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.
I covered the lack of a Virginia medical fee schedule in a number of articles. Some of the articles were:
- Virginia Medical Fee Schedule Hell May Freeze Over After All
- Lack of Virginia Fee Schedule Expensive for Employer – WCRI
- Virginia Rule 14 – Is It A Fee Schedule
WCRI (Workers Compensation Research Institute) and NCCI agree that Medical Fee Schedules Reduce Costs. Some of the Virginia articles from those two organizations are:
- Medical Fee Schedules – 43 State WCRI Report
- Virginia’s Decision on Medical Fee Schedules -Do Nothing Cost Employers Extra 13%
- Virginia Has The Highest Medical Cost Per Claim
The Virginia Workers Compensation Commission:
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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