IWCC Releases 2012 Fee Schedules

The IWCC stated at the December Medical Fee Advisory Board meeting that the Year 2012 rates would not be available until 12/31/11, but both the new rates and data specifications for downloading the rates are now available on the IWCC's website.

The IWCC updated the medical fee schedule lookup with the new 2012 hospital and non-hospital fee schedule regions.  Since the current and previous years' fee schedules are based on the geozip regions, they are still available under the Archived Fee Schedules 2006 through 2011 tab on the main screen.

Current fee schedule lookup



New fee schedule lookup

Both the IWCC's Rules and Instructions and Guidelines for treatment on or after 9/1/11 are still in process and not available at this time.  A draft version was presented at the December Medical Fee Advisory Board meeting, and at that time, the Secretary of the Commission, Kimberly Janas, requested comments on the draft version.

Arbitrator and 1/1/2012 Fee Schedule Updates

2012 Fee Schedule Region Update
The new IWCC fee schedule regions, and their recalculated fee schedule amounts, become effective on 1/1/2012.  The regions are moving from geozip-based to region/county-based. Per the IWCC Medical Fee Advisory Board's December meeting, the new fee schedule reprice amounts and finalized medical fee schedule lookup will not be publicly available until Saturday, 12/31/2011.

We are currently attempting to confirm the exact data file layout format, and if there will be any sort of geozip to region crosswalk, with Glen Boyle and the IWCC. 

Arbitrator Jutila's case reassignments
The IWCC updated its case reassignment schedule for January 2012.

Effective January 1, 2012, Arbitrator Jutila's cases will be reassigned among the three Region 6 arbitrators: Arbitrators Fratianni, Kinnaman, and O'Malley. Accordingly, the January call, scheduled for Dec. 29, has been cancelled. Corrected notices will be sent.

Send settlement contracts to either of the current Chicago arbitrators (in January, Arbitrator Fratianni or O'Malley). Arb. Williams will still hear Jutila cases during his December trial cycle.

Arbitrator Jutila Passed Away

The IWCC announced the passing of Arbitrator Jerry Jutila on Thursday:

We are sorry to announce that Arbitrator Jerry Jutila passed away today. Jerry joined the Commission as an arbitrator in 2004, served as acting chairman in 2008, then returned to his arbitrator position. He was widely respected as an intelligent, thoughtful, and fair person.

While he struggled with his illness, he worked on a document, "Lessons Learned on the Eighth Floor," intended to help train the new arbitrators. It was just distributed to arbitrators this past week.

Full of practical advice, writing tips, humor, and gentle guidance ("Listen to the other side." "We are public servants and have a duty to be helpful."), he told arbitrators, "At the end of the day, you are going to derive a great deal of satisfaction" from helping people resolve conflicts. The document is a fitting reflection of Jerry's character.

Before coming to the Commission, Jerry represented injured workers for decades, at the firms May, Decker and Associates; Collins, Jutila and Shovlain; and Gibson and Kopsick.

He was a Life Fellow of the Illinois State Bar Association since 1996 and was a member of numerous professional law associations.

Jerry was honorably discharged from the U.S. Air Force Security Service, where he served as Staff Sergeant and Intelligence Analyst.

Our sympathies go to Jerry's wife, Barb, and their extended circle. His passing is an enormous loss.

IWCC December Updates

The IWCC's Medical Fee Advisory Board meeting is scheduled for Wednesday, December 7 at 2pm.  Currently, the only identified topic of discussion on the agenda is a status update on the changes to the medical fee schedule. 

We did send an inquiry to Glen Boyle regarding the posting of the new fee schedule regions' rates on the IWCC website.  Per his response, the anticipated release timeframe should be the end of this week.  We will verify this is still the release schedule at the Board meeting on Wednesday.

IWCC issues impairment ratings to the arbitrators
The Commission voted to provide recommendations to its arbitrators regarding the use of the American Medical Association impairment ratings in the determination of permanent partial disability awards.

Section 8.1b of HB 1698/Public Act 097-0018 included the following language:

...The most current edition of the American Medical Association's "Guides to the Evaluation of Permanent Impairment" shall be used by the physician in determining the level of impairment.

The Commission issued a memo to arbitrators regarding the use of the AMA impairment ratings. It includes the following guidance:

1. An impairment report is not required to be submitted by the parties with a settlement contract. 
2. If an impairment rating is not entered into evidence, the Arbitrator is not precluded from entering a finding of disability.

NCCI's IWCC Presentation

On Wednesday, November 30, NCCI (National Council on Compensation Insurance, Inc) presented an overview of both the Illinois and national workers' compensation markets for the IWCC Advisory Board and Medical Fee Advisory Board. 

This presentation, by Terri Robinson and Karen Ayres, was a slightly condensed version of the 2011 Illinois State Advisory Forum report NCCI released in October at its Rosemont, IL meeting. 

