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Jurisdictional Adoptions of Treatment Guidelines in North America

   (Click on State/Province Name for Treatment Guidelines)

Jurisdiction

Treatment Guidelines

National Guideline

Local  Guideline

Legislation or Rule 

Explanation

Outcomes

Alabama

none

 

 

 

 

 

Alaska (withdrawn own)*

Considering

 

 

SB130 2005

“make recommendations for medical procedure guidelines to the task force”

 

Alberta

Own (15)

 

X

 

The Workers' Compensation Board (WCB) - Alberta, 9912 - 107 Street, Edmonton, AB T5J 2S5 

 

Arizona

Considering

 

 

HB2405 2007

Required the Industrial Commission to adopt evidence-based treatment guidelines by 2009

 

Arkansas

Own (1)

 

X

 

Arkansas Workers' Compensation Commission, 324 Spring Street, Little Rock, AR 72203

 

Bahamas ODG   X     National Insurance Board of the Bahamas, PO Box N-7508, Nassau, Bahamas, adopted ODG in 2003  

British Columbia

ODG

X

 

 

Workers' Compensation Board of British Columbia, Vancouver, BC V6B 5L5, adopted ODG in 2004

 

California (withdrawn own)*

ACOEM + ODG

 

SB228 2003

ACOEM 2nd ed mandatory “interim” guidelines and new rules allow others (like ODG) as a supplement. DWC Embraces New ODG Chronic Pain Guideline (08/07) DWC Chooses ODG for Post-surgical Guidelines (11/07).

Insurers have realized a 70% reduction in costs since 2003. – Insurance Commissioner Poizner 1/1/08

Colorado

Own (10) + ODG (state fund)

X

X

 

CO Division of Workers’ Compensation, 1515 Arapahoe, Denver CO 80202; State fund uses ODG since 2003: Pinnacol Assurance, 7501 E. Lowry Blvd., Denver, CO 80220

 

Connecticut

Own (4) + ODG (state fund)

X

X

 

CT Workers' Compensation Commission, Capitol Place, 21 Oak Street, Hartford, CT 06106; State fund adopted ODG in 2003: CT Healthcare Workers Compensation Trust, 866 North Main St., Wallingford, CT 06492

 

Delaware

Considering

 

 

SB362 2006; SB1 2007

Calls for creation of a 17-member Health Care Advisory Council that would develop treatment protocols

 

Florida  (withdrawn(withdrawn own)*

AHRQ (ODG + others)

X

 

SB50A  2003

According to a 2007 newsletter from Florida's largest WC insurer, "Florida has mandated the use of evidence-based medicine in managed care arrangements. Summit quickly began using ODG because it provides the widely accepted, evidence-based criteria that Florida statutes require."

Loss costs have dropped 50.4% since the Florida Legislature passed SB 50A (NCCI, 09/18/07) Since Florida's sweeping reforms in 2003 overall reductions in rates will reach 58.3%. (NCCI, 09/08/08)

Georgia

Considering

 

 

 

Legislature proposed WC study for 2007

 

Hawaii

ODG

X

 

Originally ODG and ACOEM were adopted by rules, but rescinded by legislature.  Now major insurers have adopted ODG (2005) and agreement to use ODG was signed by Governor (9/1/06).

Hawaii Cuts Loss Costs 38% (Insurance Comm J.P. Schmidt 09/18/07) HI WC Rates Down 61% Over Four Years. (Hawaii Reporter, 9/17/08)

Idaho

none

 

 

 

 

 

Illinois

Considering

  

 

HB2137 2005

“requires utilization review, consistent with URAC.”

 

Indiana

none

 

 

 

 

 

Iowa

none

 

 

 

 

 

Kansas

ODG

X

 

Guidelines 01/01/08

Kansas Adopts ODG - December 2007; Kansas Department of Labor Div of WC, 800 SW Jackson, Topeka, KS 66612 http://www.dol.ks.gov/WC/HTML/wc_odg.asp

 

Kansas indicates they are seeing positive responses to the use of ODG to help provide the best care for injured workers.

