurring after May 1, 2010 the effective date of this paragraph .... [LRB inserts date], shall be an amount sufficient to bring the total weekly benefits to the same proportion of $582 $615 as the employee's weekly benefit bears to the maximum in effect on the date of injury.

SB456,62 Section 62. 102.44 (3) of the statutes is amended to read:

SB456,41,9 102.44 (3) For permanent partial disability not covered by ss. 102.52 to 102.56, the aggregate number of weeks of indemnity shall bear such relation to 1,000 weeks as the nature of the injury bears to one causing permanent total disability and. The weekly indemnity for such permanent partial disability shall be payable at the rate of two-thirds of the average weekly earnings of the employee, the earnings to be computed as provided in s. 102.11. The weekly indemnity , shall be in addition to compensation for the healing period, and shall be for the period that the employee may live, not to exceed 1,000 weeks.

SB456,63 Section 63. 102.44 (4m) of the statutes is created to read:

SB456,41,17 102.44 (4m) The department shall promulgate rules establishing minimum permanent disability ratings for amputation levels, losses of motion, sensory losses, and surgical procedures resulting from injuries for which permanent partial disability is claimed under sub. (3) or (4). Those rules shall provide that those minimum ratings for a surgical procedure performed on an injured employee do not apply if it is shown that after the procedure the injured employee suffers from no actual impairment as a result of the employee's injury.

SB456,64 Section 64. 102.44 (5) (intro.) of the statutes is amended to read:

SB456,41,22 102.44 (5) (intro.) In cases where in which it is determined that periodic benefits granted by the federal social security act are paid to the employee because of disability or old age, the benefits payable under this chapter shall be reduced as follows:

SB456,65 Section 65. 102.44 (5) (a) of the statutes is amended to read:

SB456,42,7 102.44 (5) (a) For each dollar that the total monthly benefits payable under this chapter, excluding attorney fees and costs, plus the monthly benefits payable under the social security act for disability or old-age assistance exceed 80% 80 percent of the employee's average current earnings as determined by the social security administration, the benefits payable under this chapter shall be reduced by the same amount so that the total benefits payable shall do not exceed 80% 80 percent of the employee's average current earnings. However, no total benefit payable under this chapter and under the federal social security act may be reduced to an amount that is less than the benefit payable under this chapter.

SB456,66 Section 66. 102.44 (5) (c) of the statutes is amended to read:

SB456,42,13 102.44 (5) (c) Failure of the employee, except for excusable neglect, to report social security disability or old-age assistance payments within 30 days after written request shall allow the employer or insurance carrier to reduce weekly compensation benefits payable under this chapter by 75% 75 percent. Compensation benefits otherwise payable shall be reimbursed to the employee after reporting.

SB456,67 Section 67. 102.44 (5) (e) of the statutes is amended to read:

SB456,42,21 102.44 (5) (e) The reduction prescribed by this section subsection for benefits payable under the social security act for disability shall be allowed only as to payments made on or after July 1, 1980, and the reduction prescribed by this subsection for benefits payable under the social security act for old-age assistance shall be allowed only as to payments made on or after July 1, 2016, and those reductions shall be computed on the basis of payments made for temporary total, temporary partial, permanent total, and permanent partial disability.

SB456,68 Section 68. 102.44 (5) (h) of the statutes is created to read:

SB456,43,2 102.44 (5) (h) No reduction under this subsection shall be made on account of periodic benefits paid to an injured employee under the social security act for old-age assistance if it is shown that, notwithstanding the receipt of those benefits, the injured employee is available for work.

SB456,69 Section 69. 102.44 (5m) of the statutes is created to read:

SB456,43,10 102.44 (5m) (a) Subject to pars. (b) to (f), an employer or insurer may reduce the amount of benefits payable under this chapter to an injured employee, including benefits paid in a lump sum under a compromise settlement under s. 102.16 (1), by the amount of benefits paid or payable to the injured employee under the worker's compensation law of any other state for the same injury, including benefits paid in a lump sum under a compromise settlement under the worker's compensation law of that state.

