Changes Will Make Payment Methodology Consistent With Industry Standards
WASHINGTON, DC – The U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP) has published a final rule under the Black Lung Benefits Act conforming the Department’s payment of medical benefits for disabled coal miners to industry standards and streamlining bill-processing procedures.
The new regulations adopt industry-standard payment formulas derived from those used by Medicare and are similar to those used by other OWCP-administered compensation programs for federal employees. The new rule also codifies the black lung program’s current payment practice for prescription drug payments, and its bill-processing procedures.
“The new rule brings the U.S. Department of Labor’s payment formulas into line with those used throughout the health-care industry, particularly those used by Medicare and other OWCP programs,” said Office of Workers’ Compensation Programs Director Julia K. Hearthway. “These regulations will ensure that miners continue to receive the medical care they need for treatment of black lung disease and they will see no change.”
The Act provides compensation to miners who are totally disabled due to pneumoconiosis, commonly called black lung disease. Disabled miners are also entitled to medical services needed to treat their disease. The Black Lung Disability Trust Fund pays these benefits when there is no liable coal mine company or when the liable company either cannot or does not pay. When the Trust Fund pays on behalf of a liable coal company, the Department subsequently seeks reimbursement.
Current regulations require the Trust Fund to pay for medical services at prevailing community rates, but do not specify how those rates are determined. Historically, OWCP’s Division of Coal Mine Workers’ Compensation relied on internally derived formulas to calculate payments to physicians, hospitals, and other providers. These formulas are now out of date, necessitating this new rule.
The rule is available for public inspection at the Federal Register on June 13, 2018, and at this link. It will be published on June 14, 2018.
The mission of the Division of Coal Mine Workers’ Compensation is to administer claims filed under the Black Lung Benefits Act. The act provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, survivors of miners whose death was attributable to or hastened by pneumoconiosis, and survivors of miners who were entitled to benefits at the time of their death. The act also provides eligible miners with coverage for medical treatment of lung diseases arising out of coal mine employment. More information is available at: http://www.dol.gov/owcp/dcmwc/.