Montana Administrative Register Notice 24-29-316 No. 17   09/02/2016    
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In the matter of the amendment of ARM 24.29.1591 related to utilization and treatment guidelines for workers' compensation injuries







TO: All Concerned Persons


1. On September 23, 2016, at 10:30 a.m., the Department of Labor and Industry (department) will hold a public hearing in the Sanders Auditorium of the DPHHS Building at 111 North Sanders Street, Helena, Montana, 59601, to consider the proposed amendment of the above-stated rule.


2. The department will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice.  If you require an accommodation, contact the department no later than 5:00 p.m., on September 16, 2016, to advise us of the nature of the accommodation that you need.  Please contact the Department of Labor and Industry, Attn: Maralyn Lytle, Employment Relations Division, P.O. Box 8011, Helena, MT 59604-8011; telephone (406) 444-6604; fax (406) 444-4140; Montana TTD (406) 444-5549; or e-mail mlytle@mt.gov.


3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:


          24.29.1591 Utilization and Treatment Guidelines (1) and (1)(a) remain the same.   

          (b) for medical services provided July 1, 2014 through June 30, 2015: "Montana Utilization and Treatment Guidelines, 2nd edition, 2014"; and

          (c) for medical services provided on or after July 1, 2015: "Montana Utilization and Treatment Guidelines, 3rd edition, 2015."; and

          (d) for medical services provided on or after January 1, 2017: "Montana Utilization and Treatment Guidelines, 4th edition, 2016."

          (2) The Montana Guidelines consist of the following nine chapters and General Guideline Principles which are included at the beginning of each chapter:

          (a) Low Back Pain;

          (b) Shoulder Injury;

          (c) Upper Extremity Thoracic Outlet;

          (d) Lower Extremity;

          (e) Chronic Regional Pain Syndrome;

          (f) Cervical Spine Injury;

          (g) Chronic Pain Disorder;

          (h) Traumatic Brain Injury; and

          (i) Eye Injury; and

          (j) Cumulative Trauma.

(3) through (5) remain the same.


AUTH: 39-71-203, 39-71-704, MCA

IMP:     39-71-704, MCA


          REASONABLE NECESSITY: There is reasonable necessity to update the Montana Utilization and Treatment Guidelines to incorporate the changes to the thoracic outlet treatment guidelines which have recently been developed by the State of Colorado. The division of the upper extremity guidelines into the thoracic outlet and cumulative trauma chapters is an editorial decision of the department, and allows the Montana guidelines to follow the update cycle of Colorado.  The updated guidelines have been reviewed by the department's advisory medical providers group, and their comments have been taken into account by the department.


          4. A copy of the proposed 2016 publication, identified as the "Montana Utilization and Treatment Guidelines, 4th edition, 2016," is available and can be accessed at: http://erd.dli.mt.gov/work-comp-claims/medical-regulations.


          5. A printed version of the proposed 2016 publication is also available by contacting Maralyn Lytle at the address, e-mail, or telephone numbers listed in paragraph 2 of this notice.


6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Maralyn Lytle, Employment Relations Division, P.O. Box 8011, Helena, MT 59604-8011; telephone (406) 444-6604; fax (406) 444-4140; Montana TTD (406) 444-5549; or e-mail mlytle@mt.gov, and must be received no later than 5:00 p.m., on October 7, 2016.


7. The department's Office of Administrative Hearings has been designated to preside over and conduct this hearing.


8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request, which includes the name and e-mail or mailing address of the person to receive notices, and specifies the particular subject matter or matters regarding which the person wishes to receive notices. Such written request may be mailed or delivered to the Department of Labor and Industry, attention: Mark Cadwallader, 1315 E. Lockey Avenue, P.O. Box 1728, Helena, Montana 59624-1728, faxed to the department at (406) 444-1394, e-mailed to mcadwallader@mt.gov, or may be made by completing a request form at any rules hearing held by the agency.


9. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of this notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.


10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.


11. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rule will not significantly and directly impact small businesses.



/s/ Mark Cadwallader                          /s/ Pam Bucy

Mark Cadwallader                               Pam Bucy, Commissioner

Alternate Rule Reviewer                     DEPARTMENT OF LABOR AND INDUSTRY


Certified to the Secretary of State August 22, 2016.


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