Fee Schedule Updated

The Commission has updated its medical fee schedule to include maximum reimbursement rates for codes that had been previously listed as "POC53.2."  Section 8.2 of the Workers' Compensation Act authorizes the Commission to establish fee schedule reimbursements using provider non-discounted charge data, non-Medicare relative values, and conversion factors from established fee schedule amounts. 

The Workers' Compensation Medical Fee Advisory Board voted to approve the reimbursements for 16,000 codes on the Professional Services fee schedule, all of which had been paid at 53.2% of the billed amount. 

To view the new Professional Services fees, click the new button, "2013 Professional (10-11-13)" at https://iwcc.ingenix.com/IWCC.asp

2014 Fee schedule rates will increase 1.52%; 7% lower than 2006

Medical fee schedule rates will increase 1.52% on January 1, 2014. If the fee schedule had tracked medical inflation, rates would be 30% higher than in 2006; instead, rates are 7% lower than 2006.

Section 8.2(a) of the Illinois Workers' Compensation Act provides that, each year, fee schedule rates shall increase or decrease by the percentage change in the Consumer Price Index-U (CPI-U) in the previous year.

The 2014 rates will be posted as soon as the vendor, Optuminsight, calculates them and obtains information about new and deleted codes. The rates are usually posted at the end of the year. We will give notice on our blog when the rates are online.

2012 NCCI IL Statutory Data Report & Advisory Rates

A couple of additional Illinois Department of Insurance updates...

The IDOI recently posted NCCI's 2012 Rating Organization Statutory Data Submission on its website.  NCCI is required by the Illinois Insurance Code to submit the following information annually: 

1. Indemnity and medical paid and paid+case losses for each of the past 10 years, by policy year
2. Medical payments for each of the past 10 years, by policy year
3. Indemnity claim Information including cumulative paid+case losses, by policy year by calendar year of development. This includes losses and frequency of claims in medical only, permanent partial disability, permanent total disability, temporary total disability and fatalities 
4. Frequency and severity by injury type
5. Aggregate (indemnity+medical) paid+case losses, and claim count by class of employee

The IDOI also confirmed that it had completed its review and filed NCCI's proposed 3.8% reduction for the WC Advisory and Lost Cost rates effective 2013 (see our previous overview of the filing & the IDOI's August press release announcing the rate review).

National WC Premium Rate Ranking Study

The Oregon Department of Consumer and Business Services' 2012 Oregon Workers’ Compensation Premium Rate Ranking Summary is now available.  This biannual report ranks the WC premiums of all 50 states and the District of Columbia.

Illinois is ranked as the 4th highest premium in 2012 rankings, at 151% of the median states of Georgia & New Mexico, down one spot from 3rd highest premium in the 2010 study. 

The workers' compensation premium rates used for the study are from 1/1/2012, or late 2011 depending on the state, so they do not appear to include any of NCCI's current recommended rate changes for various states.  Our previous post detailed the announcement that the Illinois Department of Insurance is currently reviewing NCCI's recommended 3.8% decrease to the IL workers' compensation advisory and loss cost rates.

IWCC Dental Fee Schedule Effective Date

As previously posted, the Illinois Workers' Compensation Commission modified its dental fee schedule rates and methodology. 

The IWCC updated its website yesterday with the effective date of that schedule.  The IWCC dental fee schedule will apply for all dates of service on or after June 20, 2012. 

The full IWCC post:

The Commission has posted a fee schedule for dental services provided on or after June 20, 2012. Bills should be paid at the lesser of the actual charge or the fee schedule amount.

As part of the changes instituted by HB 1698/PA 97-18, the legislature directed the Commission to create a dental fee schedule. Thanks to the Workers' Compensation Medical Fee Advisory Board and the Illinois State Dental Society for their help in obtaining and analyzing the needed data.

Illinois-Specific NCCI Presentations

The National Council on Compensation Insurance, Inc. (NCCI) has a couple of Illinois-specific presentations/reports currently available on its website.

On 9/13/2012, NCCI presented its complete overview of the Illinois workers' compensation environment.  The Illinois State Advisory Forum presentation provides a detailed comparison of national workers' compensation and employment trends to the economic conditions of the workers' comp industry in Illinois. 

• In August, the Illinois Department of Insurance announced it had begun its roughly 60 day calculation confirmation process after NCCI filed for an overall 3.8% decrease to the workers' compensation advisory and loss cost rates.
• This IWCC release contains an overview from the NCCI report regarding the potential rate reductions for several employer categories.

In addition to the 2012 Illinois State Advisory Forum, NCCI has a parallel report and  presentation that research the impact of the introduction of the Illinois workers' compensation fee schedule in 2006.

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.