SB456,43,20 (b) An employer or insurer that is liable to an injured employee for benefits payable under this chapter may request in writing that the injured employee report to the employer or insurer any benefits paid or payable to the injured employee under the worker's compensation law of any other state. If for reasons other than excusable neglect an employee fails to respond to a request under this paragraph within 30 days after the date of the request, the employer or insurer may reduce the employee's weekly compensation benefits under this chapter by 75 percent until such time as the employee reports that information. On receipt of that information, the employer or insurer shall reimburse the employee for all compensation benefits otherwise payable during the period of the reduction.

SB456,43,24 (c) An employer or insurer that reduces the amount of benefits payable under this chapter as permitted under par. (a) shall report that reduction to the department and, on request of the department, shall furnish proof of the basis for that reduction that is satisfactory to the department.

SB456,44,6 (d) An employer or insurer may reduce the amount of benefits payable under this chapter as permitted under par. (a) only as to payments under the worker's compensation law of another state made on or after the effective date of this paragraph .... [LRB inserts date], and shall compute that reduction on the basis of payments made for temporary total, temporary partial, permanent total, and permanent partial disability.

SB456,44,10 (e) An employer or insurer may not reduce the amount of benefits payable under this chapter as otherwise permitted under par. (a) on account of payments made under the worker's compensation law of another state to a dependent of the employee.

SB456,44,15 (f) An employer or insurer may not reduce the amount of temporary disability benefits payable under this chapter by the amount of temporary disability benefits payable under the worker's compensation laws of another state during a period in which an injured employee is receiving vocational rehabilitation services under s. 102.61 (1) or (1m).

SB456,70 Section 70. 102.58 of the statutes, as affected by 2015 Wisconsin Act 55, is amended to read:

SB456,45,5 102.58 Decreased compensation. If injury is caused by the failure of the employee to use safety devices that are provided in accordance with any statute, rule, or order of the department of safety and professional services and that are adequately maintained, and the use of which is reasonably enforced by the employer, if injury results from the employee's failure to obey any reasonable rule adopted and reasonably enforced by the employer for the safety of the employee and of which the employee has notice, or if injury results from the intoxication of the employee by alcohol beverages, as defined in s. 125.02 (1), or use of a controlled substance, as defined in s. 961.01 (4), or a controlled substance analog, as defined in s. 961.01 (4m), or if injury results from any other negligence attributable to the employee, the compensation and death benefit provided in this chapter shall be reduced by 15 percent but the total reduction may not exceed $15,000 in proportion to the amount of negligence attributable to the employee.

SB456,71 Section 71. 102.75 (1) of the statutes, as affected by 2015 Wisconsin Act 55, is amended to read:

SB456,45,23 102.75 (1) The department shall assess upon and collect from each licensed worker's compensation insurance carrier and from each employer exempted under s. 102.28 (2) by special order or by rule, (b) or (bm) from the duty to carry insurance under s. 102.28 (2) (a) the proportion of total costs and expenses incurred by the council on worker's compensation for travel and research and by the department, the division, and the commission in the administration of this chapter for the current fiscal year, plus any deficiencies in collections and anticipated costs from the previous fiscal year, that the total indemnity paid or payable under this chapter by each such carrier and exempt employer in worker's compensation cases initially closed during the preceding calendar year, other than for increased, double, or treble compensation, bore to the total indemnity paid in cases closed the previous calendar year under this chapter by all carriers and exempt employers, other than for increased, double, or treble compensation. The council on worker's compensation, the division, and the commission shall annually certify any costs and expenses for worker's compensation activities to the department at such time as the secretary requires.

SB456,72 Section 72. 102.75 (4) of the statutes is amended to read:

SB456,46,5 102.75 (4) From the appropriation under s. 20.445 (1) (ra), the department shall allocate the amounts that it collects in application fees from employers applying for exemption under s. 102.28 (2) (b) and the annual amount that it collects from employers that have been exempted under s. 102.28 (2) (b) to fund the activities of the department under s. 102.28 (2) (b) and (c) with respect to those employers.

