Workers’ Compensation Commission evaluating medical fee schedule changes

Shawn Ashley, eCapitol

The chair of the Workers’ Compensation Commission hopes to see the state move toward a formulaic medical fee schedule and away from an arbitrary schedule.

Former Rep. Mark Liotta, who chairs the commission, said, “We think we should move forward with a plan of small, incremental changes toward a fee schedule that is formulaic, predictable and logical and less arbitrary.”

Liotta was scheduled to discuss the issue Friday at a joint meeting of the commission and its Physician Advisory Committee. The advisory committee meeting, however, had to be cancelled when it was realized the agenda for the meeting had not been properly posted. The commission was called to order and then adjourned since its agenda called only for it to participate in the advisory committee’s meeting.

The fee schedule determines the maximum amount to be paid by insurers to providers for certain services, Liotta explained. Providers are free to bill more than the amount set on the fee schedule, he added, and in some cases, providers have agreements to provide the service at a lower rate.

The current fee schedule, which was adopted by administrative rule, originally was implemented in 2012 by the Workers’ Compensation Court administrator. The court is now known as the Workers’ Compensation Court of Existing Claims and deals only with those claims filed before the commission came into existence in 2014.

In his prepared remarks, Liotta said, “…it is my evaluation our fee schedule is the produce of many historical legislative efforts which included the various medical disciplines and is, in effect, arbitrary with no logical formulaic basis.”

Liotta wrote in his prepared remarks that 38 states have chosen a structure that is formulaic, predictable, logical and uniform to the extent reasonable and practicable. That is the goal the commission is pursuing, he added.

Liotta suggests the commission “…move forward with a plan of small, incremental changes toward a formula every year, instead of every two years.” That, he wrote, currently is being researched.

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