The proportion of workers’ compensation medical costs subject to physician
fee schedules is declining, threatening the effectiveness of the traditional
cost containment measure, a report says.
Several factors are contributing to the trend, including medical providers
shifting from charging private practice fees to billing for procedures through
hospitals or other facilities that employ them, Boca Raton, Florida-based NCCI
Holdings Inc. said in the report released Tuesday, January 19.
Billing by hospitals and the other facilities may not fall under a workers’
comp fee schedule, the rating and research entity said.
The report, “Medicare and Workers’ Compensation Medical Cost Containment,”
examined how Medicare reimbursement rates influence prices paid for medical
services, including those funded through state workers comp
systems.
“To maintain the effectiveness of medical fee schedules,
workers’ compensation [systems] might consider using Medicare billing approaches
for hospital stays and ambulatory services, but in doing so should adapt
Medicare models to workers’ compensation priorities,” NCCI said in the report.
The NCCI report is available online at www.ncci.com.
Filed by Roberto Ceniceros
of Business
Insurance, a sister
publication of Workforce
Management. To
comment, e-mail editors@workforce.com.
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