IWCC & JCAR December Meeting Schedule

With just over a month remaining in 2012, here are the remaining scheduled IWCC and JCAR meetings for December.

Illinois Workers' Compensation Commission

December 5, 2012 

Self-Insurers Advisory Board

• Thompson Center, 100 W Randolph Street, Chicago
• 10:30am in the 8th Floor Chairman's Conference Room
• Self-Insurers Advisory Board meeting agenda

Workers' Compensation Medical Fee Advisory Board

• Thompson Center, 100 W Randolph Street, Chicago
• 1:00pm in Room 9-039 (9th Floor)
• The agenda for the Advisory Board's December meeting contains several updates including
• a report from Glen Boyle
• a discussion on compounded drugs
• updates on the Rules and Commission
• WC Medical Fee Advisory Board meeting agenda

Joint Committee on Administrative Rules

December 11, 2012

• Michael A Bilandic Building, 160 N LaSalle St, Chicago
• 11:00am in Room 600C
• As of this morning, the December JCAR agenda includes
• One (1) Department of Insurance-proposed rulemaking concerning a Medical Malpractice Data Base
• Medical Malpractice Data Base (50 Ill. Adm. Code 928) proposed 7/6/12 (PDF Page 205)
• No IWCC-proposed rulemakings
• JCAR December meeting agenda

 

WC PPP: Pending Second Notice

As part of the JCAR's First Notice process for the new WC PPP rules, all interested parties were permitted to submit public comments about the proposed regulatory changes to the IDOI up until the June 11, 2012 deadline.

At this point, JCAR has not addressed the modifications to 50 Ill. Adm. Code 2051 with the IDOI at its monthly meetings, and, as of this post, the WC PPP rules are not scheduled on the agenda for the December JCAR meeting.

• Preferred Provider Programs (50 Ill. Adm. Code 2051) proposed 4/27/2012 (PDF Page 286)

IWCC Announces Physician-Dispensed Pharmacy Changes Effective Today

In addition to its updated file viewing process, the Illinois Workers' Compensation Commission also announced that the modification to the physician-dispensed pharmacy reimbursement methodology is effective today, November 20, 2012. 

This change was recently discussed at the General Assembly's Joint Committee on Administrative Rules' November meeting.

The final rule will appear in the December 7, 2012 edition of the Illinois Register.

Issue 33 of JCAR's Illinois Register (PDF page 94) contained the actual updated language that states reimbursement for physician-dispensed prescriptions is based on the original manufacturer's NDC code, not the repackaged NDC code:

10) Prescriptions

A) This schedule applies to prescriptions filled and dispensed outside of a licensed pharmacy.

B) Prescriptions shall be billed at the Average Wholesale Price, plus a dispensing fee of $4.18. [820 ILCS 305/8.2(a-3)]

C) Average Wholesale Price or its equivalent as registered by the National Drug Code shall be set forth for that drug on that date as published in Medispan. [820 ILCS 305/8.2(a-3)]

D) If a prescription has been repackaged, the Average Wholesale Price used to determine the maximum reimbursement shall be the Average Wholesale Price for the underlying drug product, as identified by its National Drug Code from the original labeler.

New IWCC File Request Process

The Illinois Workers' Compensation Commission announced a new process for requesting and viewing case files from the department.

The announcement on the IWCC website states:

Effective immediately, people who wish to view a case file in which they are not a party or attorney of record (petitioner, petitioner’s attorney, respondent, or respondent’s attorney) must submit a Freedom of Information Act (FOIA) request. We will process your request as quickly as possible, but please understand FOIA gives agencies five business days to respond to a request.    

Please email your request to Deputy General Counsel/FOIA Officer, Dennie Michelle Zankel (312/814-8770) and copy Nicholas Velazquez (312/814-6560). Alternately, you may mail requests to 100 W. Randolph Ste 8-200, Chicago, IL 60601. If you have any questions, please contact Ms. Zankel or Mr. Velazquez.      

Parties and attorneys must provide proof of identity (ARDC card and/or valid State ID) before viewing files. Please allow 24 hours for us to process these requests.      

The IWCC is dedicated to protecting the information of all claimants to ensure that information is not compromised under any circumstances.

Approved IWCC Rules Published in the Illinois Register (Updated)

In addition to the new Department of Insurance WC EDI proposed rules published in the Illinois Register today, two final IWCC rules appeared as well. 

As we covered in several previous updates, JCAR issued "Certificates of No Objection" at its September 11, 2012 meeting for two separate Illinois Workers' Compensation Commission administrative code modifications. The IWCC filed them with the Secretary of State, and they appeared in today's (11/16/2012) Illinois Register.  

• Miscellaneous (50 Ill Adm Code 7110) proposed 3/2/12, effective date of rulemaking 11/5/2012 (PDF document pages 217-239)
  • Incorporates all of HB 1698/Public Act 97-18’s modifications and updates to the medical fee schedule reimbursement and methodology rules. (See our previous post with an outline of the major updates)
• Alcohol and Drug Sample Collection and Testing (50 Ill Adm Code 9140) proposed 6/15/12, effective date of rulemaking 11/5/2012 (PDF document pages 240-273)

These rules do not include the physician-dispensed pharmacy modifications, discussed in our previous posts. While that rulemaking is continuing through the process after the November JCAR meeting, that is a separate rulemaking that will be filed and published at a later date.  **Updated 11/20/2012:  the physician-dispensed pharmacy changes are effective 11/20/2012.  Please see this new post regarding these rules.