During Wednesday's meeting, many of the questions and comments from the audience revolved around NCCI's recommended -8.8% advisory premium rate adjustment on 9/1/2011.  HB 1698/Public Act 097-0018 required NCCI to file revised rates and loss costs by September 1, and the Illinois Department of Insurance approved that rate reduction. 

According to the presentation, while NCCI stated that many of HB 1698's modifications to the workers' comp system should lower system costs, it could only quantify a few of those changes with the information available and the required deadline to recommend a new premium rate.  The actuaries at NCCI calculated that the following reforms would reduce the overall workers' compensation costs for Illinois by 8.8%:

• the 30% fee schedule reduction                     -7.4%
• the changes to the wage differential benefits   -0.8%
• the changes to PPD carpal tunnel benefits       -0.6%  

NCCI has also filed its annual rate update, a 3.5% increase, with the IDOI for 1/1/2012.  NCCI's 1/1/2012 rate updates for neighboring states: 

• Indiana:  +2.6%
• Iowa:  +4.4%
• Missouri:  -3.0%

While the Illinois rate increase is 3.5%, that number is misleading when compared to its neighboring states.  Unlike those states, the Illinois rate increase is calculated off the 9/1/2011 rates, rather than the 1/1/2011 rates. 

Taking into account the -8.8% reduction to the rates on 9/1/2011, the recommended 3.5% increase to the Illinois rates equate to a rate reduction of -5.3% from the 1/1/2011 rates for Illinois.

The full NCCI Illinois State Advisory Forum report is available on the NCCI website.

NCCI's Illinois Insurance Market Presentation

On Wednesday, November 30, the National Council on Compensation Insurance (NCCI) will present its findings concerning the state of both the Illinois and national workers' compensation insurance markets to the IWCC's Medical Fee Advisory Board.

In response to the passage of HB 1698/Public Act 097-0018, NCCI filed, and the Illinois Department of Insurance approved, an 8.8% decrease in the voluntary advisory insurance rates effective 9/1/11.  However, in September, NCCI requested a 3.5% increase for the 2012 rates. This Business Insurance article from October provides a general overview of the two rate changes.

The NCCI presentation is scheduled for 9:00am in Room 9-040 of the James R. Thompson Center.

IWCC Updated Workplace Notice and SSNs

A couple of short updates about the Illinois Workers' Compensation Commission.

The IWCC posted a new employer workplace notice, which incorporates the PPP into the notification language. The workplace notice now includes the following:

If the employer notifies you that it has an approved Preferred Provider Program for workers’ compensation, the PPP counts as one of your two choices of providers.

The IWCC also announced through its website that it will no longer accept Social Security numbers.

Effective immediately, in response to the Illinois Supreme Court Order M.R. 138, the Commission will no longer collect Social Security numbers. The Social Security field has been eliminated from the application and settlement contract forms. Do not enter the number on existing forms. Please update your electronic forms.  

We will request the SSN in those limited circumstances where the information is necessary, and only then at such time as necessary, e.g., to process payment from the Rate Adjustment Fund or Injured Workers Benefit Fund.  

We will remove the numbers from existing files upon request.

Next IWCC Medical Fee Advisory Board Meetings

The IWCC Medical Fee Advisory Board has two scheduled meetings in the coming weeks.

On Wednesday, November 30, the National Council on Compensation Insurance (NCCI) will provide the Board with a presentation concerning the state of both the Illinois and national workers' compensation insurance markets.  The meeting is scheduled for 9:00am in Room 9-040 of the James R. Thompson Center.

The Board will then meet one week later for its regularly scheduled meeting at 2:00pm on Wednesday, December 7. The IWCC website does not have the meeting agenda posted at this time, but this will be the last scheduled Board meeting before the implementation of the new IWCC fee schedule regions on 1/1/2012. 

1/1/2012 Fee Schedule Region Maps & Update

As covered in previous posts, there are major changes to the IWCC's fee schedule regions coming January 1, 2012. The regions, and the providers' fee schedule amounts, will change in less than 2 months.

While the Medical Fee Advisory Board initially voted to use a weighted average to collapse the geozip regions, Chairman Mitch Weisz announced at the October 18 meeting that the IWCC will utilize a straight average, without weighting, to collapse the current geozip fee schedule amounts into the four Non Hospital and fourteen Hospital regions.  Our September 20 Board Meeting update included two examples of the the geozip collapse utilizing both a weighted average and a straight average methodology. 

The current IWCC fee schedule lookup utilizes the 3 digit geozip; however, the new regions are defined by county, not geozip.  Per our latest conversations with the IWCC, the new medical fee region lookup and rates will not appear on the IWCC website until the end of the year. 

