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To amend sections 121.03, 3304.23, 3304.231, 4121.12, 4121.121, 4121.37, 4121.44, 4121.63, 4123.343, 4123.511, 4123.512, 4123.76, 4123.83, 5703.21, and 5747.18 and to enact section 4123.591 of the Revised Code to make appropriations for the Bureau of Workers' Compensation for the biennium beginning July 1, 1999, and ending June 30, 2001, to provide authorization and conditions for the operation of Bureau of Workers' Compensation programs, to rename the Head Injury Program the Brain Injury Program, and to designate the Administrator of Workers' Compensation as a member of the Brain Injury Advisory Committee in place of the Industrial Commission Chairperson. BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: Section 1. That sections 121.03, 3304.23, 3304.231, 4121.12, 4121.121, 4121.37, 4121.44, 4121.63, 4123.343, 4123.511, 4123.512, 4123.76, 4123.83, 5703.21, and 5747.18 be amended and section 4123.591 of the Revised Code be enacted to read as follows: Sec. 121.03. The following administrative department heads
shall be appointed by the governor, with the advice and consent
of the senate, and shall hold their offices during the term of
the appointing governor, (A) The director of budget and management; (B) The director of commerce; (C) The director of transportation; (D) The director of agriculture; (E) The director of human services; (F) Until July 1, 1997, the director of liquor control; (G) The director of public safety; (H) The superintendent of insurance; (I) The director of development; (J) The tax commissioner; (K) The director of administrative services; (L) The administrator of the bureau of employment services; (M) The director of natural resources; (N) The director of mental health; (O) The director of mental retardation and developmental disabilities; (P) The director of health; (Q) The director of youth services; (R) The director of rehabilitation and correction; (S) The director of environmental protection; (T) The director of aging; (U) The director of alcohol and drug addiction services;
Sec. 3304.23. (A) There is hereby created in the
rehabilitation services commission a (B) To the extent that funds are available, the (1) Identify existing services in this state to assist
survivors and families of survivors of (2) Promote the coordination of services for survivors and
families of survivors of (3) Explore options for delivery of services to survivors
and families of survivors of (4) Explore the establishment of a traumatic brain injury incidence reporting system to collect information on the incidence and character of traumatic brain injury in this state; (5) Promote practices that will reduce the incidence of
(6) Develop training programs on dealing with (7) Identify sources of available funds for services for
survivors and families of survivors of (8) Explore options for the delivery of case management
services to residents of this state who are survivors of (9) Provide assistance to assure that services for
survivors and families of survivors of (a) Designed to enhance the survivor's ability to lead an independent and productive life; (b) Available within close proximity of the survivor's home; (c) Provided in the least restrictive environment; (d) Appropriate to the unique needs of the survivor. (C) The staff of the Sec. 3304.231. There is hereby created a (A) Not less than ten and not more than twelve members
appointed by the administrator of the rehabilitation services
commission, including all of the following: a survivor of (B) The directors of the departments of health, alcohol
and drug addiction services, mental retardation and developmental
disabilities, mental health, human services, and highway safety;
the The director of health shall make initial appointments to the committee by November 1, 1990. Appointments made after July 26, 1991, shall be made by the administrator of the rehabilitation services commission. Terms of office shall be two years. Members may be reappointed. Vacancies shall be filled in the manner provided for original appointments. Any member appointed to fill a vacancy occurring prior to the expiration date of the term for which the member's predecessor was appointed shall hold office as a member for the remainder of that term. Members of the committee shall serve without
compensation, but shall be reimbursed for actual and necessary expenses
incurred in the performance of their duties.
Sec. 4121.12. (A) There is hereby created the workers' compensation oversight commission consisting of nine members, of which members the governor shall appoint five with the advice and consent of the senate. Of the five members the governor appoints, two shall be individuals who, on account of their previous vocation, employment, or affiliations, can be classed as representative of employees, at least one of whom is representative of employees who are members of an employee organization; two shall be individuals who, on account of their previous vocation, employment, or affiliations, can be classed as representative of employers, one of whom represents self-insuring employers and one of whom has experience as an employer in compliance with section 4123.35 of the Revised Code other than a self-insuring employer, and one of those two representatives also shall represent employers whose employees are not members of an employee organization; and one shall represent the public and also be an individual who, on account of the individual's previous vocation, employment, or affiliations, cannot be classed as either predominantly representative of employees or of employers. The governor shall select the chairperson of the commission who shall serve as chairperson at the pleasure of the governor. No more than three members appointed by the governor shall belong to or be affiliated with the same political party. Each of these five members shall have at least three years' experience in the field of insurance, finance, workers' compensation, law, accounting, actuarial, personnel, investments, or data processing, or in the management of an organization whose size is commensurate with that of the bureau of workers' compensation. At least one of these five members shall be an attorney licensed under Chapter 4705. of the Revised Code to practice law in this state. (B) Of the initial appointments made to the commission, the governor shall appoint one member who represents employees to a term ending one year after September 1, 1995, one member who represents employers to a term ending two years after September 1, 1995, the member who represents the public to a term ending three years after September 1, 1995, one member who represents employees to a term ending four years after September 1, 1995, and one member who represents employers to a term ending five years after September 1, 1995. Thereafter, terms of office shall be for five years, with each term ending on the same day of the same month as did the term that it succeeds. Each member shall hold office from the date of the member's appointment until the end of the term for which the member was appointed. The governor shall not appoint any person to more than two full terms of office on the commission. This restriction does not prevent the governor from appointing a person to fill a vacancy caused by the death, resignation, or removal of a commission member and also appointing that person twice to full terms on the commission, or from appointing a person previously appointed to fill less than a full term twice to full terms on the commission. Any member appointed to fill a vacancy occurring prior to the expiration date of the term for which the member's predecessor was appointed shall hold office as a member for the remainder of that term. A member shall continue in office subsequent to the expiration date of the member's term until a successor takes office or until a period of sixty days has elapsed, whichever occurs first. (C) In making appointments to the commission, the governor shall select the members from the list of names submitted by the workers' compensation oversight commission nominating committee pursuant to this division. Within fourteen days after the governor calls the initial meeting of the nominating committee pursuant to division (C) of section 4121.123 of the Revised Code, the nominating committee shall submit to the governor, for the initial appointments, a list containing four separate names for each of the members on the commission. Within fourteen days after the submission of the list, the governor shall appoint individuals from the list. For the appointment of the member who is representative of employees who are members of an employee organization, both for initial appointments and for the filling of vacancies, the list of four names submitted by the nominating committee shall be comprised of four individuals who are members of the executive committee of the largest statewide labor federation. Thereafter, within sixty days after a vacancy occurring as a result of the expiration of a term and within thirty days after other vacancies occurring on the commission, the nominating committee shall submit a list containing four names for each vacancy. Within fourteen days after the submission of the list, the governor shall appoint individuals from the list. With respect to the filling of vacancies, the nominating committee shall provide the governor with a list of four individuals who are, in the judgment of the nominating committee, the most fully qualified to accede to membership on the commission. The nominating committee shall not include the name of an individual upon the list for the filling of vacancies if the appointment of that individual by the governor would result in more than three members of the commission belonging to or being affiliated with the same political party. The committee shall include on the list for the filling of vacancies only the names of attorneys admitted to practice law in this state if, to fulfill the requirement of division (A) of section 4121.12 of the Revised Code, the vacancy must be filled by an attorney. In order for the name of an individual to be submitted to the governor under this division, the nominating committee shall approve the individual by an affirmative vote of a majority of its members. (D) The remaining four members of the commission shall be the chairperson and ranking minority member of the standing committees of the house of representatives and of the senate to which legislation concerning this chapter and Chapters 4123., 4127., and 4131. of the Revised Code normally are referred, or a designee of the chairperson or ranking minority member, provided that the designee is a member of the standing committee. Legislative members shall serve during the session of the general assembly to which they are elected and for as long as they are members of the general assembly. Legislative members shall serve in an advisory capacity to the commission and shall have no voting rights on matters coming before the commission. Membership on the commission by legislative members shall not be deemed as holding a public office. (E) All members of the commission shall receive their reasonable and necessary expenses pursuant to section 126.31 of the Revised Code while engaged in the performance of their duties as members. Legislative members also shall receive fifty dollars per meeting that they attend. Members