Effective July 1st, fee schedule adjustments can be made by the Workers’ Compensation Commission without revenue neutrality.
Effective July 1st, fee schedule adjustments can be made by the Workers’ Compensation Commission without revenue neutrality.
The study compares workers’ comp fee schedules for professional services to Medicare rates within 44 states, accounting for 41% of medical costs.
Fee schedule clarity and defined reimbursement caps were discussed as ways to reduce ambiguity and prevent payment disputes.
The DIR must adopt the ODG formulary by July 1, 2027.
The meeting will take place on June 12th, aiming to explore current trends, challenges, and proposed solutions related to these drugs.
Medically unlikely edits were updated across DME, outpatient hospital services, and more.
Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.
The exemption reduces unnecessary burden and grows recognition that workers’ comp PBMs operate differently from traditional PBMs.
If enacted, House Bill 117 would trigger the first update to the Louisiana workers’ comp fee schedule in 30 years.
Topics discussed include proposals for a fee schedule by 2027, employer direction of care, and allowing more providers to provide disability opinions.
After previous drafts of new rules were withdrawn last year, a revised set of rules have been introduced, based on stakeholder feedback.
In addition to bill amendments, the bill has been deferred for one week to allow for additional review and stakeholder input.
The pilot test will run from April 24 to May 8, 2025, allowing stakeholders to provide feedback to the DWC.
Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