Maps of the new IWCC fee schedule regions

4 Regions: Non Hospital Fee Schedule Amounts

1. Cook County
2. DuPage, Kane, Lake, & Will Counties
3. Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. Clair, & Washington Counties
4. All other counties in the state

14 Regions: Hospital Fee Schedule Amounts

1. Cook, DuPage, Will, Kane, McHenry, DeKalb, Kendall, & Grundy Counties
2. Kankakee County
3. Madison, St. Clair, Macoupin, Clinton, Monroe, Jersey, Bond, & Calhoun Counties
4. Winnebago & Boone Counties
5. Peoria, Tazewell, Woodford, Marshall, & Stark Counties
6. Champaign, Piatt, & Ford Counties
7. Rock Island, Henry, & Mercer Counties
8. Sangamon & Menard Counties
9. McLean County
10. Lake County
11. Macon County
12. Vermilion County
13. Alexander County
14. All other counties in the state

IWCC Arbitrator Reassignment Follow-up

The IWCC posted a follow-up to its arbitrator reassignments. For all questions regarding arbitrators or arbitration, the IWCC’s contact is Bertha Parker. 

Currently, there are three types of arbitrator reassignments:

• Immediate reassignments
• One of HB 1698's initial changes was the termination of the IWCC arbitrators on July 1, 2011; however, they continued to serve pending either reappointment or replacement.
• When Governor Quinn announced his arbitrator appointments in October, John Dibble, Gilberto Galicia, James Giordano, Kathleen Hagan, Robert Lammie, Andrew Nalefski, Richard Peterson and Joseph Prieto were not reappointed, and Charles DeVriendt was instead appointed to the Commission.
• In addition to the initial changes, 2 reappointed arbitrators have recently changed positions, with Ruth White's appointment to the Commission and Jeffrey Tobin's appointment to the Seventh Judicial Circuit.
• The immediate reassignments and call coverage are due to the former arbitrators who were not reappointed.  The IWCC distributed the cases that were tried, but not yet decided, to the current arbitrators to render decisions.
• Temporary assignments
• Arbitrators Jutila (Chicago) and Neal (Collinsville) are out on medical leave, so the IWCC is assigning arbitrators to cover these calls.
• January 1, 2012 reassignments
• Effective January 1, 2012, the current 24 arbitrator territories reduce to 17 territories, and a combination of three arbitrators will rotate through each territory.  According to the IWCC's announcement:

For the rest of 2011, the current arbitrator assignments are still in place. These reassignments should not impair parties' ability to move their cases in November and December 2011. There is no need to cancel scheduled trials.

IWCC Arbitrator & Commissioners Update

The Illinois Workers' Compensation Commission issued several updates regarding its arbitrators and commissioners in the last week.  Here is a summary of the announcements:

On 11/7/11, Governor Quinn announced Nancy Lindsay's appointment as an IWCC arbitrator and Ruth White's appointment as an IWCC commissioner.

Nancy Lindsay served as a commissioner since 2006 and was most recently the employer representative on Panel B. As an arbitrator, her hearing sites will be Springfield and Quincy.

Ruth White served as an arbitrator for over 30 years, and she was recently reappointed by Governor Quinn to a one year term.  She will now serve as the employer representative commissioner on Panel B.

Arbitrator Jeffrey E. Tobin was recently appointed to the Seventh Judicial Circuit for the Jacksonville area, and he will no longer hear workers' compensation cases. He served as an IWCC arbitrator since 2004, and he was recently reappointed by Governor Quinn to a two year term.  

The IWCC posted the 2011 coverage schedules for the former arbitrators' calls, and the 2012 arbitrators' schedules are also available at this time.

IWCC Posts PPP Notification Form

HB 1698 contained several requirements for the creation of Illinois workers' compensation preferred provider programs (PPPs). One of those requirements was an employee PPP notification form promulgated by the Illinois Workers' Compensation Commission (IWCC). An employer with an Illinois Department of Insurance-approved PPP must provide an injured employee with the notification form at the first report of injury.

The IWCC Medical Fee Advisory Board approved a draft version of that form at its October 18 meeting, and the IWCC website now includes its PPP notification form.

Preferred Provider Program Basic Requirements:

In order for employers to implement the PPP direction of care process, HB 1698 lists two basic requirements:

1. The IWCC must promulgate a notification form that the employer will provide to an employee at the time of injury. This form is now available on the IWCC website. 
2. The PPP must be approved by the Illinois Department of Insurance (IDOI). HFN recently confirmed with the Illinois Department of Insurance (IDOI) that there are no approved or provisionally approved workers' comp PPPs. The IDOI has a link on their website of approved workers' compensation Preferred Provider Program Administrators. That list is the source for all approved workers' compensation PPPs in the state of Illinois, and currently it reads, "No Companies have been approved at this time." There is also a permanent link to the IDOI approved list located on the lower right of this blog under the heading Illinois Dept. of Insurance Registered Administrators.