appointed by the governor also shall receive an annual salary as follows: (1) On and before August 31, 1998, not to exceed six thousand dollars payable at the rate of five hundred dollars per month. A member shall receive the monthly five hundred dollar salary only if the member has attended at least one meeting of the commission during that month. A member may receive no more than the monthly five hundred dollar salary regardless of the number of meetings held by the commission during a month or the number of meetings in excess of one within a month that the member attends. (2) After August 31, 1998, not to exceed eighteen thousand dollars payable on the following basis: (a) Except as provided in division (E)(2)(b) of this section, a member shall receive two thousand dollars during a month in which the member attends one or more meetings of the commission and shall receive no payment during a month in which the member attends no meeting of the commission. (b) A member may receive no more than the annual eighteen thousand dollar salary regardless of the number of meetings held by the commission during a year or the number of meetings in excess of nine within a year that the member attends. The chairperson of the commission shall set the meeting dates of the commission as necessary to perform the duties of the commission under this chapter and Chapters 4123., 4127., and 4131. of the Revised Code. The commission shall meet at least nine times during the period commencing on the first day of September and ending on the thirty-first day of August of the following year. The administrator of workers' compensation shall provide professional and clerical assistance to the commission, as the commission considers appropriate. (F) The commission shall: (1) Review progress of the bureau in meeting its cost and quality objectives and in complying with this chapter and Chapters 4123., 4127., and 4131. of the Revised Code; (2) Issue an annual report on the cost and quality objectives of the bureau to the president of the senate, the speaker of the house of representatives, and the governor; (3) Review all independent financial audits of the bureau. The administrator shall provide access to records of the bureau to facilitate the review required under this division. (4) Study issues as requested by the administrator or the governor; (5) Contract with an independent actuarial firm to assist the commission in making recommendations to the administrator regarding premium rates; (6) Establish objectives, policies, and criteria for the administration of the investment program that include asset allocation targets and ranges, risk factors, asset class benchmarks, time horizons, total return objectives, and performance evaluation guidelines, and monitor the administrator's progress in implementing the objectives, policies, and criteria on a quarterly basis. The commission shall publish the objectives, policies, and criteria no less than annually and shall make copies available to interested parties. The commission shall prohibit, on a prospective basis, specific investment activity it finds to be contrary to its investment objectives, policies, and criteria. The investment policy in existence on March 7, 1997, shall continue until the commission approves objectives, policies, and criteria for the administration of the investment program pursuant to this section. (7) Advise and consent on all of the following: (a) Administrative rules the administrator submits to it pursuant to division (B)(5) of section 4121.121 of the Revised Code for the classification of occupations or industries, for premium rates and contributions, for the amount to be credited to the surplus fund, for rules and systems of rating, rate revisions, and merit rating; (b) The overall policy of the bureau of workers' compensation as set by the administrator; (c) The duties and authority conferred upon the administrator pursuant to section 4121.37 of the Revised Code; (d) Rules the administrator adopts for the health partnership program and the qualified health plan system, as provided in sections 4121.44, 4121.441, and 4121.442 of the Revised Code. (8) Perform all duties required under section 4121.125 of the Revised
Code
(G)
Sec. 4121.121. (A) There is hereby created the bureau of
workers' compensation, which shall be administered by the administrator of
workers' compensation. A person appointed to the position of administrator
shall possess significant management experience in effectively managing an
organization or organizations of substantial size and complexity. The
governor shall appoint the administrator as provided in section 121.03 of the
Revised Code, and the administrator shall
serve at the pleasure of the governor. The governor shall fix the
administrator's salary
on the basis of the administrator's experience and the administrator's
responsibilities and duties under this
chapter and Chapter 4123., 4127., and 4131. of
the Revised Code. The governor shall not appoint to the position of
administrator any person who has, or whose spouse
has, given a contribution to the campaign committee of the governor in
an amount greater than one thousand dollars during the two-year period
immediately preceding the date of the appointment of the administrator.
The administrator shall hold no other public office and shall devote full time to the duties of administrator. Before entering upon the duties of the office, the administrator shall take an oath of office as required by sections 3.22 and 3.23 of the Revised Code, and shall file in the office of the secretary of state, a bond signed by the administrator and by surety approved by the governor, for the sum of fifty thousand dollars payable to the state, conditioned upon the faithful performance of the administrator's duties. (B) The administrator is responsible for the management of the bureau of workers' compensation and for the discharge of all administrative duties imposed upon the administrator in this chapter and Chapters 4123., 4127., and 4131. of the Revised Code, and in the discharge thereof shall do all of the following: (1) Establish the overall administrative policy of the bureau for the purposes of this chapter and Chapters 4123., 4127., and 4131. of the Revised Code, and perform all acts and exercise all authorities and powers, discretionary and otherwise that are required of or vested in the bureau or any of its employees in this chapter and Chapters 4123., 4127., and 4131. of the Revised Code, except the acts and the exercise of authority and power that is required of and vested in the oversight commission or the industrial commission pursuant to those chapters. The treasurer of state shall honor all warrants signed by the administrator, or by one or more of the administrator's employees, authorized by the administrator in writing, or bearing the facsimile signature of the administrator or such employee under sections 4123.42 and 4123.44 of the Revised Code. (2) Employ, direct, and supervise all employees required in connection with the performance of the duties assigned to the bureau by this chapter and Chapters 4123., 4127., and 4131. of the Revised Code, and may establish job classification plans and compensation for all employees of the bureau provided that this grant of authority shall not be construed as affecting any employee for whom the state employment relations board has established an appropriate bargaining unit under section 4117.06 of the Revised Code. All positions of employment in the bureau are in the classified civil service except those employees the administrator may appoint to serve at the administrator's pleasure in the unclassified civil service pursuant to section 124.11 of the Revised Code. The administrator shall fix the salaries of employees the administrator appoints to serve at the administrator's pleasure, including the chief operating officer, staff physicians, and other senior management personnel of the bureau and shall establish the compensation of staff attorneys of the bureau's legal section and their immediate supervisors, and take whatever steps are necessary to provide adequate compensation for other staff attorneys. The administrator may appoint a person holding a certified position in the classified service to any state position in the unclassified service of the bureau of workers' compensation. A person so appointed shall retain the right to resume the position and status held by the person in the classified service immediately prior to the person's appointment in the unclassified service. If the position the person previously held has been filled or placed in the unclassified service, or is otherwise unavailable, the person shall be appointed to a position in the classified service within the bureau that the department of administrative services certifies is comparable in compensation to the position the person previously held. Reinstatement to a position in the classified service shall be to a position substantially equal to that held previously, as certified by the department of administrative services. Service in the position in the unclassified service shall be counted as service in the position in the classified service held by the person immediately prior to the person's appointment in the unclassified service. when a person is reinstated to a position in the classified service as provided in this section, the person is entitled to all rights, status, and benefits accruing to the position during the person's time of service in the position in the unclassified service. (3) Reorganize the work of the bureau, its sections, departments, and offices to the extent necessary to achieve the most efficient performance of its functions and to that end may establish, change, or abolish positions and assign and reassign duties and responsibilities of every employee of the bureau. All persons employed by the commission in positions that, after November 3, 1989, are supervised and directed by the administrator under this section are transferred to the bureau in their respective classifications but subject to reassignment and reclassification of position and compensation as the administrator determines to be in the interest of efficient administration. The civil service status of any person employed by the commission is not affected by this section. Personnel employed by the bureau or the commission who are subject to Chapter 4117. of the Revised Code shall retain all of their rights and benefits conferred pursuant to that chapter as it presently exists or is hereafter amended and nothing in this chapter or Chapter 4123. of the Revised Code shall be construed as eliminating or interfering with Chapter 4117. of the Revised Code or the rights and benefits conferred under that chapter to public employees or to any bargaining unit. (4) Provide offices, equipment, supplies, and other facilities for the bureau. The administrator also shall provide suitable office space in the service offices for the district hearing officers, the staff hearing officers, and commission employees as requested by the commission. (5) Prepare and submit to the oversight commission information the administrator considers pertinent or the oversight commission requires, together with the administrator's recommendations, in the form of administrative rules, for the advice and consent of the oversight commission, for classifications of occupations or industries, for premium