Work Comp Chicago Illinois Workers Compensation Attorneys
2005 - 2006 REFORMS IN ILLINOIS WORKERS COMPENSATION
Illinois recently adopted a new "Medical Fee Schedule" effective for all workers compensation medical services rendered on or after Feb. 1, 2006 which now cap the maximum allowable fees for hospital inpatient and doctor charges that Illinois workers compensation will pay for related medical bills. The fee schedule is determined by date of service, zip code where the care is rendered and the medical procedure code. The medical fee schedule is available for public access on the Illinois Workers Compensation Commission website. (see) Medical fee schedule
Cost of living increases are built into the fee schedule but the rate of inflation on medical fees is now tied to the Consumer Price Index (CPI-U). Doctors and hospitals are now allowed payment of statutory interest at 1% per month on outstanding medical bills. Workers compensation attorneys should know how to apply the new Illinois Medical Fee Schedule for review of any disputed or contested medical bills. Chicago workers comp attorneys should be aware of and apply the new medical fee schedule to disputed bill packages and address the maximum allowable amounts (with interest) in their proposed awards.
Illinois also recently adopted "Utilization Review" of medical care as a measure to review the "necessity" or "reasonableness" of proposed or ongoing medical treatment. Medical providers will now be subject to greater scrutiny for the "reasonableness" or "necessity" of prescribed medical care. Employers and insurance carriers will also be subject to greater scrutiny for "denial of care" decisions.
Effective and retroactively applied to July 2005, workers compensation carriers and adjusters will no longer be permitted to deny medical care without documenting a sufficient medical basis. Decisions to deny care must now be determined by a licensed medical professional pursuant to certain URAC standards. Medical determinations are now to be made only by a medical professional in "peer to peer" reviews for the necessity of care pursuant to generally accepted medical guidelines. Failure to follow statutory requirements in "denial of care" decisions may result in substantial awards of penalties and attorneys fees. Contact our Chicago Workers Compensation Attorneys for questions concerning the new Utilization Review provisions.
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- New partial temporary disability payments for temporary light duty return to work
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