We will continue to provide PPP updates as the IDOI finalizes its regulations and moves towards approving the preferred provider program applications currently under Department review.

IWCC Approves PPP Notification Form & Changes Fee Schedule Regions

There were two major announcements that came out of the IWCC Medical Fee Advisory Board's October 18 meeting.

First, the Board approved its HB 1698-mandated Preferred Provider Program (PPP) employee notification form. The Board made a final change to the proposed form at the meeting, and it approved the modified form for release to the public. It will be available on the IWCC's website in the near future.

The Medical Fee Advisory Board also approved a second document that will appear on the IWCC's website as well. This document is an example of the type of information employers could provide employees to educate them about a PPP before an injury; however, this particular document is not mandatory.

There is only one IWCC PPP notification form required by HB 1698. After an employee reports an injury, the employer with a PPP must provide the employee with the PPP notification form promulgated by the IWCC. An employer with a PPP is allowed to notify its employees about the program at any time, but an employer with a PPP is required to provide the IWCC's PPP injury notification form to an employee after the employee's report of injury.

Second, the methodology for calculating the new fee schedule regions changed. At the September Medical Fee Advisory Board meeting, the Board voted to utilize a weighted average, by geozip population, to calculate the new 14 hospital regions and 4 non-hospital regions. However, at yesterday's meeting, Chairman Weisz announced that the IWCC will utilize a straight average, without weighting, to collapse the current geozip fee schedule amounts into the 1/1/2012 fee schedule regions. There were no further updates on when the new regions' fee schedule amounts would appear on the IWCC's medical fee schedule lookup.

No IDOI-Approved or Provisionally Approved PPPs

Since we have recently received several inquiries regarding "provisionally approved" workers' compensation preferred provider programs (PPPs), we felt the need for a brief clarification.

HFN confirmed with the Illinois Department of Insurance (IDOI) this morning that there are no applications that have been approved or provisionally approved for use as a Workers’ Compensation Preferred Provider Program.

The IDOI has a link on their website of Approved Workers' Compensation Preferred Provider Program Administrators.  That list is the source for all approved workers' compensation PPPs in the state of Illinois, and currently it reads, "No Companies have been approved at this time."  

There is also a permanent link to the list (Approved Work Comp PPPs) located on the lower right of this blog under the heading Illinois Dept. of Insurance Registered Administrators.

We will provide updates once the IDOI begins to approve PPP applications, but, for the moment, there are no approved (provisionally or otherwise) workers' comp PPPs in the state of Illinois.

Gov. Quinn Appoints Seven to Workers' Compensation Commission

It has been a very busy week keeping up with the changes at the Illinois Workers' Compensation Commission (IWCC). 

On Monday, Governor Quinn's office announced seven appointments (two new Commissioners and five reappointments) to the Workers' Compensation Commission. Three additional Commissioners are currently serving four year terms that are set to expire on January 21, 2013.

Reappointed Commissioners:

• Mario Basurto
• Daniel R. Donohoo
• David L. Gore Jr
• Kevin W. Lamborn
• Nancy H. Lindsay

New Commissioners:

• Charles DeVriendt
• Michael Paul Latz

Currently Serving Commissioners:

• Yolaine Dauphin
• Thomas Tyrrell
• Mitchell Weisz (Chairman)

IWCC Posts Coverage Schedule for Former Arbitrators' Calls

Since Gov. Quinn appointed the new IL workers' compensation arbitrators on Friday, the IWCC needs to reassign the former arbitrators' current cases.  The IWCC website now has the coverage schedule for the calls of the former arbitrators. 

In its News section, the IWCC's website states

...Finally, please be aware that we are in the process of consolidating 24 arbitrator territories to 17, reassigning 85,000 cases among the newly appointed arbitrators, and switching our continuance schedule from two months to three months. It is an enormous undertaking, and we are doing this with a 30-year-old mainframe system. We are doing everything we can to make this a smooth transition, but please expect some bumps in the road. Check this website frequently for announcements regarding changes in calls or trials. We will appreciate your understanding and patience. If you have questions, please contact the Chairman's Office (312/814-6560).

IWCC Medical Fee Advisory Board Meeting Reminder

The IWCC Medical Fee Advisory Board's next meeting is Tuesday, October 18 at 2pm. The Board meeting will take place in room 9-034 at the Thompson Center.

The agenda includes both a status update on the new hospital and non-hospital region fee schedules and the preferred provider program (PPP) notification form.

At the September Medical Fee Advisory Board meeting, Mitch Weisz, the IWCC Chairman, stated that their goal was to have a finalized version of the PPP notification form available to the public by early October.