rates and contributions, for the amount to be credited to the surplus fund, for rules and systems of rating, rate revisions, and merit rating. The administrator shall obtain, prepare, and submit any other information the oversight commission requires for the prompt and efficient discharge of its duties. (6) Keep the accounts required by division (A) of section 4123.34 of the Revised Code and all other accounts and records necessary to the collection, administration, and distribution of the workers' compensation funds and shall obtain the statistical and other information required by section 4123.19 of the Revised Code. (7) Exercise the investment powers vested in the administrator by section 4123.44 of the Revised Code in accordance with the investment objectives, policies, and criteria established by the oversight commission pursuant to section 4121.12 of the Revised Code. The administrator shall not engage in any prohibited investment activity specified by the oversight commission pursuant to division (F)(6) of section 4121.12 of the Revised Code. All business shall be transacted, all funds invested, all warrants for money drawn and payments made, and all cash and securities and other property held, in the name of the bureau, or in the name of its nominee, provided that nominees are authorized by the administrator solely for the purpose of facilitating the transfer of securities, and restricted to the administrator and designated employees. (8) Make contracts for and supervise the construction of any project or improvement or the construction or repair of buildings under the control of the bureau. (9) Purchase supplies, materials, equipment, and services; make contracts for, operate, and superintend the telephone, other telecommunication, and computer services for the use of the bureau; and make contracts in connection with office reproduction, forms management, printing, and other services. Notwithstanding sections 125.12 to 125.14 of the Revised Code, the administrator may transfer surplus computers and computer equipment directly to an accredited public school within the state. The computers and computer equipment may be repaired or refurbished prior to the transfer. (10) Separately from the budget the industrial commission submits, prepare and submit to the director of budget and management a budget for each biennium. The budget submitted shall include estimates of the costs and necessary expenditures of the bureau in the discharge of any duty imposed by law as well as the costs of furnishing office space to the district hearing officers, staff hearing officers, and commission employees under division (D) of this section. (11) As promptly as possible in the course of efficient administration, decentralize and relocate such of the personnel and activities of the bureau as is appropriate to the end that the receipt, investigation, determination, and payment of claims may be undertaken at or near the place of injury or the residence of the claimant and for that purpose establish regional offices, in such places as the administrator considers proper, capable of discharging as many of the functions of the bureau as is practicable so as to promote prompt and efficient administration in the processing of claims. All active and inactive lost-time claims files shall be held at the service office responsible for the claim. A claimant, at the claimant's request, shall be provided with information by telephone as to the location of the file pertaining to claim. The administrator shall ensure that all service office employees report directly to the director for their service office. (12) Provide a written binder on new coverage where the administrator considers it to be in the best interest of the risk. The administrator, or any other person authorized by the administrator, shall grant the binder upon submission of a request for coverage by the employer. A binder is effective for a period of thirty days from date of issuance and is nonrenewable. Payroll reports and premium charges shall coincide with the effective date of the binder. (13) Set standards for the reasonable and maximum handling time of claims payment functions, ensure, by rules, the impartial and prompt treatment of all claims and employer risk accounts, and establish a secure, accurate method of time stamping all incoming mail and documents hand delivered to bureau employees. (14) Ensure that all employees of the bureau follow the orders and rules of the commission as such orders and rules relate to the commission's overall adjudicatory policy-making and management duties under this chapter and Chapters 4123., 4127., and 4131. of the Revised Code. (15) Manage and operate a data processing system with a common data base for the use of both the bureau and the commission and, in consultation with the commission, using electronic data processing equipment, shall develop a claims tracking system that is sufficient to monitor the status of a claim at any time and that lists appeals that have been filed and orders or determinations that have been issued pursuant to section 4123.511 or 4123.512 of the Revised Code, including the dates of such filings and issuances. (16) Establish and maintain a medical section within the bureau. The medical section shall do all of the following: (a) Assist the administrator in establishing standard medical fees, approving medical procedures, and determining eligibility and reasonableness of the compensation payments for medical, hospital, and nursing services, and in establishing guidelines for payment policies which recognize usual, customary, and reasonable methods of payment for covered services; (b) Provide a resource to respond to questions from claims examiners for employees of the bureau; (c) Audit fee bill payments; (d) Implement a program to utilize, to the maximum extent possible, electronic data processing equipment for storage of information to facilitate authorizations of compensation payments for medical, hospital, drug, and nursing services; (e) Perform other duties assigned to it by the administrator. (17) Appoint, as the administrator determines necessary, panels to review and advise the administrator on disputes arising over a determination that a health care service or supply provided to a claimant is not covered under this chapter or Chapter 4123. of the Revised Code or is medically unnecessary. If an individual health care provider is involved in the dispute, the panel shall consist of individuals licensed pursuant to the same section of the Revised Code as such health care provider. (18) Pursuant to section 4123.65 of the Revised Code, approve applications for the final settlement of claims for compensation or benefits under this chapter and Chapters 4123., 4127., and 4131. of the Revised Code as the administrator determines appropriate, except in regard to the applications of self-insuring employers and their employees. (19) Comply with section 3517.13 of the Revised Code, and except in regard to contracts entered into pursuant to the authority contained in section 4121.44 of the Revised Code, comply with the competitive bidding procedures set forth in the Revised Code for all contracts into which the administrator enters provided that those contracts fall within the type of contracts and dollar amounts specified in the Revised Code for competitive bidding and further provided that those contracts are not otherwise specifically exempt from the competitive bidding procedures contained in the Revised Code. (20) Adopt, with the advice and consent of the oversight commission, rules for the operation of the bureau. (21) Prepare and submit to the oversight commission information the administrator considers pertinent or the oversight commission requires, together with the administrator's recommendations, in the form of administrative rules, for the advice and consent of the oversight commission, for the health partnership program and the qualified health plan system, as provided in sections 4121.44, 4121.441, and 4121.442 of the Revised Code. (C) The administrator, with the advice and consent of the senate,
shall appoint a chief operating officer who
has significant experience in the field of workers'
compensation insurance or other similar insurance industry experience if the
administrator does not possess such experience. The chief operating officer
shall not commence the chief operating officer's duties
until after the senate consents to the chief
operating officer's appointment. The chief operating officer
shall serve in the unclassified civil service of the state.
Sec. 4121.37. The administrator of workers' compensation having, by virtue of Section 35 of Article II, Ohio Constitution, the expenditure of the fund therein created for the investigation and prevention of industrial accidents and diseases, shall, with the advice and consent of the workers' compensation oversight commission, in the exercise of the administrator's authority and in the performance of the administrator's duty, employ a superintendent and the necessary experts, engineers, investigators, clerks, and stenographers for the efficient operation of a division of safety and hygiene of the bureau of workers' compensation, which is hereby created. The general assembly hereby declares that in furtherance of the authority granted to the administrator pursuant to Section 35 of Article II, Ohio Constitution, and to encourage public employers to operate and maintain safe places of employment for public employees of this state, the administrator, with the advice and consent of the oversight commission, may transfer funds, certified as provided in section 126.07 of the Revised Code, from the safety and hygiene fund to the occupational safety loan fund created in section 4121.48 of the Revised Code, for the purposes of that section. The administrator of workers' compensation, with the
advice and consent of the oversight commission, shall pay into the safety and
hygiene
fund, which is hereby created in the state treasury, the portion
of the contributions paid by employers, calculated as though all
employers paid premiums based upon payroll, not to exceed
The superintendent, under the direction of the administrator, shall prepare an annual report, addressed to the governor, on the amount of the expenditures and the purposes for which they have been made, and the results of the investigations and researches. The administrator shall include the administrative costs, salaries, and other expenses of the division of safety and hygiene as a part of the budget of the bureau of workers' compensation that is submitted to the director of budget and management and shall identify those expenditures separately from other bureau expenditures. The superintendent shall be a competent person with at
least five years' experience in industrial accident or disease
prevention work. The superintendent and up to six positions in
the division of safety and hygiene as the administrator, with the advice and
consent of the oversight commission, designates are in
the unclassified civil service of the state as long as the administrator, with
the advice and consent of the oversight commission, determines the positions
subordinate to the superintendent are
primarily and distinctively administrative, managerial, or
professional in character. All other full-time employees of the
division of safety and hygiene are in the classified civil
service of the state.
