IWCC Medical Fee Schedule Re-Posted

As of this morning, the Illinois Workers' Compensation Commission's website has the 2013 Medical Fee Schedule re-posted on its fee schedule page.  The following link will take you the website lookup (choose Treatment Year 2013 for the new rates): Medical Fee Schedule/FAQ  

The original link was retracted by the IWCC contractor, Optuminsight, due to data integrity issues. 

Unless there are any further announcements from the IWCC, the 2013 fee schedule is effective January 1, 2013.

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 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.

IWCC Dental Fee Schedule Posted

The new IWCC Dental Fee Schedule for Non-Hospital Regions 1-4 is now posted on the Illinois Workers' Compensation Commission's website. 

As of this morning, the IWCC Instructions and Guidelines are still pending publication in the Illinois Register, but the new region-specific fee schedule reprice amounts for dental codes D0120-D9999 are available for review.

The codes are located on the IWCC's Medical Fee Schedule page, under the heading NON-HOSPITAL FEE SCHEDULES.

We will follow-up with additional posts when the IWCC publishes the effective date for the dental fee schedule and its Instructions and Guidelines.