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Final Rule Governing the Black Lung Disability Trust Fund’s Payment of Medical Benefits Has Been Issued

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Final Rule Governing the Black Lung Disability Trust Fund’s Payment of Medical Benefits Has Been Issued

The Office of Workers’ Compensation Programs has issued a Final Rule governing the Black Lung Disability Trust Fund’s payment of medical benefits under the Black Lung Benefits Act.

The Final Rule:

  • Adopts modern payment formulas for physicians, hospitals and other providers that are derived from the formulas used in the Medicare program. These formulas are also similar to those used by other OWCP programs (e.g., Federal Employees Compensation and Energy Employees Occupational Illness Compensation programs).
  • Codifies the black lung program’s current practices for the payment of prescription drugs and the submission of medical bills for payment.
  • Provides greater clarity about fees paid to providers, which should speed processing and payment of benefits as well as make it easier for the Trust Fund to obtain reimbursement from coal companies.
  • Prohibits providers from seeking additional payments from miners for covered services that have been paid by the Trust Fund.

Miners will not see any change in the medical care they receive to treat their black lung disease.

The regulations will be effective August 31, 2018.  The rules will apply to medical equipment, prescription drugs, and inpatient medical services provided or rendered after that date. The rules governing payment of professional medical services and outpatient medical services have a delayed application date and will apply to services rendered after November 30, 2019.

DOL Press Release of Final Rule

The Final Rule is available for public inspection today on the Federal Register’s website at: https://www.federalregister.gov/documents/2018/06/14/2018-12418/black-lung-benefits-act-medical-benefit-payments. The Federal Register will publish the rule on June 14, 2018. The published version will be available online at the same website location.

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