Sec. 4121.44. (A) The administrator of workers' compensation shall oversee the implementation of the Ohio workers' compensation qualified health plan system as established under section 4121.442 of the Revised Code. (B) The administrator shall direct the implementation of the health partnership program administered by the bureau as set forth in section 4121.441 of the Revised Code. To implement the health partnership program, the bureau: (1) Shall certify one or more external vendors to provide medical management and cost containment services in the health partnership program for a period of two years beginning on the date of certification, consistent with the standards established under this section; (2) May recertify external vendors for (3) May integrate the certified vendors with bureau staff and existing bureau services for purposes of operation and training to allow the bureau to assume operation of the health partnership program at the conclusion of the certification periods set forth in division (B)(1) or (2) of this section. (C) Any vendor selected shall demonstrate all of the following: (1) Arrangements and reimbursement agreements with a substantial number of the medical, professional and pharmacy providers currently being utilized by claimants. (2) Ability to accept a common format of medical bill data in an electronic fashion from any provider who wishes to submit medical bill data in that form. (3) A computer system able to handle the volume of medical bills and willingness to customize that system to the bureau's needs and to be operated by the vendor's staff, bureau staff, or some combination of both staffs. (4) A prescription drug system where pharmacies on a statewide basis have access to the eligibility and pricing, at a discounted rate, of all prescription drugs. (5) A tracking system to record all telephone calls from claimants and providers regarding the status of submitted medical bills so as to be able to track each inquiry. (6) Data processing capacity to absorb all of the bureau's medical bill processing or at least that part of the processing which the bureau arranges to delegate. (7) Capacity to store, retrieve, array, simulate, and model in a relational mode all of the detailed medical bill data so that analysis can be performed in a variety of ways and so that the bureau and its governing authority can make informed decisions. (8) Wide variety of software programs which translate medical terminology into standard codes, and which reveal if a provider is manipulating the procedures codes, commonly called "unbundling." (9) Necessary professional staff to conduct, at a minimum, authorizations for treatment, medical necessity, utilization review, concurrent review, post-utilization review, and have the attendant computer system which supports such activity and measures the outcomes and the savings. (10) Management experience and flexibility to be able to react quickly to the needs of the bureau in the case of required change in federal or state requirements. (D) The administrator may
limit freedom of choice of health care provider or supplier by
requiring, beginning with the period set forth in division
(B)(1) or (2) of this section, that claimants shall pay an
appropriate
out-of-plan (E) The administrator, six months prior to the expiration of the bureau's certification or recertification of the vendor or vendors as set forth in division (B)(1) or (2) of this section, may certify and provide evidence to the governor, the speaker of the house of representatives, and the president of the senate that the existing bureau staff is able to match or exceed the performance and outcomes of the external vendor or vendors and that the bureau should be permitted to internally administer the health partnership program upon the expiration of the certification or recertification as set forth in division (B)(1) or (2) of this section. (F) The administrator shall establish and operate a bureau of workers' compensation health care data program. The administrator may contract with the Ohio health care data center for such purposes. The administrator shall develop reporting requirements from all employees, employers and medical providers, medical vendors, and plans that participate in the workers' compensation system. The administrator shall do all of the following: (1) Utilize the collected data to measure and perform comparison analyses of costs, quality, appropriateness of medical care, and effectiveness of medical care delivered by all components of the workers' compensation system. (2) Compile data to support activities of the selected vendor or vendors and to measure the outcomes and savings of the health partnership program. (3) Publish and report compiled data to the governor, the speaker of the house of representatives, and the president of the senate on the first day of each January and July, the measures of outcomes and savings of the health partnership program and the qualified health plan system. The administrator shall protect the confidentiality of all proprietary pricing data. (G) Any rehabilitation facility the bureau operates is eligible for inclusion in the Ohio workers' compensation qualified health plan system or the health partnership program under the same terms as other providers within health care plans or the program. (H) In areas outside the state or within the state where no qualified health plan or an inadequate number of providers within the health partnership program exist, the administrator shall permit employees to use a nonplan or nonprogram health care provider and shall pay the provider for the services or supplies provided to or on behalf of an employee for an injury or occupational disease that is compensable under this chapter or Chapter 4123., 4127., or 4131. of the Revised Code on a fee schedule the administrator adopts. (I) No certified health care provider shall charge, assess, or otherwise attempt to collect from an employee, employer, a managed care organization, or the bureau any amount for covered services or supplies that is in excess of the allowed amount paid by a managed care organization, the bureau, or a qualified health plan. (J) The administrator shall permit any employer or group
of employers who agree to abide by the rules adopted under this
section and sections 4121.441 and 4121.442 of the Revised Code to
provide services or supplies to or on behalf of an employee for
an injury or occupational disease that is compensable under this
chapter or Chapter 4123., 4127., or 4131. of the Revised Code
through qualified health plans of the Ohio workers' compensation
qualified health plan system pursuant to section 4121.442 of the
Revised Code or through the health partnership program pursuant
to section 4121.441 of the Revised Code. No amount paid under
the qualified health plan system pursuant to section 4121.442 of
the Revised Code by an employer who is a state fund employer
shall be charged to the employer's experience or otherwise be
used in merit-rating or determining the risk of that employer for
the purpose of the payment of premiums under this chapter, and if
the employer is a self-insuring employer, the employer shall not
include that amount in the paid compensation the employer
reports under section 4123.35 of the Revised Code.
Sec. 4121.63. Claimants who the administrator of workers'
compensation determines could probably be rehabilitated to
achieve the goals established by section 4121.61 of the Revised
Code and who agree to undergo rehabilitation shall be paid living
maintenance payments for a period or periods which do not exceed
six months in the aggregate, unless review by the administrator
or Living maintenance payments shall be paid in weekly amounts, not to exceed the amount the claimant would receive if the claimant were being compensated for temporary total disability, but not less than fifty per cent of the current state average weekly wage. LIVING MAINTENANCE PAYMENTS SHALL COMMENCE AT THE TIME THE CLAIMANT BEGINS TO PARTICIPATE IN AN APPROVED REHABILITATION PROGRAM. A claimant receiving living maintenance payments shall be
deemed to be temporarily totally disabled and shall receive no
payment of any type of compensation except as provided by
division (B) of section 4123.57 of the Revised Code for the
periods during which the claimant is receiving living maintenance
payments.
Sec. 4123.343. This section shall be construed liberally to the end that employers shall be encouraged to employ and retain in their employment handicapped employees as defined in this section. (A) As used in this section, "handicapped employee" means an employee who is afflicted with or subject to any physical or mental impairment, or both, whether congenital or due to an injury or disease of such character that the impairment constitutes a handicap in obtaining employment or would constitute a handicap in obtaining reemployment if the employee should become unemployed and whose handicap is due to any of the following diseases or conditions: (1) Epilepsy; (2) Diabetes; (3) Cardiac disease; (4) Arthritis; (5) Amputated foot, leg, arm, or hand; (6) Loss of sight of one or both eyes or a partial loss of uncorrected vision of more than seventy-five per cent bilaterally; (7) Residual disability from poliomyelitis; (8) Cerebral palsy; (9) Multiple sclerosis; (10) Parkinson's disease; (11) Cerebral vascular accident; (12) Tuberculosis; (13) Silicosis; (14) Psycho-neurotic disability following treatment in a recognized medical or mental institution; (15) Hemophilia; (16) Chronic osteomyelitis; (17) Ankylosis of joints; (18) Hyper insulinism; (19) Muscular dystrophies; (20) Arterio-sclerosis; (21) Thrombo-phlebitis; (22) Varicose veins; (23) Cardiovascular, pulmonary, or respiratory diseases of
a (24) Coal miners' pneumoconiosis, commonly referred to as "black lung disease"; (25) Disability with respect to which an individual has completed a rehabilitation program conducted pursuant to sections 4121.61 to 4121.69 of the Revised Code. (B) Under the circumstances set forth in this section all
or such portion as the administrator determines of the
compensation and benefits paid in any claim arising hereafter
shall be charged to and paid from the statutory surplus fund
created under section 4123.34 of the Revised Code and only the
portion remaining shall be merit-rated or otherwise treated as
part of the accident or occupational disease experience of the
employer. If the employer is a self-insuring employer, the
proportion of such costs whether charged to the statutory surplus
fund in whole or in part shall be by way of direct payment to
such employee or (C) Any employer who An employer shall file an application UNDER THIS SECTION for a
determination
with the bureau or commission in the same manner as other claims. An
application only may be made in cases where a
handicapped employee or (D) The circumstances under and the manner in which an apportionment under this section shall be made are: (1) Whenever a handicapped employee is injured or disabled
or dies as the result of an injury or occupational disease
sustained in the course of and arising out of (2) Whenever a handicapped employee is injured or disabled or dies as a result of an injury or occupational disease and the administrator finds that the injury or occupational disease would have been sustained or suffered without regard to the employee's pre-existing impairment but that the resulting disability or death was caused at least in part through aggravation of the employee's pre-existing disability, the administrator shall determine in a manner that is equitable and reasonable and based upon medical evidence the amount of disability or proportion of the cost of the death award that is attributable to the employee's pre-existing disability and the amount found shall be charged to the statutory surplus fund. (E) The benefits and provisions of this section apply only to employers who have complied with this chapter either through insurance with the state fund or as a self-insuring employer. (F) No employer shall in any year receive credit under
this section in an amount greater than the premium (G) Self-insuring employers may, for all claims made after
January 1, 1987, for compensation and benefits under this
section, pay the compensation and benefits directly to the
employee or the employee's dependents. If such an employer
chooses to pay compensation and benefits directly, (H) An order issued by the administrator pursuant to this
section is appealable under section 4123.511 of the Revised Code
but is not appealable to court under section 4123.512 of the
Revised Code.