As of this morning (October 17), the IWCC website stated:

When an employee notifies the employer of an injury, an employer that has a PPP must notify the employee of this in writing. The Workers' Compensation Medical Fee Advisory Board is exchanging draft versions of the PPP notification letter. We will post it once it is completed.

We will provide any updates regarding the PPP notification form, and any other topics covered at the Board meeting, later this week.

NCCI Requests IL Rate Increase for Next Year

In addition to the announcement of the new Illinois workers' compensation arbitrator appointments, there is another update regarding the Illinois workers' compensation landscape.

Business Insurance posted an article that details NCCI Holding's request with the Illinois Department of Insurance for a 3.5% workers' compensation rate increase next year. 

Gov. Quinn Appoints New Arbitrators

Governor Quinn announced the new Illinois workers' compensation arbitrator appointments this afternoon.

One of the first changes resulting from HB 1698 was the termination of the Workers’ Compensation Commission arbitrators for the State of Illinois on July 1, 2011. The IWCC's Workers' Compensation Advisory Board was charged with advising Governor Quinn on arbitrator appointments and reappointments.

According to the press release, 10 former arbitrators were not reappointed by Governor Quinn. They include:

• John Dibble, Gilberto Galicia, James Giordano, Kathleen Hagan, Robert Lammie, Andrew Nalefski, Richard Peterson and Joseph Prieto.
• Charles DeVriendt will be appointed to the Commission instead.
• Jennifer Teague, a former arbitrator who resigned as of July 30, 2011.

New Illinois workers' compensation arbitrators are:

IL Preferred Provider Programs (PPPs) Approval Process Update

There seems to be a growing consensus that the Illinois Department of Insurance (IDOI) approval process for the new workers’ compensation preferred provider programs (PPPs) could continue through the rest of 2011. Employers would have the ability to designate an IDOI-approved PPP in early 2012. This article from Business Insurance supports our recent conversations with the IDOI regarding the PPP approval timeframe.

After receiving comments from interested parties on its draft rule, the IDOI is currently reviewing and evaluating the comments in order to create the administrative rules that will finalize the criteria required for IDOI PPP approval. The timeframe is also dependent on the Joint Committee on Administrative Rules’ (JCAR) schedule. JCAR provides an overview of the IL rulemaking process on its website.

For networks, like HFN, currently awaiting final review in the IDOI’s PPP process, the release of the draft rule, and eventually the finalized administrative rules, is the final step towards establishing compliance with the IDOI and gaining its approval for their PPPs.

IWCC's Fiscal Year 2010 Annual Report

The Illinois Workers' Compensation Commission (IWCC) released their Annual Report for Fiscal Year 2010.

While the report briefly mentions this year's reforms to the IL workers' comp system, it mostly summarizes the system pre-HB 1698. 

Beginning on page 21, the report provides an interstate comparison of workers' compensation metrics. Many of the metrics come directly from reports by various sources including the Workers’ Compensation Research Institute (WCRI), the National Council on Compensation Insurance (NCCI), and the 2010 Oregon Workers’ Compensation Premium Rate Ranking Report.

The Oregon study, when it was released in October of 2010, showed that Illinois' workers' compensation insurance premiums increased from 2004 to 2010.  That moved Illinois from the 23rd highest state in 2004 to the 3rd highest state in 2010 for insurance costs. 

The reform measures included in HB 1698 prompted NCCI to file for an 8.8% decrease in Illinois' voluntary advisory insurance rates effective 9/1/11.  It will be interesting to see where Illinois ranks when Oregon releases its next study, if that rate modification is included in the report.

IDOI-Approved PPP & PPA Links

We now have permanent direct links to the Illinois Department of Insurance’s lists of approved PPPs and PPAs.  The links will remain on the lower right side of the blog under the heading Illinois Dept. of Insurance Registered Administrators.

PPP Approval Process Clarification

We have received several inquiries in the last couple of days regarding the Illinois Department of Insurance (IDOI) workers' compensation preferred provider program (PPP) approval process.  There seems to be confusion over whether the IDOI has begun to approve PPP applications.  As of our conversation with the IDOI this morning, the Department has not approved any PPP applications.

HFN submitted an application to become an IDOI-approved PPP, and it is still in process with the Department.  We do not have a definitive time frame on when the IDOI will complete its review and approval process. 

The IDOI does have a new approved PPP report on its website.  The report reads, as of 1:30pm on September 26, "No Companies have been approved at this time."

We will continue to provide PPP updates on both the IDOI approval process and the IWCC notification form as the preferred provider program development process continues in the state of Illinois.

IWCC Fee Schedule Region Recalculation Update

The main issue on the agenda at the most recent IWCC Medical Fee Advisory Board meeting, besides the PPP notification form, was a final decision on the fee schedule calculations for the HB 1698-mandated new fee schedule regions.

