The Workers’ Compensation Board is in the process of building a new online business information system, OnBoard, which will eventually replace the Board’s legacy paper-based claims systems and the eCase system with a single, web-based platform. OnBoard will provide stakeholders with increased accuracy, paperless transactions and a user-friendly interface for interacting with the Board.
OnBoard: Limited Release, the first phase of OnBoard, will be implemented on March 7, 2022. Attorneys should be aware of some key dates and updates ahead of the phased launch of OnBoard: Limited Release.
For complete details about OnBoard: Limited Release, see Subject Number 046-1497, OnBoard: Limited Release Implementation Update for Attorneys.
OnBoard: Limited Release (OBLR), which will roll out in three phases, is designed to move several key processes for health care providers and insurers from paper to online. This includes the prior authorization request (PAR) process for medication, durable medical equipment, and medical treatment or testing. It also includes the submission of Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0) within OBLR.
The first phase to launch is explained in detail below, but here is a quick look at the full implementation schedule:
Phase One
|
Medication PARs & Form HP-1.0
|
March 7, 2022
|
Phase Two
|
Durable Medical Equipment PARs
|
April 4, 2022
|
Phase Three
|
Treatment/Testing PARs
|
May 2, 2022
|
Medication PARs will be used for medication requests (replacing the current New York Workers’ Compensation Drug Formulary [Drug Formulary] prior authorization request process). With the implementation of OnBoard: Limited Release Phase One, medical marijuana will also be requested via a Medication PAR, which will replace the current process using the Attending Doctor’s Request for Approval of Variance and Carrier's Response (Form MG-2).
Drug Formulary
It is important to note that the current Drug Formulary application within the Medical Portal will not be accessible as of 5 p.m. on Friday, March 4, 2022, but will be available again as “read-only” on March 7, 2022, so that previously approved medication requests may be reviewed. All prior authorization requests that are in progress as of 5 p.m. on March 4, 2022, will be suspended and converted to a Medication PAR within OnBoard: Limited Release. Processing will continue in OBLR as of 7 a.m. on Monday, March 7, 2022.
Refills and renewals of prescription medications must comply with the Drug Formulary as of March 7, 2022, when the OBLR Medication PAR process takes effect. As communicated in Subject Number 046-1408, the effective dates were previously amended to coincide with the launch of OnBoard: Limited Release.
Form HP-1.0
As of March 7, 2022, health care providers will request Board action on unpaid medical bills by submitting Form HP-1.0 online, ensuring accuracy and timely receipt. For now, health care providers will continue to receive administrative and arbitration awards by mail, and the objection and judgement processes will remain paper based.
Although attorneys will not be users of OnBoard: Limited Release, PARs and supporting documentation will be saved to the injured worker’s case folder in eCase. Attorneys should register for eCase, if they haven’t done so already. To register for eCase, go to wcb.ny.gov and select the eCase icon on the home page.
Current C-4AUTH, HP-1, MG-1 and MG-2 Forms
The C-4AUTH, HP-1, MG-1 and MG-2 forms will become obsolete with the implementation of OBLR and new requests from providers will not be accepted after the launch date of the corresponding functionality in the system. For Form HP-1, that date is March 7, 2022, and for the C-4AUTH, MG-1 and MG-2 forms, that date is May 2, 2022.
Payer responses to C-4AUTH, MG-1 and MG-2 forms submitted prior to May 2, 2022, will continue to be accepted and those requests will follow the existing process.
Providers should not submit Medication and/or DME PARs with other medical requests on paper forms. If the Board identifies an improper submission, it will not be moved forward.
Request for Further Action (RFA) Forms
The Board will start accepting the new versions of the RFA forms (Form RFA-2, Form RFA-1LC and Form RFA-1W) on May 2, 2022. Their use will become mandatory on June 6, 2022.
- After registering for eCase, claimant attorneys should sign up for email notifications. If an attorney is assigned an R Number, has an email address in their profile and is associated/on notice to the claim when a PAR is filed, they will receive an email alerting them of most actions, and directing them to review the document in eCase.
- Claimant attorneys should check with their eCase administrator to ensure that they have added a notification email to their eCase administrator page. For instructions on how to do this, visit the eCase Online Administrator’s page.
- Prepare for the handling of email notifications that will be sent to the firm’s email identified in eCase. See Claimant Attorney Email Notifications for information on the structure of email subject lines.
-
Orders of the Chair will be generated automatically if the insurer fails to respond within the designated time frame, with few exceptions. This will greatly reduce the need for claimants and claimant attorneys to track and follow up on Orders of the Chair.
- Claimant attorneys can submit a Request for Further Action by Legal Counsel (Form RFA-1LC) for a variety of circumstances and PAR types. The Form RFA-1LC process will remain the same as it is today and is not part of OnBoard: Limited Release. For full details on this process, see the fact sheet for claimant attorneys at wcb.ny.gov/onboard.
- PARs will be assigned to the insurer’s claim administrator or, if there is more than one, the claim administrator who made the most recent First or Subsequent Report of Injury (FROI/SROI) filing for the claim. Claim administrators can also assign users access to PARs.
- If there are no FROI/SROI filings, then the Board will assign the PAR to one of the insurer’s claim administrators, who must respond.
- PARs cannot be reassigned among claim administrators.
- Failure to respond timely may result in an Order of the Chair. Orders of the Chair will be generated automatically if the insurer fails to respond within the designated time frame, with few exceptions. Orders of the Chair are final, may include a penalty and cannot be objected to.
The Board will be hosting an OnBoard: Limited Release webinar for claimant and insurer attorneys. This webinar will feature what attorneys need to know as we approach the launch of OnBoard: Limited Release. Registration is not required, but take a moment to add the webinar to your calendar using the link below. If you cannot attend the webinar, the full session will be recorded and made available on the Board’s YouTube channel and resources page.
February 18, 2022 12:00 p.m. - 1:00 p.m. Add to your calendar Join webinar
Additional Resources
|