Sec. 4123.511. (A) Within seven days after receipt of any claim under this chapter, the bureau of workers' compensation shall notify the claimant and the employer of the claimant of the receipt of the claim and of the facts alleged therein. If the bureau receives from a person other than the claimant written or telecommunicated information indicating that an injury or occupational disease has occurred or been contracted with may be compensable under this chapter, the bureau shall notify the employee and the employer of the information. If the information is provided by any method of telecommunication, the person providing the information shall provide written verification of the information to the bureau according to division (E) of section 4123.84 of the Revised Code. The receipt of the information in writing, or if by a method of telecommunications, the written verification, and the notice by the bureau shall be considered an application for compensation under section 4123.84 or 4123.85 of the Revised Code provided that the conditions of division (E) of section 4123.84 of the Revised Code apply to information provided by a method of telecommunication. Upon receipt of a claim, the bureau shall advise the claimant of the claim number assigned and the claimant's right to representation in the processing of a claim or to elect no representation. If the bureau determines that a claim is determined to be a compensable lost-time claim, the bureau shall notify the claimant and the employer of the availability of rehabilitation services. No bureau or industrial commission employee shall directly or indirectly convey any information in derogation of this right. This section shall in no way abrogate the bureau's responsibility to aid and assist a claimant in the filing of a claim and to advise the claimant of the claimant's rights under the law. The administrator of workers' compensation shall assign all claims and investigations to the bureau service office from which investigation and determination may be made most expeditiously. The bureau shall investigate the facts concerning an injury or occupational disease and ascertain such facts in whatever manner is most appropriate and may obtain statements of the employee, employer, attending physician, and witnesses in whatever manner is most appropriate. (B)(1) Except as provided in division (B)(2) of this
section, in claims other than those in which the employer is a
self-insuring employer, if the administrator determines under
division (A) of this section that a claimant is or is not
entitled to an award of compensation or benefits, the
administrator shall issue an order (2) Notwithstanding the time limitation specified in division (B)(1) of this section for the issuance of an order, if the employer certifies a claim for payment of compensation or benefits, or both, to a claimant, and the administrator has completed the investigation of the claim, the payment of benefits or compensation, or both, as is appropriate, shall commence upon the later of the date of the certification or completion of the investigation and issuance of the order by the administrator, provided that the administrator shall issue the order no later than the time limitation specified in division (B)(1) of this section. (3) If an appeal is made under division (B)(1) or (2) of this section, the administrator shall forward the claim file to the appropriate district hearing officer within seven days of the appeal. In contested claims other than state fund claims, the administrator shall forward the claim within seven days of the administrator's receipt of the claim to the commission, which shall refer the claim to an appropriate district hearing officer for a hearing in accordance with division (C) of this section. (C) If an employer or claimant timely appeals the order of the administrator issued under division (B) of this section or in the case of other contested claims other than state fund claims, the commission shall refer the claim to an appropriate district hearing officer according to rules the commission adopts under section 4121.36 of the Revised Code. The district hearing officer shall notify the parties and their respective representatives of the time and place of the hearing. The district hearing officer shall hold a hearing on a disputed issue or claim within forty-five days after the filing of the appeal under this division and issue a decision within seven days after holding the hearing. The district hearing officer shall notify the parties and their respective representatives in writing of the order. Any party may appeal an order issued under this division pursuant to division (D) of this section within fourteen days after receipt of the order under this division. (D) Upon the timely filing of an appeal of the order of
the district hearing officer issued under division (C) of this
section, the commission shall refer the claim file to an
appropriate staff hearing officer according to its rules adopted
under section 4121.36 of the Revised Code. The staff hearing
officer shall hold a hearing within forty-five days after the
filing of an appeal under this division and issue a decision
within seven days after holding the
hearing under this
division. The staff hearing officer shall notify the parties and
their respective representatives in writing (E) Upon the filing of a timely appeal of the order of the staff hearing officer issued under division (D) of this section, the commission or a designated staff hearing officer, on behalf of the commission, shall determine whether the commission will hear the appeal. If the commission or the designated staff hearing officer decides to hear the appeal, the commission or the designated staff hearing officer shall notify the parties and their respective representatives in writing of the time and place of the hearing. The commission shall hold the hearing within forty-five days after the filing of the notice of appeal and, within seven days after the conclusion of the hearing, the commission shall issue its order affirming, modifying, or reversing the order issued under division (D) of this section. The commission shall notify the parties and their respective representatives in writing of the order. If the commission or the designated staff hearing officer determines not to hear the appeal, within fourteen days after the filing of the notice of appeal, the commission or the designated staff hearing officer shall issue an order to that effect and notify the parties and their respective representatives in writing of that order. Except as otherwise provided in this chapter and Chapters 4121., 4127., and 4131. of the Revised Code, any party may appeal an order issued under this division to the court pursuant to section 4123.512 of the Revised Code within sixty days after receipt of the order, subject to the limitations contained in that section. (F) Every notice of an appeal from an order issued under divisions (B), (C), (D), and (E) of this section shall state the names of the claimant and employer, the number of the claim, the date of the decision appealed from, and the fact that the appellant appeals therefrom. (G) All of the following apply to the proceedings under divisions (C), (D), and (E) of this section: (1) The parties shall proceed promptly and without continuances except for good cause; (2) The parties, in good faith, shall engage in the free exchange of information relevant to the claim prior to the conduct of a hearing according to the rules the commission adopts under section 4121.36 of the Revised Code; (3) The administrator is a party and may appear and participate at all administrative proceedings on behalf of the state insurance fund. However, in cases in which the employer is represented, the administrator shall neither present arguments nor introduce testimony that is cumulative to that presented or introduced by the employer or the employer's representative. The administrator may file an appeal under this section on behalf of the state insurance fund; however, except in cases arising under section 4123.343 of the Revised Code, the administrator only may appeal questions of law or issues of fraud when the employer appears in person or by representative. (H) Except as provided in SECTION 4121.63 of the Revised Code AND division (J) of this section, payments of compensation to a claimant or on behalf of a claimant as a result of any order issued under this chapter shall commence upon the earlier of the following: (1) Fourteen days after the date the administrator issues an order under division (B) of this section, unless that order is appealed; (2) Twenty-one days after the date when the employer has waived the right to appeal a decision issued under division (B) of this section; (3) If no appeal of an order has been filed under this section or to a court under section 4123.512 of the Revised Code, the expiration of the time limitations for the filing of an appeal of an order; (4) The date of receipt by the employer of an order of a district hearing officer, a staff hearing officer, or the industrial commission issued under division (C), (D), or (E) of this section. (I) No medical benefits payable under this chapter or Chapter 4121., 4127., or 4131. of the Revised Code are payable until the earlier of the following: (1) The date of the issuance of the staff hearing officer's order under division (D) of this section; (2) The date of the final administrative or judicial determination. (J) Upon the final administrative or judicial determination under this section or section 4123.512 of the Revised Code of an appeal of an order to pay compensation, if a claimant is found to have received compensation pursuant to a prior order which is reversed upon subsequent appeal, the claimant's employer, if a self-insuring employer, or the bureau, shall withhold from any amount to which the claimant becomes entitled pursuant to any claim, past, present, or future, under Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the amount of previously paid compensation to the claimant which, due to reversal upon appeal, the claimant is not entitled, pursuant to the following criteria: (1) No withholding for the first twelve weeks of temporary total disability compensation pursuant to section 4123.56 of the Revised Code shall be made; (2) Forty per cent of all awards of compensation paid pursuant to sections 4123.56 and 4123.57 of the Revised Code, until the amount overpaid is refunded; (3) Twenty-five per cent of any compensation paid pursuant to section 4123.58 of the Revised Code until the amount overpaid is refunded; (4) If, pursuant to an appeal under section 4123.512 of the Revised Code, the court of appeals or the supreme court reverses the allowance of the claim, then no amount of any compensation will be withheld. The administrator and self-insuring employers, as appropriate, are subject to the repayment schedule of this division only with respect to an order to pay compensation that was properly paid under a previous order, but which is subsequently reversed upon an administrative or judicial appeal. The administrator and self-insuring employers are not subject to, but may utilize, the repayment schedule of this division, or any other lawful means, to collect payment of compensation made to a person who was not entitled to the compensation due to fraud as determined by the administrator or the industrial commission. (K) If a staff hearing officer or the commission fails to issue a decision or the commission fails to refuse to hear an appeal within the time periods required by this section, payments to a claimant shall cease until the staff hearing officer or commission issues a decision or hears the appeal, unless the failure was due to the fault or neglect of the employer or the employer agrees that the payments should continue for a longer period of time. (L) Except as otherwise provided in this section or section 4123.522 of the Revised Code, no appeal is timely filed under this section unless the appeal is filed with the time limits set forth in this section. (M) No person who is not an employee of the bureau or commission or who is not by law given access to the contents of a claims file shall have a file in the person's possession. (N) Upon application of a party who resides in an area in which an emergency or disaster is declared, the industrial commission and hearing officers of the commission may waive the time frame within which claims and appeals of claims set forth in this section must be filed upon a finding that the applicant was unable to comply with a filing deadline due to an emergency or a disaster. As used in this division: (1) "Emergency" means any occasion or instance for which the governor of Ohio or the president of the United States publicly declares an emergency and orders state or federal assistance to save lives and protect property, the public health and safety, or to lessen or avert the threat of a catastrophe. (2) "Disaster" means any natural catastrophe or fire,
flood, or explosion, regardless of the cause, that causes damage
of sufficient magnitude that the governor of Ohio or the
President of the United States, through a public
declaration,
orders state or federal assistance to alleviate damage, loss,
hardship, or suffering that results from the occurrence.
