Fee Schedule Update

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On March 7, 2016, Governor Terry McAuliffe signed legislation to establish a workers’ compensation fee schedule in Virginia.  Virginia joins 45 other states in adopting a workers’ compensation fee schedule.  The fee schedule will go into effect on January 1, 2018, and will replace the current system of reimbursing medical providers at “usual and customary” rates.  It will set maximum amounts that providers may charge employers for medical services absent a contract between the parties.

The Virginia Workers’ Compensation Commission is now tasked with implementing the fee schedule and establishing a 10 member regulatory advisory panel to assist in the development of regulations related to the fee schedule.  The regulatory advisory panel will make recommendations to the Commission prior to July 1, 2017, on a variety of issues related to the establishment of the fee schedule.  The Commission will retain a consulting firm to assist with developing a methodology to provide statistically valid estimates of the reimbursement objectives for medical services within the applicable medical communities.  Once the initial fee schedule is set, it will be reviewed in the year after it becomes effective and every two years thereafter.

The legislation was introduced by Henrico Delegates, Peter Farrell and Jenifer McClellan and enjoyed wide bipartisan support, passing by unanimous votes in both the House and Senate before being signed by the Governor.  Fee schedule proponents have indicated that the goals of the effort are to create fairness and transparency for employers regarding the amounts due for medical services, thereby reducing litigation, while simultaneously maintaining the number of providers who are willing to treat workers’ compensation patients.

You can read the full text of the legislation here.

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