Legislation proposed by the Wisconsin Worker’s Compensation Advisory Council (WCAC) has been finalized and is ready for introduction in the legislature. Historically, once a WCAC approved bill was introduced, it went through a simple process of committee review and quick passage in the legislature. However, with more controversial items included – specifically a health service fee schedule – the bill’s fate is unknown.
According to the draft, by January 1, 2019, the Department of Workforce Development (DWD), the agency that oversees worker’s compensation law, will establish a schedule of the maximum fees that a health care provider may charge an employer or insurer for health services provided to an injured employee who claims worker’s compensation benefits. DWD will use various data made available to them to determine the appropriate fees per service provided. This will include comparing the average negotiated price of care for group health plans, self-insured plans and Medicare. There will also be an increase to the fee ranging between 2.5 to 10 percent to pay for the administrative costs of treating worker’s compensation patients. DWD, no less than every ten years, will adjust those fees annually by the change in the consumer price index for medical care services.
Once the fee schedule is in place the current fee dispute resolution process will no longer apply.
Other components of the bill include:
- Additional payments for permanent partial disability
- An increase to the maximum weekly compensation for permanent partial disability
- An increase in supplemental benefits
- An increase to lump sum payments in compromise agreements
- A modification to the payments of proceeds of claims against third parties
- A requirement for electronic billing
- A requirement for health care records to be in electronic format
- A limitation on the dispensing of opiates
For more details the finalized legislation can be found here.