During the August 23 meeting, the Board narrowed the potential calculation methodologies down to two options: 

1. A straight average of all the included geozips' reprice amounts for each code
2. A weighted average, by geozip population, of all the included geozips' reprice amounts for each code

After that meeting, Glen Boyle and his team ran additional calculations and examples for the two methodologies.  He presented that analysis to the Board at the meeting last Tuesday, September 20.

There was a great deal of debate over legislative intent in regard to whether the calculations for the new regions' fee schedule amounts had to maintain the 30% rate reduction that took effect on 9/1/2011.  By collapsing geozips into new regions and averaging the different geozip fee schedule amounts, some providers will see additional reductions to their current fee schedule base rates, while others in the same region will see their base rates increase.

IWCC's PPP Notification Form Update

The newly appointed IWCC Medical Fee Advisory Board met on Tuesday to discuss both the Preferred Provider Program (PPP) notification form and the potential rate recalculation formulas for the new fee schedule regions effective 1/1/2012.  This post will deal specifically with the PPP notification form.

PPP Notification Form

Once Governor Quinn signed HB 1698 into law, Illinois employers gained the ability to employ a Preferred Provider Program (PPP) to direct their injured workers to participating providers for treatment. In order for employers to implement the PPP direction of care process, HB 1698 lists two basic requirements:

1. The PPP must be approved by the Illinois Department of Insurance (IDOI).
• There is a difference between current IDOI–approved Preferred Provider Program Administrators (PPAs) and the new workers’ compensation Preferred Provider Programs (PPPs).  See our previous PPP updates here & here for more information.
• The IDOI is currently accepting and actively reviewing PPP applications.  We anticipate that the Department will begin to announce approved PPPs in the near future.
2. The Illinois Workers’ Compensation Commission (IWCC) must promulgate a notification form that the employer will provide to an employee at the time of injury.

The Medical Fee Advisory Board did not come to a consensus regarding the PPP notification form.  There was a potential form distributed at the beginning of the meeting and alternative versions were presented during the course of the discussion.
 
The Board recommends that the final version of the form remains a one page document, but there was a great deal of discussion regarding the language and phrasing for that form.  The objective of the form is to provide an injured employee with the necessary PPP information, contact information, and options regarding opting out of the PPP in a clear and concise manner that will help explain a process that will be foreign to most workers when they are injured on the job. The specific wording to accommodate that objective is still under debate. The Board members are going to review the different versions of the form and recommend changes over the next two weeks.

Mitch Weisz, the IWCC Chairman, stated that their goal was to have a finalized version available to the public by early October. 

IWCC Announces Increase to Fee Schedule Rates for 2012

The IWCC announced today that the 2012 medical fee schedule rates will increase 3.77%. The Illinois Workers’ Compensation Act requires the IWCC to update the medical fee schedule rates by the percentage change in the Consumer Price Index-U (CPI-U) during the previous year.

On September 1, 2011, the IWCC implemented a straight 30% decrease in the medical fee schedule rates, as required by HB 1698/Public Act 097-0018.

While the rates will increase by 3.77% for 2012, HB 1698/Public Act 097-0018 also mandates a complete restructuring of the medical fee schedule regions in Illinois. The full impact of this fee schedule region restructuring and rate recalculation is unknown until the Medical Fee Advisory Board makes a final decision on the recalculation methodology.

The new hospital & non-hospital regions were the main topic of discussion at the August 23 Medical Fee Advisory Board meeting, and the Board narrowed the possible rate recalculation methodologies down to two options.

The agenda for the Board meeting on September 20 at 9am includes the collapsing of the geo-zips. Glen Boyle and his team were going to have full samples of both recalculation scenarios for the Board to determine the new regions’ medical fee schedule rates for 2012.

We will provide a full update on the Board’s decisions regarding the new fee schedule regions after the meeting on Tuesday.

Gov. Quinn appoints new IWCC Medical Fee Advisory Board & Board Meeting Postponed

The IWCC Workers’ Compensation Medical Fee Advisory Board meeting on September 13 was postponed until next Tuesday, September 20 at 9am.  The agenda on the IWCC website remains the same for the next meeting, so the Board will address both the new fee schedule regions and the PPP notification form on the 20^th.

The IWCC announced that Governor Quinn appointed new members to the Workers’ Compensation Medical Fee Advisory Board.  The Board members serve four year terms.  The Board will have six new representatives serving alongside returning members Kim Moreland (Rising Medical Solutions) and John Smolk (United Airlines).

The new Workers’ Compensation Medical Fee Advisory Board:

Employee Representatives:

Jason Keller (Illinois AFL-CIO)
Dianne McGuire (College of DuPage Trustee)
vacant employee representative slot

Employer Representatives:

Barb Molloy (Molloy Consulting)
Kim Moreland (Rising Medical Solutions)
John Smolk (United Airlines)

Medical Provider Representatives:

Avi Bernstein, MD (The Spine Center)
William McAndrew (Illinois Hospital Association)
Michael Vender, MD (Hand Surgery Associates)

IWCC Medical Fee Advisory Board September Meeting

The IWCC Workers’ Compensation Medical Fee Advisory Board meeting is Tuesday, September 13 at 1:00pm. The meeting is scheduled for the James R. Thompson Center (100 W Randolph St, Chicago) in Room 9-034.

