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Virginia Medical Fee Schedule Now Reality After Decade

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Virginia Medical Fee Schedule Finally Enacted

The lack of a Virginia Medical Fee Schedule has long been a concern of mine and many of the Dominion State’s employers.   Fee schedules do save a large amount of Workers Comp dollars while still ensuring that injured employees receive the best medical care possible.

medical billing Virginia Workers Comp Fee Schedule Infographic
Wikimedia Commons – Dynamas2002

I covered the lack of a Virginia medical fee schedule in a number of articles.  Some of the articles were:

WCRI  (Workers Compensation Research Institute) and NCCI agree that Medical Fee Schedules Reduce Costs.   Some of the Virginia articles from those two organizations are:

The Virginia Workers Compensation Commission:

Hand Presenting Virginia Medical Fee Schedule People Icon Around The Small Globe
StockUnlimited

HB378  Workers’ compensation; fee schedules for medical services directs the Workers’ Compensation Commission to adopt regulations establishing fee schedules setting the maximum pecuniary liability of the employer for medical services provided to an injured person pursuant to the Virginia Workers’ Compensation Act, in the absence of a contract under which the provider has agreed to accept a specified amount for the medical service. The regulations implementing the fee schedules shall become effective on January 1, 2018.

If one wants to read about the full Virginia Fee Schedule timeline, click here.

According to the Summary on HB378, some of the concerns on the Virginia Fee Schedule are:

  • PPO Networking Stacking
  • The required reimbursement will be 100 percent of the provider’s charges if the employer unsuccessfully contests the compensability of the claim.
  • Pharmaceutical and Durable Medical Equipment Costs

Sometime in 2019, I will publish an article on the effects of HB378.

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4 Responses

  1. Hey there! I know this iss kinda off topic however , I’d figured I’d ask.

    Would you bee interested in exchanging links or maybe guest writing a blog post or vice-versa?
    My sire discusses a lot off the same subjects as yours and I thiink we could greatly benefit from each other.

    If you are interested feel frree to shoot me an e-mail.
    I look forward to hearing from you! Superb blog by the way!

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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