Kentucky

Considering ODG

X

 

 

ODG recommended as Kentucky medical guideline by Committee. Public hearing was 9/6/07. Plan is to hire new medical director before official adoption.

 

Louisiana

Considering ODG

 

 

 

Louisianans For Workers' Compensation Reform created to draft legislation to adopt ODG.

 

Maine

Own (1)

 

X

 

ME Workers' Compensation Board, 27 State House Station, Augusta, ME 04333

 

Manitoba

ODG

X

 

 

Workers Comp. Board Of Manitoba, 333 Broadway, Winnipeg, MB R3C 4W3, adopted ODG in 2004

 

Maryland

Considering

 

 

HB1423 2005

HB1423 was proposed in 2005 to implement guidelines

 

Massachusetts

Own (28) / ODG

 

X

 

MA Workers' Compensation Advisory Council, 600 Washington Street, Boston, MA 02111; 2/16/10 ODG approved for use by MA utilization review agents

 

Michigan

Considering

 

 

 

In 2002 Accident Fund required use of ODG by nurse case management/vocational rehab vendors. Public hearing/presentation on treatment guidelines  9/11/07, covering ODG and ACOEM.

 

Minnesota

Own (9)

 

X

 

Minnesota Workers’ Compensation Insurers Association, asked ODG to present to stakeholder groups

 

Mississippi

none

 

 

 

 

 

Missouri

ODG (state fund)

X

 

 

State fund adopted ODG (2005): Missouri Employers Mutual Insurance, 1000 West Nifong, Columbia, MO 65203

 

Montana (withdrawn own)*  

ODG (state fund)

X

 

SB 108 2007

“The department may establish by rule evidence-based utilization and treatment guidelines ... An insurer is not responsible for treatment or services that do not fall within”

 

Nebraska

Considering

 

 

LB1237 2006

Creates a 10-member advisory council to study issues such as utilization review and treatment guidelines.

 

Nevada

ACOEM + ODG

X

 

 

Adopted ACOEM 1st ed in 1998, but not 2nd ed; state fund uses ODG (2005)

 

New Brunswick

ODG  

X

 

 

Workplace Health, Safety and Compensation Commission, 1 Portland Street, Saint John, NB E2L 3X9

 

New Hampshire

none

 

 

 

 

 

New Jersey

none

 

 

 

 

 

New Mexico

none

 

 

 

 

 

New York

Own (4)

 

X

A6163 2007

Gov. Eliot Spitzer Guidelines Task Force released new state guidelines on 12/1/07, based on modifications to a variety of other guidelines

Governor Spitzer announced a rate decline of 20.5%, from the WC reform, including requiring evidence-based treatment guidelines. 07/11/07

Newfoundland

none

 

 

 

 

 

North Carolina

Considering 

 

 

 

Public meeting/presentation on treatment guidelines 10/11/07

 

North Dakota

ODG

X

 

 

Workforce Safety & Insurance, PO Box 5585, Bismarck, ND 58506, adopted ODG in 2005.

ND WC premiums, the lowest in the nation, dropped another 40% “This is one of the largest cash infusions into the economy that ND has seen.” - House Majority Leader Rick Berg 06/30/06

Ohio

ODG

X

 

 

Ohio Bureau of Workers' Compensation, 30 West Spring Street, Level 21 SE, Columbus, OH 43215, adopted ODG in 2003.

Use of ODG cut medical costs by 64% & lost days by 69%, treatment delay reduced 77%,  & ODG drew considerable praise from doctors. - CompManagement 05/01/06 Deloitte Consulting study of Ohio WC 04/2009 rec. to further strengthen adoption of ODG: "Should require all MCOs to use ODG in UR”; "ODG is the emerging standard for UR"; “Rec. Ohio adopt ODG for RTW.” www.ohiobwc.com/deloitte

Oklahoma (withdrawn own)*

Considering

 

 

SB1X 2005

"After public hearing, adopt treatment guidelines and protocols for treatment of injuries…  Compliance with treatment guidelines shall be mandatory."

