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.

IWCC Corrects the Implant Invoice Repricing Effective Date on Its Website

There was a discrepancy regarding the effective date of implant repricing on the IWCC Medical FAQ page.  The IWCC originally had an effective date of 6/28/11 on their website for the new implant repricing methodology; however, the new law appears to reference a 9/1/11 effective date for this change.  After being notified of this inconsistency, the IWCC has updated their Medical FAQ section to reflect the 9/1/11 effective date.   

We updated yesterday’s post to reflect the change in the effective date for the implant repricing methodology.