The current agenda includes an update from Glen Boyle regarding both potential geozip collapsing scenarios discussed at the Board meeting on August 23. His team was going run an extended analysis for the new Hospital and Non-Hospital regions using both recalculation scenarios for the September 13 meeting.

The agenda also includes discussion regarding the HB 1698–mandated IWCC PPP notification form.  The updated note on the IWCC website states

The Department of Insurance is now accepting Preferred Provider Program (PPP) applications. If you have questions, contact Kari Dennison at the Department of Insurance.

The Workers' Compensation Medical Fee Advisory Board is exchanging draft versions of the PPP notification letter. We will post it once it is completed. (revised 9/1/11)

We’ll provide an overview of any updates to the fee schedules, preferred provider program notification form, etc. later this week.

IWCC Posts New Arbitration Regions Effective 1/1/12

The IWCC posted their new downstate arbitration regions & hearing sites.  These new regions will go into effect on January 1, 2012. 

Region                   Hearing Sites

1                        Collinsville, Herrin, Mt. Vernon

2                        Quincy, Springfield, Urbana

3                        Bloomington, Kewanee, Peoria

4                        Geneva, Joliet, Ottawa

5                        Rockford, Waukegan, Woodstock

6                        Wheaton:  3 Chicago arbitrators assigned to the region

The IWCC previously announced a rescheduled judicial training program for October 20-21, 2011, since the appointment &/or reappointment process for the arbitrators may not be complete by mid-September.

NCCI Rate Change & IDOI

The Illinois Department of Insurance website posted a bulletin confirming the NCCI rate change becomes effective on September 1, 2011.

Illinois WC Preferred Provider Program (PPP) Update

An update on the Preferred Provider Program (PPP) process from the August 23^rd IWCC Workers' Compensation Medical Fee Advisory Board:

Once Governor Quinn signed HB 1698 into law, Illinois employers gained the ability to employ a Preferred Provider Program (PPP) to direct their injured workers to participating providers for treatment.  In order for employers to implement the PPP direction of care process, HB 1698 lists two basic requirements:

1.    The PPP must be approved by the Illinois Department of Insurance (IDOI).

2.    The Illinois Workers’ Compensation Commission (IWCC) must promulgate a notification form that the employer will provide to an employee at the time of injury.

During the 8/23/11 IWCC Workers’ Compensation Medical Fee Advisory Board meeting, an Illinois Department of Insurance representative confirmed that the IDOI is ready to accept PPP applications. 

The applications should follow the same format as the current PPA (Preferred Provider Program Administrator) process, and they should include all of the current PPA requirements along with the new PPP requirements specifically outlined in HB 1698.  As of today, the IDOI website does not have a list of approved, or provisionally-approved, WC PPPs on their website. 

Now that some current IDOI–approved workers’ compensation PPAs, such as HFN, have submitted their PPP applications to the state, the IWCC will need to either create a form, or provide employers the required notification criteria, to fulfill its notification form requirement detailed in HB 1698.

As of the 8/23/11 Board meeting, the Commission did not have a draft of the notification form.  The Board members stated any third parties may submit their proposed drafts of notification requirements to the Board before the next scheduled meeting on September 13.   They will discuss the standards for the notification form again at that meeting.

Once that IWCC notification form is available, employers will be able to utilize their PPPs.

As an Illinois-based and Illinois-focused company, HFN understands the requirements and opportunities for providers and employers specific to the Illinois workers’ compensation system.  For more information about the PPP process, or to designate HFN as your PPP, please email Guy Swanson, HFN’s Director of Workers’ Comp, or call 630.990.8609.

IWCC's New Fee Schedule Region Update

Discussions pertaining to the new fee schedule regions took up the vast majority of the IWCC Workers’ Compensation Medical Fee Advisory Board’s meeting on Tuesday.  Here’s an overview of that debate.

The Board passed a motion clarifying that the new regions and reprice amounts will apply to bills with dates of service of 1/1/2012 and later.  Any dates of service before 1/1/2012 will still apply the previous geozip-based fee schedules.

Reminder: IWCC Medical Fee Advisory Board Meeting

The IWCC Workers’ Compensation Medical Fee Advisory Board meeting is Tuesday, August 23 at 9:00am.  The meeting is scheduled for the James R. Thompson Center (100 W Randolph St, Chicago) in Room 9-171.  The current agenda includes an update with Glen Boyle, who the Board tasked with implementing the fee schedule modifications included in HB 1698.  Hopefully, the update will include insight into how his team is going to calculate the rates for the new fee schedule regions effective 1/1/2012.

