New Virginia Medical Fee Schedule Active on January 1, 2018
The new Virginia medical fee schedule for Workers Compensation commences in a few weeks. I actually thought it would not happen for another few years. The new Virginia medical fee schedule leaves just four states that do not have medical fee schedules. For instance, Wisconsin has no medical fee schedule and the Badger State has some of the highest medical charges in the nation for Workers Comp.
I thought a visit to the Virginia Department of Workers Compensation website would be appropriate. The fee schedule FAQ can be found here. The file is a PDF file.
Some of the highlights from the fee schedule FAQ are:
No retroactive charges on old claims –
When will the MFS become effective? The regulations implementing the fee schedule shall become effective January 1, 2018 and apply to health care services provided to an injured worker for any dates of service on or after this date, regardless of the date of injury
A PPO agreement can exceed the Fee Schedule
What if the contract or network agreement reimbursement is lesser or greater than the Medical Fee Schedule for the medical services I provide? The amount agreed upon by all parties to the contract for reimbursement of fee scheduled medical service may be less than or exceed the maximum fee amount.
The PPO network does not need to be listed (? – I think) but it should be regardless
What if I access a preferred provider network (PPO), does it need to be listed on the EOR to be reimbursed? The MFS applies in the absence of a contract.
I am sure that WCRI (Workers Comp Research Institute) will produce very interesting numbers soon on the change.
The complete new Virginia Fee Schedule can be found here. The new Virginia medical fee schedule will be adjusted at the end of the first year with a three month grace period.
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