Board Announces Changes to C-8.1/C-8.4 Forms
The Board has announced some important updates to the C-8.1 and C-8.4 forms. First, the Board reminded payers completing these forms that only the last four digits of the claimant's Social Security number should be put on the form. The Board determined as of 6/16/21 that it would no longer require the claimant's full nine digit Social Security number on the form.
The Board is also eliminating Part A of the C-8.1 form and publishing a new C-8.1 form on 7/1/22. Payers will be required to use the new form as of 8/15/22. The new C-8.1 form eliminates the objection "Requested treatment is not for an established site or condition," and moves it to a new RFA-2 form that will be published on May 2, 2022. The Board does not comment on the other objection reasons noted on the C-8.1 such as:
- Withdrawal of authorization based on a conflicting medical report
- Termination of further medical treatment based on a conflicting medical report
- Objection to further treatment based on non-appearance at a scheduled IME
- Denial of authorization based on a medical appliance or program not being covered under the WCL
- Medical necessity of a requested special service
Presumably, employers and carriers will still be able to raise these objections via the Board's RFA-2 but we are concerned that the Board did not address these objections directly in their announcement.
As of 8/15/22, payers will be required to use the new forms and should the old forms be submitted after that date, the Board will take no action.
Copyright © 2023 Hamberger & Weiss LLP