We’ll provide an overview of any updates to the fee schedules, preferred provider program timeline, etc. later this week.

IWCC Posts New Fee Schedules

The IWCC recently updated their fee schedule tables with the new Illinois workers’ compensation state fee schedule rates effective September 1, 2011.  This is the HB 1698–mandated 30% reduction of all institutional & professional fee schedules in the existing 29 geozip regions.  HB 1698’s additional fee schedule modifications also become effective on September 1.

This update is a straightforward 30% across-the-board reduction utilizing the existing 29 regions; however, the January 1, 2012 fee schedule region modification is a major change that will significantly affect provider reimbursement rates.  That modification is a complete restructuring of the regions and fee schedule calculations that will determine the fee schedule reprice amounts. 

As of the last IWCC Workers' Compensation Medical Fee Advisory Board meeting, the Board had not made a determination on how the fee schedules will be recalculated for the new regions.  Hopefully, the next Board meeting, on August 23, will provide more details on how the 29 existing regions’ fee schedule rates are going to be collapsed into 4 “non-hospital” regions and 14 “hospital” regions.  Until those decisions are finalized, it is impossible to determine the impact of these modifications.  We will report back any updates from the August 23^rd Board meeting next week.

New Illinois Workers’ Comp Fee Schedule Regions

4 Regions for “Non-Hospital Fee Schedule Amounts”

1.    Cook County

2.    DuPage, Kane, Lake, & Will Counties

3.    Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. Clair, & Washington Counties (southwestern Illinois counties across the Mississippi River from St. Louis)

4.    All other counties in the state

14 Regions for “Hospital Fee Schedule Amounts”

1.     Cook, DuPage, Will, Kane, McHenry, DeKalb, Kendall, & Grundy Counties

2.     Kankakee County

3.     Madison, St. Clair, Macoupin, Clinton, Monroe, Jersey, Bond, & Calhoun Counties

4.     Winnebago & Boone Counties

5.     Peoria, Tazewell, Woodford, Marshall, & Stark Counties

6.     Champaign, Piatt, & Ford Counties

7.     Rock Island, Henry, & Mercer Counties

8.     Sangamon & Menard Counties

9.     McLean County

10. Lake County

11. Macon County

12. Vermilion County

13. Alexander County

14. All other counties in the state

Governor Quinn Signs WC Forcible Felony/Reckless Homicide Reform Bill

Governor Quinn signed SB 1147/Public Act 097-0276 into law on Monday.  The legislation excludes injured employees from receiving workers’ compensation benefits if their claim resulted during the commission of a forcible felony, a reckless homicide, or aggravated driving under the influence of alcohol or drugs.  The law comes as a response to the State Trooper Matt Mitchell case, detailed in the Chicago Tribune & Belleville News-Democrat. 

These changes are in addition to the intoxication defense reforms included in HB 1698 (820 ILCS 305/11) as part of that overarching WC reform bill. Those changes include:

·         The measurement of intoxication is .08 for alcohol or any finding of illegal drugs.

·         The burden of proof shifts to the employee in the new law.

·         The law outlines the collection & testing processes and procedures for determination of intoxication.

While SB 1147’s reforms became effective on Monday, the HB 1698 changes only apply to injuries that occur on or after 9/1/11.

Workers' Compensation Reform Seminar

On Tuesday, August 30, HFN’s President & CEO David Kolb will take part in a panel in Oak Brook addressing the significance of new Illinois workers’ compensation legislation. Mr. Kolb will specifically detail the benefits, challenges, and current status of the new Department of Insurance–approved WC preferred provider program. 

Click here for more information about the seminar and how to RSVP to this event.

Federal Judge Denies Illinois Arbitrators’ Motion

The Belleville News-Democrat reported Saturday that U.S. District Judge Sue E. Myerscough denied the temporary restraining order requested by five Illinois workers’ comp arbitrators in federal court.  As we discussed previously, HB 1698 included a provision that terminated all of the Illinois workers’ compensation arbitrators.  The Governor and the newly appointed Workers’ Compensation Advisory Board are in the process of selecting new, or reappointing previous, arbitrators at this time.

One clarification to the article, as of this morning it states:

…The only arbitrators who will not return are those who do not have a law license, which is a requirement of the reform package. 

While HB 1698 does require that arbitrators are authorized to practice law in Illinois, there is a clause that exempts previously employed arbitrators from that requirement:

Each arbitrator appointed on or after the effective date of this amendatory Act of the 97^th General Assembly and who has not previously served as an arbitrator for the Commission shall be required to be authorized to practice law in this State by the Supreme Court, and to maintain this authorization throughout his or her term of employment.