Sec. 4123.512. (A) The claimant or the employer may appeal an order of the industrial commission made under division (E) of section 4123.511 of the Revised Code in any injury or occupational disease case, other than a decision as to the extent of disability to the court of common pleas of the county in which the injury was inflicted or in which the contract of employment was made if the injury occurred outside the state, or in which the contract of employment was made if the exposure occurred outside the state. If no common pleas court has jurisdiction for the purposes of an appeal by the use of the jurisdictional requirements described in this division, the appellant may use the venue provisions in the Rules of Civil Procedure to vest jurisdiction in a court. If the claim is for an occupational disease the appeal shall be to the court of common pleas of the county in which the exposure which caused the disease occurred. Like appeal may be taken from an order of a staff hearing officer made under division (D) of section 4123.511 of the Revised Code from which the commission has refused to hear an appeal. The appellant shall file the notice of appeal with a court of common pleas within sixty days after the date of the receipt of the order appealed from or the date of receipt of the order of the commission refusing to hear an appeal of a staff hearing officer's decision under division (D) of section 4123.511 of the Revised Code. The filing of the notice of the appeal with the court is the only act required to perfect the appeal. If an action has been commenced in a court of a county other than a court of a county having jurisdiction over the action, the court, upon notice by any party or upon its own motion, shall transfer the action to a court of a county having jurisdiction. Notwithstanding anything to the contrary in this section, if the commission determines under section 4123.522 of the Revised Code that an employee, employer, or their respective representatives have not received written notice of an order or decision which is appealable to a court under this section and which grants relief pursuant to section 4123.522 of the Revised Code, the party granted the relief has sixty days from receipt of the order under section 4123.522 of the Revised Code to file a notice of appeal under this section. (B) The notice of appeal shall state the names of the claimant and the employer, the number of the claim, the date of the order appealed from, and the fact that the appellant appeals therefrom. The administrator, the claimant, and the employer shall be parties to the appeal and the court, upon the application of the commission, shall make the commission a party. THE PARTY FILING THE APPEAL SHALL SERVE A COPY OF THE NOTICE OF APPEAL ON THE ADMNISTRATOR OF WORKERS' COMPENSATION AT THE CENTRAL OFFICE OF THE BUREAU OF WORKERS' COMPENSATION IN COLUMBUS. The administrator shall notify the employer that if the employer fails to become an active party to the appeal, then the administrator may act on behalf of the employer and the results of the appeal could have an adverse effect upon the employer's premium rates. (C) The attorney general or one or more of the attorney general's assistants or special counsel designated by the attorney general shall represent the administrator and the commission. In the event the attorney general or the attorney general's designated assistants or special counsel are absent, the administrator or the commission shall select one or more of the attorneys in the employ of the administrator or the commission as the administrator's attorney or the commission's attorney in the appeal. Any attorney so employed shall continue the representation during the entire period of the appeal and in all hearings thereof except where the continued representation becomes impractical. (D) Upon receipt of notice of appeal the clerk of courts shall provide notice to all parties who are appellees and to the commission. The claimant shall, within thirty days after the filing of the notice of appeal, file a petition containing a statement of facts in ordinary and concise language showing a cause of action to participate or to continue to participate in the fund and setting forth the basis for the jurisdiction of the court over the action. Further pleadings shall be had in accordance with the Rules of Civil Procedure, provided that service of summons on such petition shall not be required. The clerk of the court shall, upon receipt thereof, transmit by certified mail a copy thereof to each party named in the notice of appeal other than the claimant. Any party may file with the clerk prior to the trial of the action a deposition of any physician taken in accordance with the provisions of the Revised Code, which deposition may be read in the trial of the action even though the physician is a resident of or subject to service in the county in which the trial is had. The bureau of workers' compensation shall pay the cost of the stenographic deposition filed in court and of copies of the stenographic deposition for each party from the surplus fund and charge the costs thereof against the unsuccessful party if the claimant's right to participate or continue to participate is finally sustained or established in the appeal. In the event the deposition is taken and filed, the physician whose deposition is taken is not required to respond to any subpoena issued in the trial of the action. The court, or the jury under the instructions of the court, if a jury is demanded, shall determine the right of the claimant to participate or to continue to participate in the fund upon the evidence adduced at the hearing of the action. (E) The court shall certify its decision to the commission and the certificate shall be entered in the records of the court. Appeals from the judgment are governed by the law applicable to the appeal of civil actions. (F) The cost of any legal proceedings authorized by this section, including an attorney's fee to the claimant's attorney to be fixed by the trial judge, based upon the effort expended, in the event the claimant's right to participate or to continue to participate in the fund is established upon the final determination of an appeal, shall be taxed against the employer or the commission if the commission or the administrator rather than the employer contested the right of the claimant to participate in the fund. The attorney's fee shall not exceed twenty-five hundred dollars. (G) If the finding of the court or the verdict of the jury is in favor of the claimant's right to participate in the fund, the commission and the administrator shall thereafter proceed in the matter of the claim as if the judgment were the decision of the commission, subject to the power of modification provided by section 4123.52 of the Revised Code. (H) An appeal from an order issued under division (E) of section 4123.511 of the Revised Code or any action filed in court in a case in which an award of compensation has been made shall not stay the payment of compensation under the award or payment of compensation for subsequent periods of total disability during the pendency of the appeal. If, in a final administrative or judicial action, it is determined that payments of compensation or benefits, or both, made to or on behalf of a claimant should not have been made, the amount thereof shall be charged to the surplus fund under division (B) of section 4123.34 of the Revised Code. In the event the employer is a state risk, the amount shall not be charged to the employer's experience. In the event the employer is a self-insuring employer, the self-insuring employer shall deduct the amount from the paid compensation the self-insuring employer reports to the administrator under division (L) of section 4123.35 of the Revised Code. All actions and proceedings under this section which are the subject of an appeal to the court of common pleas or the court of appeals shall be preferred over all other civil actions except election causes, irrespective of position on the calendar. This section applies to all decisions of the commission or the administrator on November 2, 1959, and all claims filed thereafter are governed by sections 4123.511 and 4123.512 of the Revised Code. Any action pending in common pleas court or any other court
on January 1, 1986, under this section is governed by former
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section
4123.522 of the Revised Code.