The IWCC has an update on its website regarding the publication of these rulemakings in the Illinois Register.

DOI Proposed WC EDI Standards

The Illinois Department of Insurance's proposed-rules for workers' compensation electronic claims submission and payment standards appeared in the Illinois Register this morning. 
 
The publication of these proposed rules means that they are now in the Illinois General Assembly's Joint Committee on Administrative Rules' First Notice phase.  Any interested party or member of the public has 45 days from this publication date to submit any questions, issues, or concerns to the Illinois Department of Insurance regarding this rulemaking.
 
From the published proposed rulemaking (PDF pages 5-23):

A Complete Description of the Subjects and Issues Involved: This rule is required to implement the electronic claims provisions contained in Section 8.2a of the Illinois Workers' Compensation Act [820 ILCS 305/8.2a]. The focus of this proposed rule is to provide a legal framework for electronic billing, processing and payment of medical services and products provided to an injured employee and data reporting subject to Section 8.2a.
 

The EDI standards included in the rulemaking cover various types of provider bills, specifically

• Professional billing
• Institutional/Hospital billing
• Dental billing
• Retail Pharmacy billing

The listed IDOI contacts for public comment submission are:

Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Persons who wish to comment on this proposed rulemaking may submit written comments no later than 45 days after the publication of this Notice to: 

         

          Joe Clennon, Staff Attorney
          Illinois Department of Insurance
          320 West Washington St.
          Springfield, IL 62767-0001
          217/557-1396
          217/524-9033 (facsimile)

 

          Susan Anders, Rules Coordinator
          Illinois Department of Insurance
          320 West Washington St.
          Springfield, IL 62767-0001
          217/785-8220



 

IWCC Open House Dates

The Illinois Workers' Compensation Commission (IWCC) announced three dates in 2013 for its open house program.

You are invited to an open house at the Commission's Chicago office on January 17, 2013 (9:00 a.m start); March 14, 2013 (9:00 a.m start); or May 16, 2013 (9:00 a.m start). After an overview of our court process, visitors will observe arbitration hearings and review-level oral arguments. After oral arguments end, there will be a question-and-answer period with commissioners. The program will end around 12 noon.      

If you are interested in a Downstate program, please send an email, indicating the city you prefer and how many people would attend. You are always welcome to observe hearings at any site on your own: see the calendars web page for details.      

There is no charge to attend an open house, but registration is limited. To sign up, please send an email with the subject "open house" and the desired date and city.      

When the Commission announced an open house in Chicago in January 2010, the seats filled up on the day it was announced. Subsequent programs also filled up and have been well-received. In all, over 500 people have signed up to attend. Visitors walk away with a greater understanding of how to interact with the Commission and work with the process.
 

We attended one of the 2012 IWCC open houses, and it is an extremely useful experience, especially for those who have never seen an IWCC hearing or appeal.  The Q&A we attended with several of the commissioners lasted for roughly 20 minutes and covered a wide range of topics. 

JCAR November Update

The Joint Committee on Administrative Rules (JCAR) held its November meeting yesterday. 

Our previous JCAR Administrative Rules update details the IL Workers' Compensation Commission and Department of Insurance pending rulemakings on that agenda. 

While there was discussion regarding the internal process utilized by the IWCC with its physician-dispensed pharmacy reimbursement modification, the IWCC and IDOI rulemakings included on the agenda will continue through the process.  The IWCC and IDOI can  adopt the rules by filing them with the Secretary of State, and the effective dates will appear when published in a future Illinois Register.
 
JCAR's next meeting is currently scheduled for December 11, 2012.  As of this post, the IDOI updates to the insurance code, specifically the WC PPP rules, are not on the December agenda.

 

JCAR November/December Meetings & Pending Updates

The next meeting for the General Assembly's Joint Committee on Administrative Rules (JCAR) is scheduled for Tuesday, November 13, 2012.  The committee meeting begins at 11:00am in Room 600C of the Michael A. Bilandic building in Chicago. 

Both the Illinois Workers' Compensation Commission (IWCC) and Illinois Department of Insurance (IDOI) have several proposed changes and updates to the Administrative Code pending with JCAR.

Since our previous pending-Administrative Code post, the Department of Insurance moved another rulemaking to JCAR's Second Notice; however, the Medical Malpractice Data Base update appears on the agenda for JCAR's December meeting on 12/11/2012.

 

Illinois Workers' Compensation Commission

There are no additional updates since our previous posts. (Click here for the post covering both the JCAR process and the IWCC "Certificate of No Objection" Administrative Code updates pending publication in the Illinois Register)

JCAR Second Notice: November 13 meeting

• Arbitration (50 Ill Adm Code 7030) proposed 8/17/12 (PDF document page 72)
• Miscellaneous (50 Ill Adm Code 7110) proposed 8/17/12 (PDF document page 79)
• Incorporates the updates to the physician-dispensed pharmacy reimbursement methodology (see our previous update for more information)
• Commission Review Board Procedures (50 Ill Adm Code 7500) proposed 8/17/12 (PDF document page 96)
  
  

Illinois Department of Insurance (updated 11/9/12)

JCAR Second Notice: November 13 meeting

2013 IWCC Board Meeting Schedule



The Illinois Workers' Compensation Commission recently posted the dates and locations for its 2013 IWCC Board meetings.  See the chart below for the scheduled locations, dates, and times.

 

As a reminder, the Self-Insurers Advisory Board and the Workers' Compensation Medical Fee Advisory Board both have a final 2012 meeting scheduled for 12/5/2012 at the Thompson Center in Chicago.