SB456,73 Section 73. 102.81 (1) (a) of the statutes is amended to read:

SB456,46,13 102.81 (1) (a) If an employee of an uninsured employer, other than an employee who is eligible to receive alternative benefits under s. 102.28 (3), suffers an injury for which the uninsured employer is liable under s. 102.03, the department or the department's reinsurer shall pay to or on behalf of the injured employee or to the employee's dependents an amount equal to the compensation owed them by the uninsured employer under this chapter except penalties and interest due under ss. 102.16 (3), 102.18 (1) (b) 3. and (bp), 102.22 (1), 102.35 (3), 102.57, and 102.60.

SB456,74 Section 74. 108.10 (4) of the statutes is amended to read:

SB456,46,23 108.10 (4) The department or the employing unit may commence action for the judicial review of a commission decision under this section, provided the department, or the employing unit, after exhausting the remedies provided under this section, has commenced such action within 30 days after such decision was mailed to the employing unit's last-known address. The scope of judicial review, and the manner thereof insofar as applicable, shall be the same as that provided in s. 108.09 (7). In an action commenced by an employing unit under this section, the department shall be an adverse party a defendant under s. 102.23 (1) (a) and shall be named as a party defendant in the summons and complaint commencing the action.

SB456,75 Section 75. 165.60 of the statutes is amended to read:

SB456,47,11 165.60 Law enforcement. The department of justice is authorized to enforce ss. 101.123 (2), (2m), and (8), 175.60 (17) (e), 944.30 (1m), 944.31, 944.33, 944.34, 945.02 (2), 945.03 (1m), and 945.04 (1m) and ch. 108 and, with respect to a false statement submitted or made under s. 175.60 (7) (b) or (15) (b) 2. or as described under s. 175.60 (17) (c), to enforce s. 946.32, is authorized to assist the department of workforce development in the investigation and prosecution of suspected fraudulent activity related to worker's compensation as provided in s. 102.125, and is invested with the powers conferred by law upon sheriffs and municipal police officers in the performance of those duties. This section does not deprive or relieve sheriffs, constables, and other local police officers of the power and duty to enforce those sections, and those officers shall likewise enforce those sections.

SB456,76 Section 76. Nonstatutory provisions.

SB456,47,17 (1) Fraud investigation and prosecution; department of justice position authorization. The authorized FTE positions for the department of justice are increased by 1.0 PR-S position, to be funded from the appropriation under section 20.455 (2) (k) of the statutes, for the purpose of investigating and prosecuting fraudulent activity related to worker's compensation.

SB456,48,7 (2) Study of restricted work during employee healing period. The secretary of workforce development shall create a committee under section 15.04 (1) (c) of the statutes to study ways and means of encouraging employers to provide, and injured employees to participate in, light-duty programs under which injured employees who can return to restricted types of work during their healing periods are furnished with suitable employment that is within the physical and mental limitations of those employees. The study shall include an examination of the types of physical and mental limitations that do not preclude a return to work during the healing period and the types of work that are suitable for injured employees who have those limitations. The committee shall include representatives of employers, employees, worker's compensation insurers authorized to do business in this state, and the department of workforce development. Upon completion of the study, the committee shall report its findings, conclusions, and recommendations to the department of workforce development and the council on worker's compensation, after which the committee shall terminate its activities and cease to exist.

SB456,77 Section 77 . Initial applicability.

SB456,48,12 (1) Judicial review of worker's compensation decisions. The treatment of sections 102.23 (1) (a), (c), and (cm) and 108.10 (4) of the statutes first applies to an action for the review of an order or award of the labor and industry review commission commenced in circuit court on the effective date of this subsection.

SB456,48,16 (2) Administrative review of worker's compensation decisions. The treatment of section 102.18 (3) and (4) (b) of the statutes first applies to a petition for the review of a decision of a department of workforce development hearing examiner filed with the labor and industry review commission on the effective date of this subsection.

SB456,48,19 (3) Review of permanent partial disability awards. The treatment of section 102.18 (7) of the statutes first applies to a final award of worker's compensation made on the effective date of this subsection.

SB456,48,22 (4) Renewed periods of disability. The treatment of sections 102.03 (4) (with respect to renewed periods of disability) and 102.43 (7) (c) 1. and 2. of the statues first applies to a week of disability beginning after the effective date of this subsection.

SB456,78 Section 78. Effective date.

SB456,49,2 (1) This act takes effect on January 1, 2016, or on the day after publication, whichever is later.

SB456,49,3 (End)