Sec. 4123.591. THE ADMINISTRATOR OF WORKERS' COMPENSATION MAY FURNISH
QUARTERLY, TO THE TAX COMMISSIONER, IN A FORMAT APPROVED BY THE TAX
COMMISSIONER, A LIST CONTAINING THE NAME AND SOCIAL SECURITY NUMBER OF ANY
PERSON RECEIVING SPOUSAL
DEATH BENEFITS. UPON RECEIPT OF THIS LIST, THE COMMISSIONER SHALL RETURN TO
THE
ADMINISTRATOR, IN A FORMAT DESIGNED BY THE COMMISSIONER, INFORMATION
IDENTIFYING ANY PERSON LISTED BY THE ADMINISTRATOR WHO, AS REPORTED ON THE
MOST RECENT RETURN FILED
BY THE PERSON UNDER SECTION 5747.08 of the Revised Code, FILED UNDER THE STATUS "MARRIED
FILING JOINT RETURN," OR "MARRIED FILING SEPARATELY."
Sec. 4123.76. When an application for compensation or
benefits or an application for further compensation or benefits
is filed with the industrial commission or the bureau of workers'
compensation under section 4123.75 of the Revised Code against an
employer who has not complied with section 4123.35 of the Revised
Code, the bureau shall make and file for record in the office of
the county recorder in the counties where the employer's property
is located, an affidavit showing the date on which the
application was filed with the commission or the bureau, the name
and address of the employer against whom it was filed, and the
fact that the employer had not complied with section 4123.35 of
the Revised Code. The recorder shall accept and file the
affidavit and record the same as a mortgage on real estate and
shall file the same as a chattel mortgage and Sec. 4123.83. Each employer paying premiums into the state
insurance fund or electing directly to pay compensation to Sec. 5703.21. (A) Except as provided in divisions (B),
(C), (D), (B)(1) For purposes of an audit pursuant to section 117.15 of the Revised Code, or an audit of the department pursuant to Chapter 117. of the Revised Code, or an audit, pursuant to such chapter, the objective of which is to express an opinion on a financial report or statement prepared or issued pursuant to division (G) or (I) of section 126.21 of the Revised Code, the officers and employees of the auditor of state charged with conducting the audit shall have access to and the right to examine any state tax returns and state tax return information in the possession of the department to the extent that such access and examination are necessary for purposes of the audit. Any information acquired as the result of such access and examination shall not be divulged for any purpose other than as required for such audit or unless the officers and employees are required to testify in a court or proceeding under compulsion of legal process. Whoever violates this provision shall thereafter be disqualified from acting as an officer or employee or in any other capacity under appointment or employment of the auditor of state. (2) As provided by section 6103(d)(2) of the Internal Revenue Code, any federal tax returns or federal tax information which the department has acquired from the internal revenue service, through federal and state statutory authority, may be disclosed to the auditor of state solely for purposes of an audit of the department. (C) Division (A) of this section does not prohibit divulging information contained in applications, complaints, and related documents filed with the department under section 5715.27 of the Revised Code, or in applications filed with the department under section 5715.39 of the Revised Code. (D) Division (A) of this section does not prohibit the department of taxation providing information to the division of child support within the department of human services, or a child support enforcement agency, pursuant to division (G)(2) of section 5101.31 of the Revised Code. (E) Division (A) of this section does not prohibit the disclosure to the board of motor vehicle collision repair registration of any information in the possession of the department that is necessary for the board to verify the existence of an applicant's valid vendor's license and current state tax identification number under section 4775.07 of the Revised Code. (F) DIVISION (A) OF THIS SECTION DOES NOT PROHIBIT THE
DEPARTMENT FROM PROVIDING INFORMATION TO THE ADMINISTRATOR OF WORKERS'
COMPENSATION PURSUANT TO SECTION 4123.591 of the Revised Code.
Sec. 5747.18. The tax commissioner shall enforce and administer this chapter. In addition to any other powers conferred upon the commissioner by law, the commissioner may: (A) Prescribe all forms required to be filed pursuant to this chapter; (B) Adopt such rules as the commissioner finds necessary to carry out this chapter; (C) Appoint and employ such personnel as are necessary to carry out the duties imposed upon the commissioner by this chapter. Any information gained as the result of returns, investigations, hearings, or verifications required or authorized by this chapter is confidential, and no person shall disclose such information, except for official purposes, or as provided by section 4123.591, 4507.023 or 5101.182, division (G)(2) of section 5101.31 or division (B) of section 5703.21 of the Revised Code, or in accordance with a proper judicial order. The tax commissioner may furnish the internal revenue service with copies of returns or reports filed and may furnish the officer of a municipal corporation charged with the duty of enforcing a tax subject to Chapter 718. of the Revised Code with the names, addresses, and identification numbers of taxpayers who may be subject to such tax. A municipal corporation shall use this information for tax collection purposes only. This section does not prohibit the publication of statistics in a form which does not disclose information with respect to individual taxpayers. Section 2. That existing sections 121.03, 3304.23, 3304.231, 4121.12, 4121.121, 4121.37, 4121.44, 4121.63, 4123.343, 4123.511, 4123.512, 4123.76, 4123.83, 5703.21, and 5747.18 of the Revised Code are hereby repealed. Section 3. The Administrator of Workers' Compensation shall submit a series of reports to the Workers' Compensation Oversight Commission, the Office of Budget and Management, the Legislative Budget Office of the Legislative Service Commission, and the General Assembly semiannually during the 1999-2001 biennium, beginning on or before October 1, 1999, containing information relative to all of the following: (A) The premium cost per worker, which reports the average annual cost a state fund employer pays to provide workers' compensation coverage for its employees. The premium cost per worker is calculated by adding together an employer's total amounts of premiums and assessments paid during a calendar year and dividing that sum by the employer's average number of workers. (B) The claims cost per worker, which reports the average annual benefit cost paid for each worker who is employed by a state fund employer during the preceding twelve months. The claims cost per worker is calculated by dividing an employer's total claim expenses paid during the preceding twelve months by the employer's average number of workers. (C) The administrative cost per claim, which reports the average annual administrative expense a state fund employer pays to process a claim. The administrative cost per claim is calculated by dividing an employer's total amount of administrative expenses incurred during the preceding twelve months by the total number of claims the employer processed. (D) The direct loss ratio, which measures the relationship between an employer's revenues and workers' compensation benefits paid to an injured worker during the preceding twelve months; (E) The rate of return generated by investments of the Bureau of Workers' Compensation; (F) The customer service index, which accounts for various statistical measures reflecting the Bureau's customer service levels; (G) The Health Partnership Program performance index, which measures the effectiveness of managed care organizations working for the bureau and reflects the quality of care, customer satisfaction, and cost of care provided by the managed care organizations; (H) The rate of injury in the state per 1,000 workers; (I) The average and median number of days the bureau takes to adjudicate an injured worker's medical bill fee; (J) The return-to-work rate of state fund employers' injured workers who do not receive workers' compensation benefits for at least ninety days following their injury, which reports the number of injured workers who returned to work as a percentage of total injuries; (K) The average number of days it takes for an employer or injured worker to report an injury to the bureau, which is calculated by taking the average number of days between the date of injury and the date the claim was filed with the bureau; (L) The percentage of indemnity claims adjudicated by the bureau within fourteen days of the injury. Section 4. All items in this section are hereby appropriated out of any moneys in the state treasury to the credit of the designated fund. For all appropriations made in this act, those in the first column are for fiscal year 2000, and those in the second column are for fiscal year 2001.
