SB 1164 — workers' compensation; fraud investigations; adjudications

SenateHouse Engrossed Senate Bill workers' compensation;

adjudications State of Arizona Senate Fifty-sixth Legislature First Regular Session CHAPTER 191 SENATE BILL 1164 AN ACT AMENDING TITLE 23, CHAPTER 6, ARTICLE 2, ARIZONA REVISED STATUTES, BY ADDING SECTION 23-934;

AMENDING SECTION 1, AS ADDED BY HOUSE BILL 2431, FIFTY-SIXTH LEGISLATURE, FIRST REGULAR SESSION, AS TRANSMITTED TO THE GOVERNOR;

IF, ON INVESTIGATION, THE FRAUD UNIT IS SATISFIED THAT FRAUDULENT ACTIVITIES, STATEMENTS OR REPRESENTATIONS WERE MADE IN CONNECTION WITH A WORKERS' COMPENSATION,COMPENSATION BENEFITS OR PAYMENTS CLAIM FOR THE PURPOSE OF OBTAINING COMPENSATION,COMPENSATION BENEFITS OR PAYMENTS, THE FRAUD UNIT MAY REPORT VIOLATIONS OF LAW TO THE CLAIMANT OR CLAIMANT'S REPRESENTATIVE, TO THE REPORTING EMPLOYER, SELF-INSURED EMPLOYER OR INSURANCE CARRIER, TO THE APPROPRIATE LICENSING AGENCY AS DEFINED IN SECTION 20-466.04, AND TO THE APPROPRIATE COUNTY ATTORNEY OR THE ATTORNEY GENERAL FOR PROSECUTION.

THE RIGHT OF AN INSURANCE CARRIER, A SELF-INSURED EMPLOYER OR THE SPECIAL FUND ESTABLISHED BY SECTION 23-1065 TO ISSUE A NOTICE AFFECTING THE STATUS OF A WORKERS' COMPENSATION CLAIM AT ANY TIME IF A PRIOR DETERMINATION OF COMPENSABILITY OR ENTITLEMENT TO BENEFITS WAS PROCURED BY FRAUD.

3.

- 1 - S.B.

1164 Sec.

2.

Section 1, as added by House Bill 2431, fifty-sixth legislature, first regular session, as transmitted to the governor, is amended to read:

Section 1.

Commercial workers' compensation;

firefighters;

rate deviations;

experience modifications;

Covid-19;

intent;

delayed repeal A.

NOTWITHSTANDING SECTION 20-344, ARIZONA REVISED STATUTES, commercial workers' compensation insurers that cover firefighters and fire investigators may charge and collect additional premiums from fire districts to offset and recover Covid-19-related claims costs paid by the insurer before July 1, 2023 to the extent the fire district is able to obtain reimbursement for such additional premium charges from the American Rescue Plan Act of 2021.

This additional premium is in addition to the rate deviations prescribed in section 20-359, Arizona Revised Statutes, and any experience modifications prescribed in section 23-963.01, Arizona Revised Statutes.

A commercial workers' compensation insurer may charge a premium only if the insurance policy includes a provision that would allow the insurer to charge an additional premium.

B.

The TOTAL AGGREGATE maximum amount of the additional premium each commercial workers’ compensation insurer may charge and collect FROM ALL FIRE DISTRICT INSUREDS pursuant to subsection A of this section is $800,000.

Notwithstanding subsection A of this section, a commercial workers’ compensation insurer may not include any Covid-19-related claims costs for which the insurer charges and collects additional premiums pursuant to subsection A of this section in any experience modification charged to the fire district.

C.

The legislature intends that this section not delay payment of fire districts’ eligible COVID-19-related expenses by the industrial commission of Arizona using American Rescue Plan Act monies allocated as part of the fiscal year 2022-2023 budget.

D.

This section is repealed from and after December 31, 2024.

Sec.

3.

Conditional enactment Section 2 of this act does not become effective unless House Bill 2431, fifty-sixth legislature, first regular session, relating to commercial workers' compensation for firefighters, becomes law.

APPROVED BY THE GOVERNOR JUNE 20, 2023.

FILED IN THE OFFICE OF THE SECRETARY OF STATE JUNE 20, 2023.

- 2 -