US Labor Department proposes new rule to modernize medical benefits payments under Black Lung Benefits Act

WASHINGTON – The U.S. Department of Labor’s Office of Workers’ Compensation Programs has proposed a rule under the Black Lung Benefits Act to modernize the department’s payment of medical treatment benefits for totally disabled coal miners. The rule would more closely align payments with industry standards and streamline bill processing.

The act provides compensation to miners whose pneumoconiosis, commonly called black lung disease, has left them totally disabled. Miners awarded disability benefits are also entitled to medical services and supplies needed to treat their disease. The Black Lung Disability Trust Fund pays medical benefits when there is no liable coal mine company or when the liable company either cannot or does not pay.

Current regulations require the fund to pay for medical services at prevailing community rates, but do not prescribe how those rates are determined. Historically, OWCP’s Division of Coal Mine Workers’ Compensation relied on internally derived payment formulas to compensate hospitals and other medical professionals. These formulas have now fallen out of date.

The proposed regulations would adopt modern payment formulas derived from those used by Medicare. These formulas are consistent with industry standards and similar to those used by other OWCP-administered compensation programs for federal employees and certain energy-sector employees. The proposed rule would also codify the black lung program’s current practice for prescription drug payments. Finally, the rule would clarify fees paid to providers and payment procedures, which OWCP believes will speed bill processing and payment.

“The proposed changes to modernize medical benefit payments are important steps toward ensuring that medical providers who treat disabled coal miners are compensated for their services appropriately and promptly,” said Office of Workers’ Compensation Programs Director Leonard Howie. “Miners entitled to benefits will continue to receive the medical care they need under the proposed rules. We have listened to our stakeholders, and our goal is to work with all parties involved to improve the black lung claims process and the delivery of benefits to our nation’s miners.”

The proposed rule is available today at the Federal Register here.

The mission of the Division of Coal Mine Workers’ Compensation is to administer claims filed under the Black Lung Benefits Act. The Act provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, survivors of miners whose death was attributable to or hastened by pneumoconiosis, and survivors of miners who were entitled to benefits at the time of their death. The Act also provides eligible miners with coverage for medical treatment of lung diseases arising out of coal mine employment. More information is available at: http://www.dol.gov/owcp/dcmwc/