Workers' Compensation Fund Group
Safety and Hygiene Notwithstanding section 4121.37 of the Revised Code, the Administrator of the Bureau of Workers' Compensation shall transfer moneys from the State Insurance Fund so that appropriation item 855-609, Safety and Hygiene Operating, is provided $18,358,104 in fiscal year 2000 and $18,491,102 in fiscal year 2001. Workers' Compensation Fraud Unit The Workers' Compensation Section Fund (Fund 195) shall receive payments from the Bureau of Workers' Compensation at the beginning of each quarter of each fiscal year to fund expenses of the Workers' Compensation Fraud Unit of the Attorney General's Office. Of the foregoing appropriation item 855-410, Attorney General Payments, $694,930 in fiscal year 2000 and $714,388 in fiscal year 2001 shall be used to provide such payments. William Green Lease Payments The foregoing appropriation item 855-401, William Green Lease Payments to OBA, shall be used for lease payments to the Ohio Building Authority, and these appropriations shall be used to meet all payments at the times they are required to be made during the period from July 1, 1999, to June 30, 2001, by the Bureau of Workers' Compensation to the Ohio Building Authority pursuant to leases and agreements made under Chapter 152. of the Revised Code and Section 6 of Am. Sub. H.B. 743 of the 118th General Assembly. Of the amounts received in Fund 023, appropriation item 855-401, up to $33,123,226 shall be restricted for lease rental payments to the Ohio Building Authority. If it is determined that additional appropriations are necessary for such purpose, such amounts are hereby appropriated. Notwithstanding any other provision of law to the contrary, all tenants of the William Green Building not funded by the Workers' Compensation Fund (Fund 023) shall pay their fair share of the costs of lease payments to the Workers' Compensation Fund (Fund 023) by intrastate transfer voucher. Camera Center The Camera Center Fund (Fund 4Y6) created in division (F) of section 4121.62 of the Revised Code shall receive revenues raised by the fees Camera Center charges for its services and rent paid by tenants of the Center's facilities. The foregoing appropriation item 855-611, J.L. Camera Center Rent, shall be used to pay rent, including building operating expenses, of the J. Leonard Camera Rehabilitation Center in Columbus. The foregoing appropriation item 855-612, J.L. Camera Center Operating, shall be used for all other expenses for the Center. The Bureau of Workers' Compensation shall not consider appropriations made to the Camera Center Fund (Fund 4Y6) when establishing administrative cost rates. Balances Notwithstanding any provision of law to the contrary, the Director of Budget and Management shall make any transfers of cash balances between funds made necessary by the creation of new funds, or the consolidation of funds as authorized by the General Assembly. Within the first five days after the effective date of this section, the administering agency head shall certify to the director an estimate of the amount of the cash balance to be transferred to the receiving fund. The director may transfer the estimated amount when needed to make payments. Within thirty days after the effective date of this section, the administering agency head shall certify the final amount to the director. The director shall transfer the difference between any estimated amount previously transferred and such certified final amount. To implement such funding changes as described above pertaining to prior year encumbrance balances and commensurate appropriation authority, in fiscal year 2000 the Director of Budget and Management may cancel encumbrances outstanding on June 30, 1999, and reestablish such prior year encumbrances or parts of encumbrances as needed in fiscal year 2000 in the appropriate fund or appropriation item as authorized in this act for the same purpose and to the same vendor. As determined by the director, the appropriation authority necessary to reestablish such prior year encumbrances in fiscal year 2000 in a different fund or appropriation item within an agency or between agencies is hereby authorized. The director shall reduce each prior year's appropriation authority by the amount of the encumbrances canceled in their respective funds and appropriation items. Vocational Rehabilitation The Bureau of Workers' Compensation and the Rehabilitation Services Commission shall enter into an interagency agreement for the provision of vocational rehabilitation services and staff to mutually eligible clients. The Bureau shall provide $523,245 in fiscal year 2000 and $537,896 in fiscal year 2001 from the State Insurance Fund to fund vocational rehabilitation services and staff in accordance with the interagency agreement. Fund Balance Any unencumbered cash balance in excess of $45,000,000 in the Workers' Compensation Fund (Fund 023) on the thirtieth day of June of each fiscal year shall be used to reduce the administrative cost rate charged to employers to cover appropriations for Bureau of Workers' Compensation and Industrial Commission operations. Section 5. Accounting Within the limits set forth in this act, the Director of Budget and Management shall establish accounts indicating the source and amount of funds for each appropriation made in this act, and shall determine the form and manner in which appropriation accounts shall be maintained. The appropriations made in this act are subject to all provisions of the main operating appropriations act of the 123rd General Assembly that are generally applicable to such appropriations. Section 6. Reissuance of Voided Warrants In order to provide funds for the reissuance of voided warrants pursuant to section 117.47 of the Revised Code, there is hereby appropriated, out of moneys in the state treasury from the fund credited as provided in section 117.47 of the Revised Code, that amount sufficient to pay such warrants when approved by the Office of Budget and Management. Section 7. Judgments Against State Any appropriations contained in this act, except those to be applied to or used for payment of guarantees by or on behalf of the state or for debt service on bonds, notes, or certificates of participation, may be used for the purpose of satisfying judgments, settlements, or administrative awards ordered or approved by the Court of Claims or any other court of competent jurisdiction in connection with civil actions against the state. Section 8. Reappropriation of Unexpended Balances Notwithstanding section 131.33 of the Revised Code, unexpended balances of appropriations and reappropriations against which encumbrances have been lawfully incurred by the Bureau of Workers' Compensation are, at the close of fiscal years 1999 and 2000, to the extent of such encumbrances, hereby reappropriated from the funds from which they were originally appropriated and reappropriated and, except for encumbrances for items of special order manufacture not available on term contract or open market, made available for the purpose of discharging such encumbrances for a period of five months from the end of the fiscal year. Unexpended balances of appropriations and reappropriations against which encumbrances for items of special order manufacture not available on term contract or in the open market have been lawfully incurred are, at the close of the fiscal year, to the extent of such encumbrances, hereby reappropriated and made available for the purpose of discharging such encumbrances for a period of five months from the end of the fiscal year or, if the Director of Budget and Management approves, for a period of not more than twelve months from the end of the fiscal year. Any items for which unexpended balances are reappropriated beyond a five-month period from the end of the fiscal year shall be reported to the Controlling Board by the Director of Budget and Management. The report on each such item shall include the item, the cost of the item, the vendor involved, and the delivery date. Such reports to the board shall be updated on a quarterly basis while the encumbrance remains open. After any such period, reappropriations made for the purpose of discharging encumbrances for operating expenses, defined as those encumbrances incurred for personal services, maintenance, and equipment, are canceled. Reappropriations for encumbrances other than operating expenses or items of special manufacture not available on term contract or in the open market may be extended by obtaining the approval of the Director of Budget and Management. Section 9. Independent and Severable Items If any item of law that constitutes the whole or part of a codified or uncodified section of law contained in this act, or if any application of any item of law that constitutes the whole or part of a codified or uncodified section of law contained in this act, is held invalid, the invalidity does not affect other items of law or applications of items of law that can be given effect without the invalid item of law or application. To this end, the items of law of which the codified and uncodified sections contained in this act are composed, and their applications, are independent and severable. Section 10. Effective Dates-Codified Sections The sections of the Revised Code contained in this act, and the items of law of which such sections of the Revised Code are composed, are subject to the referendum. Therefore, under Ohio Constitution, Article II, Section 1c and section 1.471 of the Revised Code, the sections of the Revised Code contained in this act, and the items of law of which such sections of the Revised Code are composed, take effect on the ninety-first day after this act is filed with the Secretary of State. If, however, a referendum petition is filed against any section of the Revised Code contained in this act, or against any item of law of which such a section of the Revised Code is composed, the section or item of law, unless rejected at the referendum, takes effect at the earliest time permitted by law. Section 11. Effective Dates-Uncodified Sections The uncodified sections of law contained in
this act, and the items of law of which the
uncodified sections of law contained in this act are composed,
are not subject to the referendum. Therefore, under Ohio
Constitution, Article II, Section 1d and section 1.471 of the
Revised Code, the uncodified sections of law
contained in this act, and the items of law of which the
uncodified sections of law contained in this act
are composed go into immediate effect when this act becomes law.
Section 12. Section 121.03 of the Revised Code is presented in this act as a composite of the section as amended by both Am. Sub. H.B. 7 and Am. Sub. S.B. 162 of the 121st General Assembly, with the new language of neither of the acts shown in capital letters. This is in recognition of the principle stated in division (B) of section 1.52 of the Revised Code that such amendments are to be harmonized where not substantively irreconcilable and constitutes a legislative finding that such is the resulting version in effect prior to the effective date of this act. Section 13. Section 4123.511 of the Revised Code is presented in this act as a composite of the section as amended by both Am. Sub. H.B. 362 and Am. Sub. H.B. 363 of the 122nd General Assembly, with the new language of neither of the acts shown in capital letters. This is in recognition of the principle stated in division (B) of section 1.52 of the Revised Code that such amendments are to be harmonized where not substantively irreconcilable and constitutes a legislative finding that such is the resulting version in effect prior to the effective date of this act. |
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