 

Ontario

ODG

 

 

Workplace Safety and Insurance Board (WSIB), 200 Front Street West, Toronto, ON M5V 3J1, adopted ODG in 2003.

 

Oregon

Own (1) & ODG

X

X

SB670 2005 

MCO Rules were published on 05/22/06 “requiring approval of national treatment standards used by MCOs." ODG approved 2007

 

Pennsylvania

none

 

 

 

 

 

Rhode Island

Own (37)

 

X

 

RI Dept Labor & Training Div of Workers' Comp, 1511 Pontiac Avenue, Cranston, RI 02920

 

South Carolina

Considering

 

 

Senator Larry Martin is proposing legislation.

 

South Dakota

Considering

 

 

 

Tennessee

ODG/ACOEM

X

 

 

Requested presentations by ACOEM & ODG. At Public hearing on 7/31/07 proposed adoption of ODG and ACOEM, effective 12/20/07

 

Texas (withdrawn (withdrawn own)*

ODG

X

 

HB7 2006

“Commissioner of WC is required to adopt treatment and return to work guidelines.”  On 12/29/06 the final rules adopting ODG were signed by Commissioner Betts to apply to all WC treatment after 5/1/07

NCCI Says Texas Benefits from Reforms, where the expected loss rate decreased by 25%. 01/15/08 Texas Outcomes Data from DWC (preliminary - 12/2008): disputes declined by 44%; spinal fusions declined by 71% (for annualized savings of $211 million); average medical cost/claim declined by 26%.

Utah

ODG/ACOEM

 

HB150 2006

“The commission shall establish by rules medical treatment and quality care guidelines.”  Utah rules (3/15/07) for Commission approval of guidelines used by insurers, including (1) “scientifically based” supported by medical studies; (2) "peer reviewed” medical studies have been reviewed; & (3) updated at least bi-annually, sources must be identified, reasonably priced, & easily accessible

 

Vermont

ODG

X

 

 

Lisa Stratton W C Section Chief, State Of Vermont, 128 State St., Drawer 33, Montpelier, VT 05633, adopted ODG in 2004

 

Virginia

none

 

 

 

 

 

Washington

Own (16)

 

X

 

Washington State Dept. of Labor and Industries, PO Box 44850, Olympia, WA 98504

 

West Virginia

Own (12) + ODG (state fund)

X

X

SB1004 2005 

BrickStreet Mutual Insurance Co. (WV WC), 4700 MacCorkle Ave., Charleston, WV 25304, currently uses ODG, and is establishing a network requiring ODG 

Insurance Commissioner Jane Cline approves rate reduction of 27.5%.  01/22/08

Wisconsin

Same as Minnesota

 

X

SB474 2006

Requires DWD to promulgate rules establishing standards for determining the necessity of treatment. They have proposed adapting the Minnesota guidelines to the needs of Wisconsin. 

 

Wyoming

Own (2)

 

X

 

WY Workers’ Safety and Compensation Division, 1510 E. Pershing Blvd., Cheyenne, WY 82002

 

Yukon

ODG

X

 

 

Yukon Workers' Comp. Board, 401 Strickland St., Whitehorse, YT Y1A 5N8, adopted ODG in 2004

 

Note: numbers in parentheses after Own are the number of individual own state guidelines.

 

These 35 states/provinces have adopted guidelines, 23 of which have selected ODG. Of the remaining, Work Loss Data Institute provides links to their state specific adoptions.

 

*(withdrawn) means these states had their own treatment guidelines but withdrew them, in most cases to adopt nationally recognized guidelines.

 


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