Workers’ Comp Medical Fee Schedule in Works

05.23.2014
Issues & Policies

Workers’ compensation costs have a significant impact on Connecticut’s ability to be economically competitive.
As a result of one particular workers’ compensation case, now being appealed, the state, municipalities and private sector employers have all been experiencing higher workers’ compensation medical costs.
To stop costs from surging further and to eliminate the uncertainty that now exists in Connecticut’s workers’ comp system, the legislature this year required the state Workers’ Compensation Commission (WCC) to establish formulas, similar to fee schedules, for inpatient and outpatient care rendered at hospitals and ambulatory surgical centers (ASC).
The chair of the WCC has begun work on establishing the formulas. By statute, the formulas must be Medicare-based, and the WCC chair must consult with employers and their insurance carriers, self-insured employers, hospitals, ambulatory surgical centers, third-party reimbursement organizations and other entities as necessary.
Adoption of the payment formulas must take place no later than Jan. 1, 2015, after which the WCC chair will publish the formulas and will specify the time period by which any insurer or employer without a negotiated agreement must comply with the resulting hospital and ASC rates.
After the initial publication of the formulas, the formulas will be published on the following January first of each year.
For more information, contact CBIA’s Bonnie Stewart at 860.244.1925 | bonnie.stewart@cbia.com | @CBIAbonnie

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